Care Home: Wickett Hern Road

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What the care home does well Information given to people who use the service was excellent, it was written in a number of different formats including brail, audio and pictures. People using the service at the time of this inspection said:"We like to come here; we try to book our stays so that we can be there together". "The staff are always kind and they take us out, we enjoyed our trips to Famingoland, it was great fun". "We went to the night club that was great we liked dancing and singing". "We like the food, we try to eat healthy, but sometimes we like to have Chinese takeaway". "If I am worried about something I would talk to Denise". "We have had meeting to talk about the home closing, and we have made a wish list of the things we would like to see when the home reopens. We have been involved in the colour schemes and the types of equipment we may need". Staff had developed good systems to ensure relevant information was shared with families before and following stays at the home. Regular house meeting had taken place to ensure people and their families were consulted about the temporary closure of the home. Advocacy services have been used to facilitate the meetings, which has given people an opportunity to express their concerns about the changes to the provision of the service. What has improved since the last inspection? Person centred plans were being developed to ensure important information is recorded. People said they had been involved in putting together their care plans, which included things they needed some support from staff to complete. Opportunities to join in activities have improved since the last inspection. The manager has used the staffing budget to create a flexible use of staff time. It means that extra staff can be provided for outings. Staff training has improved since the last inspection, to ensure staff has the right skills and competencies to deliver a good service to people. Makaton training (signs used to communicate) has been undertaken by two staff which means they can communicate better with people who use the service. CARE HOME ADULTS 18-65 Wickett Hern Road 123 Wickett Hern Road Armthorpe Doncaster South Yorkshire DN3 3TB Lead Inspector Valerie Hoyle Key Unannounced Inspection 2nd June 2008 11:00 Wickett Hern Road DS0000032121.V364925.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 Wickett Hern Road DS0000032121.V364925.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. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wickett Hern Road Address 123 Wickett Hern Road Armthorpe Doncaster South Yorkshire DN3 3TB 01302 831969 01302 833616 NONE 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) DMBC Denise Evers Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The emergency bed is used for a maximum of 12 weeks Two specific named service users over the age of 65, named on variation application dated 30th September 2005 (and variation dated 25th September 2006), to continue to receive respite care at the home. 6th June 2006 Date of last inspection Brief Description of the Service: Wickett Hern Road provides a respite service for adults with a learning disability. The home is owned and managed by Doncaster Metropolitan Borough Council. The home can accommodate eight service users; one of the beds is made available for emergency admissions for short stay only. The facility is set within the residential area of Armthorpe on the outskirts of Doncaster. The home has its own transport and this assists people to maintain their education, work or day centre placements during a period of respite. Information gained on the 2nd June 2008 indicates that the current fees range from £66.20 to £490. Additional charges include outings, meals whilst out of the home and personal toiletries. The home provides information to guests and their relatives prior to admission into the home. Service Users Guides are available on request from the manager. The last published inspection report is available on request and a copy is available for visitors to read. Wickett Hern Road DS0000032121.V364925.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 that the people who use this service experience good quality outcomes. This unannounced inspection of this service took place over 5.5 hours starting at 11:00 to 16:30; this included a partial inspection of the home. Three people who use the service, two relatives and six staff were spoken to during the visit; their views are included throughout the report. Occupancy at this respite unit is consistently high throughout the year. Five beds were occupied on the day of this inspection. Three people’s care plans (person centred plans) were looked at. Policies relating to medication, complaints, protection of vulnerable adults and handling of people’s monies were looked at. Three staff recruitment and training records were examined to assess how people were protected. Surveys were not used at this inspection, although they were sent to people in January 2008 when an Annual Service Review was carried out on the service. The outcome of the review confirmed people continued to receive a good level of service. The registered manager Denise Evers has been in post since October 2007 and was successfully registered by CSCI in January 2008. She holds the Registered Managers Award (RMA), and continues to develop her own knowledge and management experience. The AQAA was sent to the home in October 2007, this was returned to us on time which demonstrates responsiveness and cooperation. An annual quality assurance assessment (AQAA) is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The registered providers had informed CSCI that funding has been secured to undertake extensive alterations to the building. The work is due to commence in September 2008 and will involve the home closing temporarily until work is completed. Alternative accommodation has been proposed to enable the service to continue during the closure, families and people who use the service have been consulted to keep them informed about the process. The inspector would like to thank everyone who agreed to being interviewed as part of the inspection process, and the friendliness of staff. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Staff recruitment files could be more accessible, to ensure the information is easily retrieved. POVA (Protection of Vulnerable Adults) and CRB checks Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 7 (Criminal Records Bureau) were not found on the files examined, although the head office could confirm that the checks had been carried out. Although statutory training had been undertaken since the last inspection, formal fire instruction has not taken place. The lack of training in emergency procedures could pose significant risk to people who use the service. 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. Wickett Hern Road DS0000032121.V364925.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 Wickett Hern Road DS0000032121.V364925.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): 1, 2 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. EVIDENCE: The home has developed a comprehensive Statement of Purpose and Service User’s Guide, which was very specific to the guest (people) and considers the different styles of accommodation, support, treatment, and specialist services required to meet the needs of people who use the service. The information was in a format suitable for their and their families’ needs, using, for example, appropriate language, pictures or Braille. They had also transferred the information onto an audio tape, with assistance from the local library. This demonstrates a clear commitment to valuing people. There was a comprehensive assessment used to assess the needs of prospective people who spend time at the home. The placing authority also provided detailed information about the person and examples of completed assessments were looked at and the manager said it was used in all cases, including emergency stays, to ensure staff are able to meet the needs of guests. New people were always encouraged to visit the home for tea and meet other people and staff before making decisions about using the respite Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 10 services. The manager has responsibility to undertake visits to new people to assess their care needs. People said they looked forward to stays at the home, and their stays were often arranged to fit in with friends who also stay at the home. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 11 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, 9 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. Individuals were involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: Three care plans were looked at. A variety of different and creative methods were used to help people to contribute to the development of their care plan and the ongoing review process. Person Centred Plans were being developed, an example was looked at. The plan used photographs, pictures and words to describe things that were important to the person. Staff had received specialised training to develop the plans, to ensure people were engaged and encouraged to be fully involved in the process. Staff actively provides one to one support, to keep the care plan up to date and make sure that other staff always knows the person’s current needs and wishes. The care plan includes a comprehensive risk assessment, which had been regularly reviewed. The staff were proactive in the management of risks to Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 12 ensure people were able to continue with their lifestyle while staying at the home. Where limitations on freedom, choice or facilities were in place staff always acts in the best interests of the person. People said they were aware of information written about them and had been involved in putting together their plan. They said the staff understood their needs and helped support with the tasks they found difficult to achieve. People bring small amounts of money with them during their respite stay so that they can participate in activities and outings, including trips to the bowling alley and coast. Facilities were available for guests to keep their money safe in their allocated bedroom or staff can keep the money safe. Records were looked at, which confirmed this arrangement. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 13 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, 17 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet people’s expectations. EVIDENCE: People were able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home has sought the views of the people and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. People said they really enjoyed trips to Flamingo land and were looking forward to going to the Yorkshire Outlet at Doncaster. The manager said that using staffing budgets to provide a flexible service, means that people can enjoy more leisure activities and outings. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 14 People were encouraged and supported to continue their education while staying at the home. People attend training centres during the day. Staff escorts people to the centres using the homes mini bus. The bus was also used during the evenings to enable people to socialise. People said their favourite places to visit were the bowling alley, cinema and pubs for lunch and a drink. They said they enjoyed a late night at ‘under the stars’ which was a night club for people with disabilities. Meals were well balanced and nutritional and cater for varying cultural and dietary needs of people staying at the home. For those individuals who need support during mealtimes, it is offered in an intrusive way. Mealtimes was flexible and relaxed, staff were patient and helpful, and allow individuals the time they needed to finish their meal comfortably. The staff actively encourages healthy eating while respecting people’s choices and rights. People said they try to eat good foods that help them stay healthy. They confirmed that food was good and they also enjoyed having Chinese takeaways as a treat. The provision of respite care at the home means that people return to their families after their stay. Staff were aware of the importance of maintaining routines to ensure continuity of care, for when they return to their own home environment. People were able to maintain and develop new friendships during their stays at the home. Two people said they always try to arrange their stays together and enjoy sharing their room at Wickett Hern Road. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 15 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. The health and personal care that people receive was based on their individual needs. The principles of respect, dignity and privacy were put into practice. EVIDENCE: The manager said people retain their own GP whilst staying at the home, although an emergency arrangement can be made if needed. Records examined and discussion with the staff confirmed people’s healthcare needs are met. The manager said people were escorted to medical appointments and comprehensive records were completed to ensure information is shared with those who care for the individual. An audit of medication stocks and records was undertaken and were found to be correct. Staff at the home ask relatives to ensure sufficient medication is provided for the length of stay of the guest and that it is labelled and in its original packaging to ensure their safety. People were able to self-medicate during their stay and were provided with lockable cupboards to ensure it is stored safely. The staff follow procedures to ensure people can safely Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 16 administer their own medication following a comprehensive risk assessment. All staff had received accredited medication training provided by a local college, to ensure they have the necessary skills and knowledge to undertake this task. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 17 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. People who use the service were able to express their concerns, and had access to a robust, effective complaints procedure, and were protected from abuse, and had their rights protected. EVIDENCE: The home had a complaints procedure that was available to people and visitors. The procedure was also referred to in the information given to new people, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection was included in the procedure. The local authority had developed a user friendly, easy read procedure to make it better for people to understand. People said they would tell Denise if they were worried about anything. The staff at the home had developed their own comments/compliments folder, which collates all information from people and their carers following their respite stay at the home. Staff contacts relatives after each stay at the home to feed back any relevant information about their relatives. The call also gives opportunity for relatives to discuss any concerns they may have. Wickett Hern Road DS0000032121.V364925.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, 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 well-maintained safe environment suitable for guests. The home provides a clean and hygienic environment to maintain the health and safety of guests. EVIDENCE: Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 19 The registered providers have informed CSCI that funding has been secured to undertake extensive alterations to the building. The work is due to commence in September 2008 and will involve the home closing temporarily until completed. A partial tour of the building found it clean and free from odours. The home provides comfortable communal areas with one lounge and a dining area. The grounds were tidy, and accessible to the guests, the rear garden includes a small grassed area. It is well situated in Armthorpe, within easy walking distance of all local shops, and parks. Wickett Hern Road DS0000032121.V364925.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, 35 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. Staff in the home were trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: Staff rotas were looked at to ensure there was sufficient numbers to meet the needs of people at the home. Staff interviewed confirmed the rotas were a true reflection on the actual staff working. The staff said they enjoyed working at the home and felt they did a good job. They expressed anxiety about the planned closure of the home while refurbishment takes place. Staff confirmed that they receive training to enable them to meet the needs of people. Two staff had completed Makaton for beginners to give them skills needed to communicate better with some of the people using the service. The manager said they intend to progress onto a higher level of training which should improve their knowledge and skills further. Training opportunities have improved from the last inspection at the home including moving and handling, safeguarding adults, health and safety, and Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 21 first aid. The manager said staff infection control training is continuing using a distant learning package. Three staff continue to work towards gaining NVQ qualifications, while six staff have already achieved Level 2/3 NVQ. A number of staff were accessing the Learning Disability Award Framework (LDAF) accredited training to develop service specific qualifications. Three staff recruitment files were looked at, to make sure the right people were employed at the home. They included two references, an application form and contract of employment. CRB (Criminal Records Bureau) checks and POVA 1st checks (Protection of Vulnerable Adults) were not on the file. The manager was able to confirm that the checks had been undertaken, following a telephone call to the central office where they were stored. Wickett Hern Road DS0000032121.V364925.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, 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. People who use the service were protected by sound management practises, and their views were actively sought to improve the service. Good health and safety procedures ensured they were safe. EVIDENCE: The manager has been in post for seven months she has the required Registered Managers Award (RMA) and has recently received safeguarding adults training. She continues to attend courses to enhance her knowledge and competencies. Since taking her registered position she has developed information packages to a high standard and leads a highly motivated staff team. She is keen to develop the social and leisure activities and people said, “Denise is very good, we can tell her our problems and she is very kind”. Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 23 Quality assurance systems have been developed to ensure people can express their views. A sample of the completed questionnaires was looked at and people confirmed that activities had improved. The manager has developed the survey using smiley faces to determine satisfaction levels. This demonstrates a proactive approach to gaining people’s views. Maintenance and service records examined were up to date and current to the services provided. Accident records were fully completed for both guests and staff and the manager carries out her own investigation. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures are in place and service records were examined and were current. Staff had not received refresher fire safety training, although the manager said she was in the process of arranging the training. Wickett Hern Road DS0000032121.V364925.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 4 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 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 2 X Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 25 Yes Are there any outstanding requirements from the last inspection? 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 23(4)(d) Requirement Staff must attend refresher fire training to ensure they familiar with emergency procedures Timescale for action 01/08/08 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. Refer to Standard YA34 Good Practice Recommendations The manager should check the date on the CRB as good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. 50 of care staff achieve a care NVQ 2 2. YA32 Wickett Hern Road DS0000032121.V364925.R01.S.doc Version 5.2 Page 26 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 Wickett Hern Road DS0000032121.V364925.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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