Inspection on 02/11/07 for Grovelands

This is the latest available inspection report for this service, carried out on 2nd November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Grovelands 27/02/06

Grovelands 05/12/05

Grovelands 26/03/05

Grovelands 03/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Grovelands 45 Grove Avenue Yeovil Somerset BA20 2BE Lead Inspector Barbara Ludlow Key Unannounced Inspection 2nd November 2007 10:20 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 Grovelands DS0000061698.V353330.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. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grovelands Address 45 Grove Avenue Yeovil Somerset BA20 2BE 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) 01935 475521 01935 382510 Somerset Care Limited Mrs Jacqueline Bridie Howells Care Home 60 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (30) of places Grovelands DS0000061698.V353330.R01.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 providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP - maximum 30 places 2. Dementia - Code DE - maximum 30 places The maximum number of service users who can be accommodated is 60. 3rd January 2007 Date of last inspection Brief Description of the Service: Groveland’s provides residential services for 60 adults. The registration is for 30 older people in the Older Persons (OP) category for personal care only and 30 older people in the older persons category with dementia (DE). Groveland’s is sited in a pleasant residential area of Yeovil. The town centre is about one mile away. There are bus services with stops nearby and local shops, pubs, clubs and doctors’ surgeries close to the home. The home has now been fully rebuilt and refurbished to a very high standard. The home is divided into two distinct accommodation areas. The residential area has ‘Marshwood’ on the ground floor and ‘Ham Hill’ on the first floor. The dementia care area has, ‘Nine Springs’ on the ground floor and ‘Pennywood’ on the first floor. Each named unit accommodates fifteen people. Individual private accommodation is a bedroom with en suite facility, which includes a walk in shower. Communally in each area there is a lounge, separate dining room space, a bathroom with an assisted bathing facility and a separate disabled toilet. A large garden surrounds the building with level access from various exits in the home, some bedrooms have garden access. The garden adjacent to the dementia care unit is secure. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 5 The home has an experienced and established management and staff team. Fees range from: £373.00 (Somerset Social Services rate) to £580.00 per week. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This inspection visit was carried out over a seven hour period. The registered manager and the manager overseeing the dementia care unit transferring into Grovelands from Sunningdale Lodge were on duty. Both gave up their time and personal commitments to assist throughout the day with the inspection process. The Annual Quality Assurance Assessment (AQAA) had been completed and was sent to CSCI in May 2007. Questionnaires were sent to service users, staff, relatives and visiting health care professionals. Their comments are included in the report. A tour of the premises was made. Residents were spoken with and daily life at the home was observed. Lunchtime was observed in one area of the home. People living at the home, their visitors, staff and one visiting professional were spoken with during the day. Records were requested and sampled. These included the care plans, staff recruitment and maintenance records. Feedback was given to the home managers at the site visit. The inspector would like to thank all who contributed to the inspection process. What the service does well: The transition into the new home from the people living in phase one of the development and those who transferred in from another Somerset Care dementia care home has been managed smoothly. We heard how staff had worked together with residents and relatives to make the move in a positive and supportive way. The home offers excellent accommodation. There is a determined effort by staff to meet the care needs of people who live at Grovelands. Initiatives such as coloured china is being used to encourage people on the dementia care unit Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 7 to enjoy their food and eat more was discussed with staff at the inspection. This work is being assessed by the company and professionals involved. 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. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 does not apply. Quality in this outcome area is good. Up to date information in a range of formats, is available to inform people enquiring about the service. Pre admission assessment and information gathering is undertaken to ensure that personal and social care needs can be met when the person is admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes information, the statement of purpose and service user guide have been updated. This was to meet the requirements for registration when the building work was completed and the registered number of places went up to 60. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 10 The AQAA states that an improvement in the last 12 months is the presentation of the service user guide in varied formats, being printed in a large font, available in Braille and also available on a compact disc (CD). One care plan was sampled for a recent admission to Grovelands. Records had been received at the home; these had informed the care planning undertaken at Grovelands. This person did not have a community care assessment. Pre admission assessment had been made to inform the process and a relative had visited and had chosen the home on the person’s behalf. One person who had come recently to live at the home was seen with their family. Their bedroom had been personalised and was very comfortable. The family confirmed that they were made to feel welcome and were pleased with the home. This person said that attention had been paid to their chronic health condition. This person said they were very pleased to have received contact from the community health service for screening and advice since their admission to the home. A specialist dementia care nurse from the Somerset Partnership (mental health care trust) was seen; assessments for placement into the dementia care unit, which is funded as a Specialist Residential Care unit (SRC) at Grovelands are all screened by them. We heard of the working partnership with the home to assess prospective clients. This involves families and the process is completed before an admission to the home is made. The nurse expressed their confidence in the management and the staff team at the Grovelands SRC unit. The feedback from those in residence and relatives was positive. Feedback from visiting professionals was received also. This gave an example of the staff being supportive with a new admission and of the management arranging for an occupational therapist to advise them on how to minimise the risk of falling, for this person. Grovelands DS0000061698.V353330.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): 7,8,9,10 Quality in this outcome area is good. Staffs in the home keep good records. Personal and social care is planned and recorded in a person centred way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans have been computerised and a hard copy is held of the record. This is signed by the person in residence to confirm their agreement to the plan for their care. The naming of these records was seen to be in a smaller font centralised on the first page and not in the information box with the persons title and civil status, this document presents in an impersonal way. There was no photographic identification with the new care plan format. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 12 The computerised records were introduced in June. These were seen and a sample of four care plans alongside the hard copies of the records and the previous care plan were read. Information had been recorded well. However, baseline information such as weight was not brought forward on the computer records. Where there looked to have been weight loss on the new records, the old records were sampled, this demonstrated in one case a marked weight gain since admission to the home. Staff were aware of the risk to monitoring without reference to the full history. One person recently admitted to the home was pleased to have received specialist input from the community health care services, with screening and assessment of their diabetes. Staffs were spoken with about particular health issues relating to individuals. The staff knew their residents well and spoke with a good understanding of their health, well being and of care interventions. Medications management was sampled, Storage was safe and the room temperature is monitored. The small medication storage rooms have portable air conditioning units to be used to reduce the temperature in the storerooms should it reach 25 degrees Celsius, the maximum recommended temperature for the storage of medication. The medications fridge temperature records were sampled, they were up to date and were shown to be in a safe range. The home uses Pharmacy Plus and the records for ordering and returns were seen. There was appropriate and lockable storage. No controlled drugs were held. A stock control sheet is used for management monitoring purposes. For some people living at the home their blood sugar monitoring checks are performed by staff. An example was seen of the system used for taking the ‘finger prick’ capillary blood sample, this was a not ‘sharp safe’ system in line with the guidance from the Medical Devices Agency for care home staff. This was brought to the attention of the manager and was to be rectified at the inspection by the ordering of a sharp safe device for handling lancets, for each of the named people as required. The staff have access to the recommended drug reference book, the British National Formulary (BNF) dated March 2007. Medication Administration Records were sampled, these were completed to a satisfactory standard. In the dementia care unit (SRC unit) coloured crockery is used to encourage dietary intake by helping people to visualise the meal properly against a strong Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 13 colour. Staffs have noticed positive results. All staff spoken with were interested in using what is known about dementia to achieve the best outcomes and care for the people who live at the home in the SRC unit. The enthusiasm and experience of the staff is promoting the ethos of person centred care at Grovelands. All people were seen to be treated with kindness and in a dignified manner by staff throughout the inspection day. There is a good rapport with community support staff. The regular specialist nurse input is valuable for promoting best practice. Feedback from health care professionals was positive and indicated that staff at Grovelands are flexible, adaptable, very supportive and caring. Other comment included action taken to ‘minimise risk’, people are ‘well looked after’ and ‘respected’. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. There are good social opportunities, trips out and activities at the home. Visitors are welcomed. The home uses corporate menus and mealtimes are social occasions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a very tidy and welcoming reception area, visitors are asked to sign in and also to use hand cleansing gel on arrival. This is an infection control measure. The home now has a designated hairdressing room. The salon is nicely fitted and decorated and was in use at the inspection. The home has a volunteer who comes each Monday Wednesday and Friday, the activity coordinator works Tuesday Wednesday Thursday. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 15 People who require day care, up to 2 people each weekday, attend Monday to Friday. The home’s notice board displayed lots of information about events at the home, these included a trip planned to visit Brimsmore Garden Centre where there is a £5 charge towards the transport. The dates of residents meetings. Flexercise which is held every day but in different parts of the home. The Shop is available on Tuesday Wednesday Thursday. A Christmas bingo event is to be held in Birchfield Hall, for which the notice said ‘it was open to all’. Christmas activities were also advertised. One lady and her visiting family were spoken with; they were preparing to go out for a walk together. All expressed satisfaction with the environment and care at Grovelands. People in residence asked, made complimentary comments about the food. Dining was observed as a social occasion, people living at the home use the dining rooms to eat together although meals can be taken separately if this is preferred. Coloured crockery is used to encourage people to eat, staff explained that it is effective and were pleased to report that people who were not eating well have been encouraged to eat more due to the presentation. Staff informed the inspector that the research says this presentation can help a person to see their food on the plate more clearly. People living at the service reported that they chose what to have for lunch and tea each morning. Many said the food was ‘very good’. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good No complaints have been recorded. There are policies and systems in place to ensure complaints are recorded and are appropriately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no complaints made to CSCI or the home. Somerset Care Limited (SCL) has a clear policy called ‘Seeking your Views’, through which complaints and concerns can be raised with the home and the company. People living at the home and relatives who were asked said they would be comfortable to raise their concerns with the manager or staff at the home. Staff spoken with were clear in their understanding of adult protection and of raising any concerns using the staff whistle blowing policy. One member of staff said they were attending a course on the Protection of Vulnerable Adults the following week organised by the company. One new member of staff confirmed having a CRB check returned prior to them commencing working at the home. Six new staff recruitment files were checked and demonstrated good recruitment practice. This would help to protect service users from harm by the thorough checking of the suitability of candidates applying to work in the care home. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is excellent. The home has been purpose built to a high specification and is excellent in presentation and facilities offered. The home is arranged into four units providing care in a small service user groups. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has been recently fully opened and now offers sixty places arranged in four units over two floors. The home has private gardens, some parts are secure, and these have been thoughtfully landscaped for ease of access and safety. Some bedrooms have doors leading onto the garden. The bedrooms are spacious and all have en suite facilities with walk in showers and adapted toilets. The home has sufficient sluice facilities, assisted bathing and assisted toilet facilities. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 18 There is sufficient mixed communal lounge and dining space for the people in each of the four distinct areas of the home. Corridors and all doorways are wide for ease of access and there are handrails around the corridors. One assisted bathroom on the dementia care unit was out of order due to a water leak from the bath, this was awaiting repair. Staff facilities are well appointed and there is lockable storage for their personal belongings. There are staff hand washing facilities and there is hand cleansing gel available for staff and visitors. Staff have access to gloves, aprons and waste disposal for hygienic working. Staff stations are situated centrally on each unit. There is nurse call throughout the home and the home is fitted with fire detection and fire safety equipment. There is good natural light from the many large windows and the home has attractive domestic style artificial lighting throughout. The home has been decorated and furnished to a high standard and is homely and comfortable. Newly accommodated people were asked about the home, all were very satisfied with their accommodation. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good Staff are safely recruited, have training opportunities and are supported by the management and the company in their work. Staffs met with were committed and caring in their approach to their work. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were spoken with about their recruitment and they confirmed having recruitment checks made including a Criminal Record Bureau (CRB) check prior to commencing working at the home. Staff confirmed having received induction training and having access to courses and training in care to National Vocational Qualification (NVQ) levels 2 and 3. Staffs working in the dementia care unit have been offered dementia care training. Staff with dementia care experience moved to the home with the service users transferring in from the dementia care unit at Sunningdale Lodge, when Phase 2 of the redevelopment of the home opened at Grovelands. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 20 Six staff recruitment records were sampled, three in detail and three for the evidence of a CRB check. All were satisfactory with references received and CRB checks in place before they commenced working at the home, this demonstrated good recruitment practice. This good practice provides protection for people living at the home by preventing the people being put at risk of harm from unsuitable people coming to work at the home. Positive comments were made about the staff by people living at the home, their visitors and visiting professionals. Staff were described as ‘caring’, ‘flexible’, ‘know the service users really well and respond to their individual needs’. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good The home has an experienced manager and there is support from the wider management team. Quality is monitored to inform improvements to the service. The home is newly refurbished and commissioned and maintenance is carried out as required. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an experienced registered manager. The manager has had the support of the registered manager from Sunningdale Lodge during the Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 22 transition of staff and service users into the dementia care unit at Grovelands, the SRC unit. The manager does not act as appointee for any service users. The manager confirmed that small amounts of money could be held if required. In which case records would be maintained and access would be suitably restricted. The home has been newly rebuilt and expanded. The fire officer made a satisfactory visit in September 2007 on completion of phase two of the homes redevelopment. The home undertakes quality assurance and there are regular staff and service users / family meetings. One relative confirmed this during the inspection, saying she felt involved and part of the home. Maintenance records were sampled, the fire alarm testing was up to date and carried out on a weekly basis. The alarm received attention and servicing in October 2007. Fire extinguishers had been serviced in August 2007.The emergency lighting was confirmed as being fully tested and checked every three months; the manager should confirm with the maintenance department that this is sufficient. During the tour of the premises there was generally good attention to the health and safety of the premises. In one bathroom (which had an out of order notice on the door due to a water leak) and in a toilet on the dementia care unit the bathroom cabinets were not locked securely and contained latex gloves. These can be a hazard to dementia care residents. The cupboards were attended to and were locked at the inspection. A requirement will be made for the safe management of such equipment on the dementia care unit. Grovelands DS0000061698.V353330.R01.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 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 2 Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 24 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 OP38 Regulation 13(4)(a) Requirement Latex gloves must be stored securely at all times on the dementia care units. Timescale for action 19/12/07 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 OP38 Good Practice Recommendations The frequency of the emergency lighting checks was three monthly, this should be confirmed with the maintenance department to ensure this is sufficient. Grovelands DS0000061698.V353330.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Grovelands DS0000061698.V353330.R01.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!