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Inspection on 31/10/05 for 10 Beeches Road

Also see our care home review for 10 Beeches Road for more information

This inspection was carried out on 31st October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents appeared content. Overall the homes documentation in respect of the residents with very few exceptions was maintained to a high standard. Beeches Road is a comfortable and homely environment that as far as possible resembles a domestic style living environment. Assessments of any risks presented to the residents and staff are well documented and clear. Observation of interaction between staff and the residents at the time of the inspection, and examination of care records indicate that the service provided is meeting the needs of the residents at the home and that staff are well supported by committed management. Discussion with some of the staff indicated an interest in the service and commitment to the residents.

What has improved since the last inspection?

There was a noted improvement in the detail contained within residents lifestyle agreements, there was evidence of the residents having six monthly multidisciplinary reviews, a business plan has been developed and systems for quality monitoring are more robust. There has also been development of some of the homes policies and procedures. The staff training plan is now clearer and there was evidence of staff receiving training in a number of key areas including equal opportunities and disability. The arrangements for residents medication is now more detailed and clearer.

What the care home could do better:

There is a need to ensure that the residents likes and dislikes are updated, this to reflect their current views and develop personal care planning in the form of resident`s individual books. Some policies and information have been presented in pictorial formats, this work to be continued. The home needs to send out questionnaires for statekeholders, this as the previous ones are now dated (over a year old). The acting manager also needs to apply for registration to the CSCI. The premises need redecoration to exterior woodwork and the area at the back of the cooker needs attention so as to make it easier to clean. It was also noted that some areas of the training plan need to be updated as the current one undersells the home in terms of the training already provided.

CARE HOME ADULTS 18-65 10 Beeches Road Rowley Regis West Midlands B65 0BB Lead Inspector Mr Jon Potts Unannounced Inspection 31st October 2005 9:40 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 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 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 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. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 10 Beeches Road Address Rowley Regis West Midlands B65 0BB 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) 0121 559 4384 N/A Inshore Support Limited Tracy Ann Perkins Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1/3/05 Brief Description of the Service: 10 Beeches Road is home for two physically able younger adults who have a learning disability with additional mental health needs. The home is an extended two bed roomed terraced property near the centre of Blackheath, sited in an established residential area. The house offers a choice of lounge areas, a reasonably sized kitchen dining area and two large single bedrooms, one an en-suite. The property is generally well presented and is furnished in a domestic style. The home only accommodates long stay placements and does not accept emergency admissions. The residents are currently male but the home will accept referrals from either gender. The home does not cater for adults with mobility difficulties. The mission statement of the home is to “support the individual to attain personal independence, choice and responsibility in a homely environment which expresses unconditional acceptance and tolerance and is committed to friendship and growth” 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out between 9.40am and 1.20m and involved the acting manager and discussion with staff. The inspector met both residents. Information/evidence was drawn from case tracking, staff files; sight of documents, policies and procedures and through discussion with the manager and staff. What the service does well: What has improved since the last inspection? What they could do better: There is a need to ensure that the residents likes and dislikes are updated, this to reflect their current views and develop personal care planning in the form of resident’s individual books. Some policies and information have been presented in pictorial formats, this work to be continued. The home needs to send out questionnaires for statekeholders, this as the previous ones are now dated (over a year old). The acting manager also needs to apply for registration to the CSCI. The premises need redecoration to exterior woodwork and the area at the back of the cooker needs attention so as to make it easier to clean. It was also noted that some areas of the training plan need to be updated as the current one undersells the home in terms of the training already provided. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 6 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. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 5 Information about the home is available in the services combined statement of purpose/service users guide. Further information, some individual to the resident is also detailed in a lifestyle agreement (terms and conditions) that is available to every resident. Residents’ needs are assessed prior to admission and on a regular and on going basis. EVIDENCE: A copy of the home’s statement of purpose/service users guide was seen during the course of the inspection, this containing a range of information about the home for prospective users. The manager needs to look at adapting this document so that it is available in other formats that would be more useable to service users that have difficultly reading. The home was seen to have detailed pre-admission assessment information in place from the purchasers of the service (local authorities), this information carried through to the homes care plans and related information, with updates obtained through regular multidisciplinary reviews. Terms and conditions (called lifestyle agreements) are available to residents these containing all the necessary details expected. Again it would be useful to 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 9 have copies of these documents in a pictorial format. Out of the two lifestyle agreements seen, one was not signed, this requiring the input of the resident’ or their representative. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Residents’ needs are assessed on an ongoing basis through reviews, with most changes reflected in individual plans. Residents are supported to be involved in decisions about their day-to-day life. The use of a robust risk assessment process supports resident’s independence and safety. EVIDENCE: Care plans are in place for all residents, two of these examined in depth at the time of the inspection. The plans seen were detailed and information from reviews and assessments had influenced the update of these documents. Discussion with staff indicated a working awareness of the contents of the care plans and risk assessment documentation. Whilst the copies of one multidisciplinary review minutes have not to date been received at the home, these reviews are held approximately six monthly and a record has been made of the outcomes. There was evidence of the registered manager having written to the social worker requesting an ‘official’ copy of the review notes for one resident. Some of the recommendations form the one resident’s review were still to be actioned, this including the development of a ‘book’ for the resident 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 11 that information about what they enjoy, what they are good at and their likes and dislikes. The home has documented information in respect of the residents likes and dislikes although there were found to be some anomalies, this suggesting that these lists should be reviewed. There is detail within the care plans and risk assessments as to where there may be limitations upon the residents although the manager was advised that an explicit statement as to exactly what these limitations are would be useful for purposes of clarity and understanding. Discussion with a staff member indicated that they have a good understanding of the care plan discussed and of what good care constituted. One resident was seen to have some involvement with advocacy services and information was seen to be readily available if needed. The individual risk assessments on the case file examined were found to be very detailed and were clearly informing the practices of the staff. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 & 17 The residents are supported to have involvement in activities and leisure appropriate to their needs and abilities, a number of these community based. Residents are supported to have relationships in accordance with their wishes and risk assessments in place at the home. Residents are able to access a healthy diet in keeping with their individual choices, this in pleasant surroundings. EVIDENCE: The care plans seen and associated documentation clearly showed that residents are involved in appropriate activities in accordance with their individual abilities, a number of these with a community orientation, this assisted by the fact that the home has its own allocated transport. Discussion with the acting manager clearly indicated that the type of transport used by the home was influenced by the resident’s needs, for example Beeches rd had a larger car so that the two residents were afforded more space when travelling. The home has developed a policy on sexuality that is drawn from 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 13 British Institute for learning disability documentation. Arrangements for contact with families are detailed within care documentation. Risk assessments are in place in respect of contact with others outside of the home where this is appropriate. The records of foods taken by the residents indicate that there is an appropriate and well balanced diet made available to them. The home does have a set menu although this is subject to change based on the wishes and choices of the residents on a daily basis. Resident’s likes and dislikes in respect of food were seen to be documented with the record of foods reflecting these choices, although these would benefit from some update with the resident involved. All residents have been nutritionally assessed and outcomes from these assessments built into their care plans. The plans for the resident’s activities were seen to be structured and available to the residents in the dining area. Full records are kept of the actual activities that they participate in on a day-to-day basis, these on weekly sheets although the manager was advised to ensure that these were dated. These records reflected the activity plans. The home has a charter of rights in place and staff were aware of how residents should be treated so that their rights were respected. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Residents receive appropriate personal support and their physical and emotional needs are met. The residents right to self-administration are limited following risk assessment, although the homes policies and procedures do protect residents in this area. EVIDENCE: Evidence showed records of choices allowed within daily routines in a number of areas, although the care plans did reflect a degree of structured intervention. Discussion with staff and observation/listening to staff interacting with residents evidenced staff having awareness of how they should communicate with residents. The member of staff spoken to and the acting manager showed a good working awareness of the care plan and risk assessments discussed. There was clear documented evidence of the resident’s choices having been documented in their individual case files, these however needing some review. It was clear that all the residents are given personal space as and when they require it, the building allowing for this provision, with a lounge available for each resident. There was clear evidence that the residents were assisted to access health services whether specialised or pertaining to routine health not associated with 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 15 their learning disability. One of the residents had not however seen a dentist or optician recently, this stated to be due to the resident’s preferences. These choices do need to be clearly documented. There was evidence that staff had involved the resident with these services in the past, with a dental care plan available in the resident’s case file. The home was seen to have a policy on medication, this recently revised. Staff were stated to have received accredited medication training. The homes systems for the administration, storage and ordering of medication were judged to be acceptable with no gaps in medical administration records, clear information available about the medication in use and evidence of audits by the contracted pharmacist. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Procedures are in place to support residents in expressing their views and dealing with any concerns that they may have. Residents are protected from abuse, neglect and self home by the homes procedures. EVIDENCE: The home was seen to have appropriate policies in place in respect of complaints. The home has developed a pictorial complaints procedure that carries the phone number for the police, CSCI, Social Services and other managers within Inshore support with photos of one of the latter. There have been no complaints received at the home or at the CSCI in the last 12 months. The home had copies of appropriate policies and procedures in addition to the local authorities Protection of vulnerable adults procedure. The member of staff spoken to had a good understanding of the procedures to follow in the instance that they witnessed abuse. The recording in case files showed that any bruising or injuries were documented on body maps, these seen to be completed and containing reference to even minor bruising/injury. Incident report forms are completed where an injury maybe due to non – accidental reasons, such as restraint. All staff have training in approaches to challenging behaviours (called positive approaches), the member of staff spoken to able to explain methods used in some detail, these consistent with the records seen. Records of restraint were seen to carry detail of the exact type of restraint that was used when other methods such as diversion failed. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 10 Beeches Rd is a comfortable and overall safe environment that is suitable for the residents accommodated. Overall the house was seen to be clean and hygienic. EVIDENCE: The home is sited in a suitable position and presents as a homely environment in keeping with the provision of ‘normal’ domestic style living. There is no indication that the house is anything other that a domestic home, this ensuring that it blends into the immediate community. The home has a redecoration and refurbishment programme identifying works, although it was noted that the exterior woodwork does need attention, this to be painted or restrained. All the communal living areas within the home presented as being comfortable and clean although the tiles to the rear of the cooker do need attention, this as they are stained and do not present a smooth surface, making them difficult to clean. With the exception of the area to the rear of the cooker the house was seen to be clean and hygienic at the time of the visit and there were no concerns in respect of the premises and the control of infection. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 & 35 Staff evidenced in discussion a good understanding of their job role. The staff seen presented as competent with an acceptable level of qualification evidenced. Resident’s needs are met by appropriately trained staff. EVIDENCE: The staffing ratios required for the resident’s were seen to be consistent with those stipulated by the purchasers and the homes assessments. The inspector judged the staffing ratios at the time of the inspection to be appropriate. Discussion with staff indicated that they had a good understanding of what were the current relevant issues for the residents (based on their care plans) and how to provide an appropriate service that respected quality of life issues. The home was seen to have a training plan that clearly identified training staff held, what was booked and what was needed. There are currently five out of ten staff that have completed NVQ level two this meeting the required benchmark of 50 of the staff team so trained. Three more staff are undertaking NVQ training. Discussion with the manager in respect of the homes training plan, and with staff, indicated that some trained detailed as needed was in fact in respect of updates, where staff had previously completed the training, as opposed to not having undertaken the training at all. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 19 The home has a structured induction programme in place with an external training company providing input into accredited induction training. The service manager is negotiating with the company for a greater focus on the learning disability award framework. The staff member interviewed did state that they felt very well supported by the manager and the company. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 40 Residents’ benefit from a well run home. The home’s systems for self-monitoring have improved since the last inspection, with the homes annual planning process having a clear focus on areas that have a direct link to better outcomes for the residents. Resident’s rights and best interests are safeguarded by the homes record keeping, policies and procedures. EVIDENCE: The current registered manager has taken on a more senior position in the company and an acting manager, who was present for the inspection, has been identified. The acting manager stated that she has completed her application for registration although this is yet to be submitted to the CSCI. Evaluation of the acting manager’s ‘fitness’ will be made through the registration process. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 21 Based on the overall outcomes of this inspection the acting manager, with support from senior management is judged to be managing the home competently. The homes systems for self-monitoring have developed with a senior manager now carrying out monthly audits against formative standards set by the company. Whilst there is scope to develop these standards for more detailed audits (as is seen to be happening), the work undertaken so far is recognised as a positive step. There was clear evidence of these audits identifying issues for the home, these seen to have been followed up based on the findings of the inspector. There was clear evidence of the home consulting with residents and relatives through questionnaires although these were last used over 12 months ago and need to be developed to include a wider stakeholder group (for example doctors, social workers etc). The homes business plan clearly identified the priorities for the home over the next twelve months. It was clear that the homes business plan has been partly met. The homes policies and procedures have developed since the last inspection and are readily accessible to the staff in the home. There was discussion with the acting manager who stated that there is on-going work to develop further policies in a suitable formats for residents that are unable to read. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 10 Beeches Road Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 3 X X X DS0000040084.V262854.R01.S.doc Version 5.0 Page 23 No 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 YA6 Regulation 12 & 15 Timescale for action The recommendations from N.C’s 31/01/06 last review must be actioned this to include the development of a book for the resident. The information in respect of 31/12/05 resident’s likes and dislikes must be updated. Reasons for J.O’s limited contact 30/11/05 with dentists and opticians must be documented. The exterior woodwork to the 28/02/06 house requires redecoration. The tiles at the back of the 31/12/05 cooker need to be replaced so as this area is easier to clean. The acting manager must submit 31/12/05 an application to the CSCI for registration. Requirement 2 3 4 5 6 YA7 YA19 YA24 YA30 YA37 12(2) 13(1)b 23(2) b 16(2) j 10 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 YA5 Good Practice Recommendations The resident or their representative should sign the DS0000040084.V262854.R01.S.doc Version 5.0 Page 24 10 Beeches Road 2 3 4 5 YA7 YA14 YA35 YA40 lifestyle agreement for resident N.C. The limitations placed on residents should be documented in more explicit detail. The records of the actual day-to-day activities the residents undertake should be dated. To ensure that the homes training plan is accurate and reflects all the training that the staff have completed. To continue developing key policies in pictorial formats. 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 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 10 Beeches Road DS0000040084.V262854.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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