Care Home: The Old Gables

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What the care home does well The comments made by everyone connected with the home support our observations that the home is well managed and run in the best interests of the people who live there. The relative and social care professionals we spoke with said they are very satisfied with the care and support given by the staff, as well as with the facilities available at the home. Pre-admission assessments are thorough. The care and support plans are regularly reviewed and updated and reflect each individual`s preferences and needs. People are involved in making decisions about the way the home they live in is run, and the manager and staff make sure people`s views are central to any decisions. It was clear during the inspection that the staff know and understand the needs of each person and do everything they can to support people`s needs. People`s right to make individual choices is respected and supported. There is good and friendly interaction between the people who live at the home and the staff. There are enough staff on duty to make sure they have time to spend with people in conversation as well as supporting people to take part in their chosen activities. People know how to make a complaint or raise a concern if they are not satisfied with any aspect of the service. The recruitment procedures are thorough, making sure that the staff who are appointed are safe and suitable to work with the people who live at the home. The staff are encouraged to keep up their professional development by taking training to make sure their skills and knowledge are up to date. What has improved since the last inspection? This does not apply since this is the first inspection of the service. What the care home could do better: The laundry floor needs to be improved to make it impermeable and hygienic. CARE HOME ADULTS 18-65 The Old Gables 2 New Close Road Nab Wood Shipley West Yorkshire BD18 4AB Lead Inspector Liz Cuddington Key Unannounced Inspection 3rd September 2008 10:30 The Old Gables DS0000071729.V371308.R02.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 The Old Gables DS0000071729.V371308.R02.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. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Gables Address 2 New Close Road Nab Wood Shipley West Yorkshire BD18 4AB 01274 583288 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) murran@ukgateway.net Mary Theresa Care Homes (Leeds) Ltd Manager post vacant Care Home 10 Category(ies) of Learning disability (10) registration, with number of places The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered person may provide the following category of service only: Care home only -Code PC; To service user of the following gender: Either; whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 10 New service 2. Date of last inspection Brief Description of the Service: The Old Gables is registered to provide support and accommodation for up to ten adults who have a learning disability. The staffing levels are high and one to one support is offered. The house offers comfortable shared lounges, a dining room, a relaxation room and a therapy/treatment room. There is also a therapeutic bathroom with a spa bath. All the bedrooms have en suite shower rooms or bathrooms and the rooms are comfortably furnished. The gardens are spacious and designed for people to play games and relax in them. The house is situated in a quiet residential area, near to a bus route. There is limited parking in the grounds and ‘on street’ parking. The person’s local authority pays their fees. People pay their own personal expenses. The Old Gables DS0000071729.V371308.R02.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 stars. This means the people who use this service experience good quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at The Old Gables. The visit to the home was carried out over one day by one inspector. The home was registered in April 2008 and this was the first inspection. Since it was registered no complaints or concerns have been made to us about the home. The methods used to gather information included; conversations with the people living at the home, their relatives, social care professionals and the staff, looking at care plans and examining other records. We also received the home’s self-assessment questionnaire before the inspection visit. This questionnaire provided valuable information to help us form a judgement about the quality of the care and support the home provides. At the time of the visit there were only two people living at The Old Gables. Both these people, and other people connected with them, gave us their views about the support and accommodation offered at the home. We would like to thank the people who live at the home and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the service does well: The comments made by everyone connected with the home support our observations that the home is well managed and run in the best interests of the people who live there. The relative and social care professionals we spoke with said they are very satisfied with the care and support given by the staff, as well as with the facilities available at the home. Pre-admission assessments are thorough. The care and support plans are regularly reviewed and updated and reflect each individual’s preferences and needs. People are involved in making decisions about the way the home they live in is run, and the manager and staff make sure people’s views are central to any decisions. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 6 It was clear during the inspection that the staff know and understand the needs of each person and do everything they can to support people’s needs. People’s right to make individual choices is respected and supported. There is good and friendly interaction between the people who live at the home and the staff. There are enough staff on duty to make sure they have time to spend with people in conversation as well as supporting people to take part in their chosen activities. People know how to make a complaint or raise a concern if they are not satisfied with any aspect of the service. The recruitment procedures are thorough, making sure that the staff who are appointed are safe and suitable to work with the people who live at the home. The staff are encouraged to keep up their professional development by taking training to make sure their skills and knowledge are up to date. 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. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 7 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 The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 8 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 who use 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. Before people move into The Old Gables, the staff carry out a thorough preadmission assessment and introduction procedure, to make sure they will be able to meet each individual’s needs. EVIDENCE: People are given enough information about the home before deciding to move in, and they also receive a contract stating the room the person will have. A senior member of staff will visit people in their own home or in hospital to carry out an assessment and make sure the home can meet their needs before offering a place. The home invites people to come and spend time at the home, before reaching a decision. They encourage people and their families to visit as often as they wish and talk to the people who already live at the home and the staff. Some people may also like to stay for a few days, or longer, to get a better idea of what it is like to live at The Old Gables. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 9 On the day of our visit one person who may choose to live at the home, visited for the second time. The staff were expecting the visit and a brochure with photographs of the home and some of the rooms was given to the person to take away. This means that the home can get to know the person’s needs and also the individual and their relatives have the information they need to help them make such an important decision. Very comprehensive assessments have been carried out for all the prospective residents. These show in detail the person’s individual needs and how these are to be met. The care plans included the pre-admission assessments completed by the home, and Social Services’ needs assessments where this applies. These assessments form the basis for the person’s individual plan of care and support. The Old Gables DS0000071729.V371308.R02.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, 8, 9 & 10 People who use 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. To maintain their autonomy and independence, staff support people to make choices and decisions about all aspects of their daily lives. People are involved in planning their care and are supported to take risks. EVIDENCE: Two individual care and support plans were looked at. Although the plans are still being developed, they show that people are involved in developing and reviewing their plans. The plans reflect the individual’s preferences and needs and clearly demonstrate the person’s involvement in making all the decisions that affect them. Each plan gives an outline of the person’s life and the people who are important to them. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 11 The people who commented confirmed that the service supports them to live the way they choose and agreed that the service meets their different needs. The plans are changed frequently, to make sure they always reflect people’s choices and wishes. Where any activity involves a potential risk, a detailed assessment is made and plans are agreed to minimise the risk, while still supporting people’s right to independence and choice. These assessments are reviewed and kept up to date. Observation, and conversations with the staff, confirmed that the staff know and understand the needs of each person who lives at The Old Gables. The staff promote people’s independence and everyone is treated as an individual. One social care professional also said that the staff seem to be competent and able to meet people’s needs. One social care professional said that they were satisfied with the service and although there seem to be some initial ‘teething problems’ they felt that these would be resolved. All the written information is securely stored and confidential information about people is only shared with those who need to know. The Old Gables DS0000071729.V371308.R02.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, 14, 15, 16 & 17 People who use 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. People are supported to attend a range of activities, to make sure each person’s needs and expectations are being met. People are offered a good choice of meals, and other foods, to make sure their dietary needs and preferences are met. EVIDENCE: As the service grows the range of activities available will expand. Currently the social and leisure activities reflect the needs of a small number of individuals. The home’s staff are able to support people to participate in activities outside the home, such as visiting local events and attractions, following their chosen sports and pursuing favourite pastimes. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 13 The individual plans are completely person centred and are amended regularly, as people settle and express interests in new activities. The plans we looked at reflected what people told us about their lives and interests. The home’s staff are looking at the opportunities that are available locally for people to do paid and voluntary work. They are also gathering information about the educational courses that the local colleges offer. The people who live at the home said that the staff and manager give them the support they need to follow their chosen activities. People’s cultural and spiritual choices are respected and every effort is made to make sure people’s wishes are fulfilled. People said they choose the meals they prefer and the staff understand any special dietary needs people may have. If they wish, people can take part in shopping and cooking. There is a dining room and as the number of people living at the home increases people will be encouraged to eat together, in order to make each mealtime a sociable occasion. The Old Gables DS0000071729.V371308.R02.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 & 20 People who use 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. People’s personal and healthcare needs are met. People are protected by the home’s medication systems. To maintain their privacy and dignity, the staff treat people with respect, care and consideration at all times. EVIDENCE: People’s health and wellbeing is observed and monitored, and any concerns are followed up with relevant health or social care staff, and the family, and their advice is followed. The plans contain detail about the individual’s physical and emotional health. The plans, and conversations with staff, confirmed that people’s cultural and individual preferences are understood by everyone and are central to the care and support they are offered. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 15 Each plan is individual and reflects the person’s choices for all aspects of their life. The way people prefer their care and support to be provided is clearly detailed. The people we spoke with said that the home and the staff meet people’s needs. Detailed records are kept of any involvement of healthcare professionals. People’s preferences are detailed in the plans, so that staff know exactly how each person likes their support to be provided and understand the routines they like to follow. Because there are high staffing levels, people’s need for support and attention, as well as maintaining a suitable routine and lifestyle, means that people’s well-being is very well cared for. There was very clear evidence that this has had a beneficial effect in a very short length of time. The medication is stored securely and safely. The Medicines Administration Record (MAR) charts are accurately completed and the quantities of medicines received, in stock and returned to the pharmacy are recorded correctly. The staff that administer medication have received suitable training. This makes sure that medicines are administered correctly and safely and that staff fully understand this area of their work. Observations during the inspection confirmed that the staff always respect people’s privacy and dignity. The Old Gables DS0000071729.V371308.R02.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 & 23 People who use 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 people who live at the home, and their relatives, are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people staying at the home are safe. EVIDENCE: The staff training records showed that the staff have taken adult protection training. They have also had training in how to manage challenging behaviour. Conversations with the manager and staff showed that they understand their responsibilities towards people with regard to protecting them from any risk of abuse or poor practice. Staff are made aware of the home’s ‘whistle blowing’ policies and procedures, to be used if they suspect abuse or see examples of poor practice. They are expected to sign to confirm that they have read the policies and procedures concerning adult protection. People we spoke with said they know how to make a complaint or raise a concern if they need to. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 28 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe, clean, comfortable, well appointed and wellmaintained environment. EVIDENCE: The house and gardens are clean, tidy and well looked after. A caretaker is employed to carry out maintenance and gardening work. They are currently recruiting for the post of housekeeper. The Old Gables is an old house that has been adapted to meet the needs of the people who will live there. All the bedrooms are spacious and well furnished and have en suite bathrooms or shower rooms. The home will adapt bedrooms to meet people’s individual needs. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 18 The shared parts of the house are comfortable and include a sitting/entrance hall, a lounge and a separate dining room, which also serves as a craft room. Other downstairs rooms include a relaxation/sensory room, which has relaxing lighting and music, and there is also a computer area. Upstairs there is a therapy/treatment room and a therapeutic bathroom with a spa bath, beautiful lighting effects and a music system. There is also a quiet lounge nearby. The garden has a large trampoline and is suitable for other outdoor activities such as ball games. The home plans to make part of the garden a sensory area and put in more seating. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 People who use 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. Sufficient staff are employed to meet people’s needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require in order to meet people’s needs. EVIDENCE: The staff rotas confirmed our observations that there are enough staff on duty to meet the care, social and leisure needs of the people who live at the home. All staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks are obtained and new staff do not begin work until these checks have been completed satisfactorily. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 20 New support staff take an accredited induction training course, followed by the Learning Disabilities Award Framework training. This makes sure they have a good understanding of their role and responsibilities, and provides a sound basis for NVQ study. The home said that one of the eight permanent members of the support staff has a National Vocational Qualification (NVQ). The remaining seven staff are working towards achieving the award. All the staff have completed their mandatory health and safety training. They have also had, or will soon have, medication administration training and specialist training such as person centred planning and swallowing awareness training, provided by speech and language therapists. People who commented said they thought the staff were well trained and competent. We were told that the staff are supportive and help people do what they want to do. The records, and the staff, confirmed that all the staff are having regular one to one supervision meetings with their line manager. This supports staff to plan their personal and professional development and gives them the opportunity to discuss any areas of concern in a confidential setting. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 People who use 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 safe and well managed and is run in the best interests of the people who live there. EVIDENCE: The acting manager has the experience and skills to run the home in the best interests of the people who live there. She has achieved the NVQ level 4 in care and plans to begin the registered managers’ award later this year. The acting manager is in the process of applying to us for registration as a suitable person to manage the service. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 22 The comments made to us confirmed our observations that the home is well managed and run in the best interests of the people who live there. There is a good management structure within both the home and the organisation, which supports the manager. The manager promotes an open and inclusive management style and everyone is involved in the decisionmaking processes. Observations during the inspection visit, and comments from other people, confirm that everyone’s views are valued and taken into account. To maintain confidentiality, people’s personal information is stored in an office that is locked when it is not being used. Where the home helps people to manage their personal finances, accurate records are kept of all transactions. The policies and procedures are kept up to date to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner and staff have basic health and safety training. All these measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. The laundry floor needs to be repaired and sealed, in order to make sure it can be kept clean and hygienic. There are no sluicing facilities, but the manager said these will be provided when they are needed. The washing machines are old and tumble driers will soon be replaced. The kitchen was clean and hygienic, although it was very hot even when not in use. There are no windows but there is an externally ventilated extractor system above the cooker. The quality assurance systems in place include ‘spot checks’ by the manager at unexpected times. The manager works alongside staff to observe practice and offer guidance and support. The operations manager visits regularly and writes a monthly report. The manager is currently devising questionnaires for the people who live at the home, their relatives, staff and healthcare professionals. The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 The Old Gables DS0000071729.V371308.R02.S.doc Version 5.2 Page 26 - 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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