Care Home: Towneley House

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What the care home does well What has improved since the last inspection? The last wishes of a resident was recorded to ensure care and instructions met residents` expectations at this difficult time. A recognised tool was being used to ensure any risks to a residents` health was recorded and action taken to protect their well being. Risk assessment showed better detail for staff to meet the needs of each person who used the service. What the care home could do better: The registered person must ensure risk assessments for tissue viability, falls or the nutritional needs of residents are reviewed on a regular basis. The registered person should ensure staff have been issued with the codes of conduct for care staff and this is documented to ensure staff are up to date with current guidelines.The registered person should undertake an audit of staff files to ensure all documents required are available for inspection. The registered person should gain the views of relatives and stakeholders to show a positive management structure and sound quality assurance systems. The registered person should ensure supervision is undertaken six times a year to help quantify how well staff are performing. CARE HOMES FOR OLDER PEOPLE Towneley House 143/145 Todmorden Road Burnley Lancashire BB11 3HA Lead Inspector Mr Graham Oldham Unannounced Inspection 31st July 2008 and 7th August 2008 10:00 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 Towneley House DS0000009456.V364868.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. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Towneley House Address 143/145 Todmorden Road Burnley Lancashire BB11 3HA 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) 01282 424739 Mr Stephen Alfred Shillito Mrs Barbara Karen Shillito Manager post vacant Care Home 22 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (10) of places Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is registered to provide care for 10 older people, not falling within any other category and 12 older people with dementia. 3rd October 2007 Date of last inspection Brief Description of the Service: Towneley House is a care home registered to provide personal care and accommodation for 12 elderly people and ten elderly people with dementia. The home is of an older type building, situated in close proximity to Burnley town centre and Towneley park. It comprises three floors, linked by a stair lift. Private accommodation consists of 11 single rooms, five of which were at least 10 sq ms, and five double rooms, two of which were under 16 sq ms. Nine single and four double rooms were en-suite. Communal areas consisted of two lounges, a dining room and a smaller dining room/smoke room. Renovations and developments were underway to increase the amount of communal space, increase some bedroom sizes and the number of single rooms, and enhance the facilities. The registered person was managing the home. Training and assessment material from the Alzheimers Disease Society was in use to ensure staff can meet the needs of the residents with dementia. The home had a mini bus that enabled residents to enjoy a range of supported outings and activities to such places as the Trafford Centre, Bury market, the coast and country runs. Residents have had the opportunity of an annual holiday abroad in recent years. A statement of purpose and service users guide is available for residents or their families to be informed of the facilities and services the home provides. The fees for Towneley House ranged from £366 - £433 per week. Not included within the fees are hairdressing, personal toiletries and money for outings. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This key unannounced inspection, which included a visit to the home, began on the 31st July 2008 and completed on 7th August 2008. Much of the information gained was obtained from talking to residents, relatives and staff members. People living within the home allowed the inspector to call them residents. Two residents were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking their plans of care, other documentation and talking to staff and family members about the care they gave each resident case tracked. Residents were then asked if the care they received was what they needed but due to the nature of their medical conditions were not able to give much detail. Two staff members were questioned about the care of the residents case tracked and the training they had undertaken. Some of the views have been reported collectively with specific comments contained within the body of the report. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted on the day of the inspection. Five staff members returned survey forms to the CSCI. All five thought they were always kept informed about the needs of residents. One said every time any information is new, staff are informed. All five thought the recruitment process was robust. Four thought the induction process covered all topics very well and one mostly. All five thought training was relevant to the role, helped understand the diversity of residents and kept them up to date. One said if care plans are updated or new service users are admitted we learn of their needs. Three staff members thought support was regular, one often and one sometimes. All five knew how to make a complaint. Three thought information communication about people who used the service always worked well and two usually. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 6 Three always thought there were enough staff and two usually. One commented “we have lots of staff”. Four thought support was always enough to meet the diverse needs of residents and one usually. Two thought the care home did well by: • Care for the elderly. Staff communicate well in all ways and we are informed of any changes. • We provide a good environment for people to live in making their lives enjoyable. The positive response demonstrated staff felt supported and valued. What the service does well: The assessment process ensured residents’ needs could be met at the home. Plans of care contained sufficient up to date information for staff to provide effective care. Medication policies, procedures and staff training protected the health and welfare of residents. Two residents case tracked said care was good. Three relatives present during the inspection said, “my mum is treated fine – she cannot get any better care anywhere else. I am happy with the care here – brilliant”, “I know my friend can be very difficult but the home look after her very well. They are very caring” and “there is always good care”. Residents and their families were satisfied with the caring attitude of staff. Three visitors present during the inspection said, “Staff are lovely. If you want anything they are there to help you and they will get you a drink. I come here every other day”, “I visit nearly every other day and there are no problems with visiting. She is very happy here and it is always a pleasure to come here no matter the time” and “Visiting is brilliant. You can come at any time. You can make your own cup of tea if you wish”. Visiting was promoted for the social benefit of residents. Two residents case tracked said food was good. Three visitors present during the inspection said, “the food always looks good”, “she is very difficult to please with food. She would not eat. She has put on weight here so it must be good. She gets a choice” and “the food is great – good”. The food served at the home was nutritious and met residents’ tastes. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 7 One visitor said, “Nobody ever seems unhappy. I am going out with them today and that is good. I am going with my mother”. Residents were able to go out weekly to various venues and on holiday yearly to help with mental stimulation. Visitors commented, “I can come and talk to the owner if I have any concerns” and “the owner will do anything she can to help”. There was an accessible complaints procedure. The open management style allowed relatives to discuss any concerns informally. Relatives commented, “Her room is lovely. She has personalised it with family photographs. I am more than satisfied with her care here”, “It is absolutely all right here. She is going to Spain again. The first time she ever went abroad in her life was since she came here” and “She is better now than ten years ago. It is clean and tidy. My mother has made friends with another resident. They are now in a room together which suits them both”. Relatives were satisfied with the services and facilities offered by this care service. Health and safety policies, procedures, staff training and the regular maintenance of equipment helped protect the welfare of residents. The robust recruitment procedures helped protect residents from possible abuse. What has improved since the last inspection? What they could do better: The registered person must ensure risk assessments for tissue viability, falls or the nutritional needs of residents are reviewed on a regular basis. The registered person should ensure staff have been issued with the codes of conduct for care staff and this is documented to ensure staff are up to date with current guidelines. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 8 The registered person should undertake an audit of staff files to ensure all documents required are available for inspection. The registered person should gain the views of relatives and stakeholders to show a positive management structure and sound quality assurance systems. The registered person should ensure supervision is undertaken six times a year to help quantify how well staff are performing. 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. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 9 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 Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP3 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The assessment process ensured a plan of care was developed to meet each resident’s needs. EVIDENCE: Two residents were case tracked. Assessment documentation was contained within the plans of care. There was an assessment from Social Services or health care professionals. A member of staff had carried out a pre-admission assessment to ensure staff had sufficient knowledge to care for the residents admitted to the care home. Intermediate care was not provided. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP7, OP8, OP9 and OP10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Plans of care and healthcare assessments contained sufficient information about each individual to inform staff of residents’ needs. Medication policies, procedures and staff training protected the health and welfare of residents. The professional attitude of staff protected the privacy and dignity of residents. EVIDENCE: Two residents involved in the case tracking process had a plan of care. Plans of care had been regularly reviewed and developed with residents or their families. Two staff members were able to accurately describe the care of residents case tracked. Three visitors spoken to in depth were extremely satisfied the care provided was what residents needed and they were kept up to date. Plans of care contained sufficient information for staff to deliver effective care. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 12 Plans of care contained details of attendance to health care professionals and specialists, such as psychiatrists, opticians, dentists and chiropodists. Plans of care contained risk assessments for falls, nutrition and tissue viability, however, one of the assessments, which highlighted a risk, had not been reviewed for several months. Access to specialists was arranged to ensure the health care needs of residents were met. Policies and procedures for the administration of medication had been reviewed using the Royal Pharmaceutical Society’s Guidelines. There was a controlled drug cupboard and register situated in a new room designed as a clinical room. There was a dedicated fridge to keep medication cool. The medication administration charts had been maintained accurately. An up to date British National Formulary was available for staff to use for reference to medication issues. The registered person said the pharmacist was available for training and advice and regularly audited the system. Medication was disposed of in a safe manner. Staff who administered medication had been appropriately trained. Medication policies, procedures and staff training helped reduce the risk of any medication errors. The inspection was mainly conducted from the dining room to observe staff interacting and caring for residents. Staff were observed to give care in a professional and private manner. The pleasant demeanour of staff ensured residents were comfortable with the personal care they received. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP12, OP13, OP14 and OP15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Leisure activities provided were suitable to residents’ tastes and helped provide a fulfilling life. Visiting was open, unrestrictive and encouraged socialising with family and friends. Residents were able to exercise choice to retain some independent living. Food served at the home met residents’ tastes and nutritional needs. EVIDENCE: On the first day of the inspection most of the residents were going on a shopping trip to Bury market in the home’s mini-bus. A trip was arranged every Wednesday. On day one of the inspection residents were listening to music and singing. On day two residents were sat outside having a drink and socialising. At one point, a visitor was sat talking to several ladies in the dining room, which was very pleasant to hear. In the lounge a professional person was giving exercises to residents. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 14 Many activities and outings are held at this home, including the trips, holidays (several residents had been to Benidorm), music and singing and entertainers attended the home about twice a month. Residents went out for lunch and drinks on a regular basis. The range of leisure activities provided residents with a fulfilling life. During the case tracking process, two care plans showed how staff could offer choices to residents. Within the plans residents were encouraged to be independent and, where possible, staff played a supporting rather than active role. Choice was offered within aspects of the routine such as dressing, getting up and going to bed, activities or food and drink. Residents chose the times they got up and went to bed. Residents were allowed choices to help them retain some control over their lives. Residents case tracked said food was good. Other residents were observed eating and said they enjoyed what they had eaten. A meal was taken by the inspector and found to be hot, nutritious and tasty. A visitor said food was good. Residents were observed being fed in an individual and discreet manner. The kitchen was clean and tidy. The cook held a relevant qualification and environmental health checks had been undertaken. Residents were satisfied with the choice and quality of food at mealtimes. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): OP16 and OP18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Policies, procedures and staff training help protect residents from possible abuse. Residents and their families were able to voice their concerns. EVIDENCE: There was a complaints procedure, which met current timescales and satisfied the requirements of the CSCI. No complaints had been made to the CSCI during the year since the last key inspection. The complaints procedure was accessible for relatives and visitors. Staff were aware of the complaints procedure. The registered person said she had dealt with any minor issues to avoid small problems becoming larger. There was a system in place for residents and relatives to complain if they wished. There had been no incidents of abuse since the last key inspection. There were adult abuse procedures for staff to follow. There was a whistle blowing policy and a copy of the ‘No Secrets in Lancashire’ document. Policies and procedures protected residents from possible financial abuse. Some staff had undertaken Protection of Vulnerable Adults training. Both staff questioned were aware of adult abuse issues. The systems used for the protection of vulnerable adults protected residents from possible harm. Towneley House DS0000009456.V364868.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): OP19 to OP26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents lived in a clean, tidy and safe environment. The facilities provided a comfortable setting and met residents’ environmental needs. EVIDENCE: A tour of building was conducted on the day of the inspection. The home was warm, clean and free from offensive odours. Several bedrooms were inspected and found to be bright and contained good levels of furniture. All bedrooms visited had been personalised. Water temperatures were checked and were safe for residents. Windows were secured and radiators guarded against possible scalding. There was a stair lift to access the upper floor. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 17 The dining room and lounge contained sufficient, good quality furniture to meet residents’ needs. All furnishings were domestic in character. Lighting was sufficient to meet the needs of residents and some were observed reading. Grab rails and disability equipment was provided in all the necessary areas. One bath was suitable for the disabled. There were good levels of equipment for leisure, including large televisions and music systems. There was no dedicated storage of wheelchairs but this did not pose a threat to the health and safety of residents. There was a system of routine maintenance. Residents were risk assessed to determine if they can hold a key to their rooms and all have a lockable space. Keypad locks stop residents from absconding and being at risk of an accident. There is a small garden area and residents can sit outside and eat. The suitable décor and domestic style setting provided a homely atmosphere for residents. There were infection control policies and procedures for staff to follow. The laundry was sited away from the kitchen and contained sufficient equipment to meet its purpose. Hand washing facilities were sited where clinical waste was produced. The laundry walls and floors could be cleaned easily. Some staff had received infection control training. Infection control policies, procedures and staff training helped protect the health and welfare of residents. Towneley House DS0000009456.V364868.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): OP27, OP28, OP29 and OP30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There were sufficient numbers of qualified and experienced staff to meet the needs of residents. The recruitment procedures protected residents from possible abuse. EVIDENCE: The staffing rota showed there were sufficient numbers of staff on duty on the day of the inspection. Three visitors were happy with the caring attitude and numbers of staff. Staff files contained records of training undertaken. Staff received recognised induction training. Two staff files demonstrated training was ongoing although supervision did not fully meet the standard. Both staff members involved in the inspection process confirmed sufficient training was offered and they were encouraged to improve and provide a better service to residents. Two staff files examined during the inspection demonstrated the recruitment procedures were robust and ensured staff were fit to be employed at the care service. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): OP31, OP33, OP35 and OP38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There was a safe system to protect residents from possible financial abuse. Health and safety policies, procedures, staff training and the regular maintenance of equipment helped protect the health and welfare of residents and staff. EVIDENCE: The registered person said they did not handle residents’ finances and explained the way the accounts were run. Receipts were issued for items paid for, such as hairdressing. The systems used to handle any residents’ monies were safe and protected residents from possible financial abuse. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 20 There was a business plan. The registered person held recorded meetings with residents and staff and met with relatives on a regular basis. Quality assurance questionnaires had been issued to residents and a summary produced for interested parties. This needed to be expanded to include relatives and stakeholders. Comments were very positive about the care offered and facilities provided. The views of all needed to be taken for management to be able to react to the changing needs of people who used the service. There was a health and safety policy. Staff spoken to said they had undertaken health and safety related training. Electrical and gas appliances and installation had been maintained to a good level. Fire alarms and other safety related equipment had been maintained. The responsible person was aware of health and safety related issues. Health and safety policies, procedures and staff training helped protect the health and welfare of residents. Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 15(2)(b) Requirement The registered person must ensure risk assessments are completed and reviewed on a regular basis. Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP29 OP30 OP33 Good Practice Recommendations The registered person should ensure there is documentary proof staff receive the General Sector Skills Council’s codes of conduct. The registered person should conduct an audit of the staff files and replace any documents such as terms and conditions or job description that are missing. The registered person should ensure quality assurance surveys are undertaken to gain the views of relatives and stakeholders. The registered person should ensure supervision is conducted on a regular basis for all staff. OP36 Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lancashire Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Towneley House DS0000009456.V364868.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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