CARE HOME ADULTS 18-65
Greswolde Park Road, 4 Acocks Green Birmingham West Midlands B27 6QD Lead Inspector
Joe OConnor Unannounced 27 April 2005 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 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 Stationary 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. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Greswolde Park Road, 4 Address 4 Greswolde Park Road Acocks Green Birmingham West Midlands B27 6QD 0121 765 4630 0121 765 4630 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Birmingham Multi-Care Ms Anne Tucker-Browne Care Home 4 Category(ies) of Younger Adults, Learning Disability, Physical registration, with number Disability of places Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Residents must be aged under 65 years. 2. That the registered manager completes the NVQ Registered Managers Award by March 2006.. Date of last inspection 17 November 2004 Brief Description of the Service: 4 Greswolde Park Road is a large traditional type house, situated in a quiet residential area close to the centre of Acocks Green Birmingham that has a variety of shops and other community resources. Public transport services operate close to the home which is not conspicuously identifed as a residential unit. Accommodation is provided in four single bedrooms that are situated on the first floor. A comfortable lounge and seperate dining room are located on the ground floor. The dining room is also used for administration, as there is no office. Bath facilites are situated on the ground floor and shower facilities are located on the first floor. The home is adapted for wheelchair use and there is a shaft lift, suitable for a wheelchair plus a member of staff. The premises has a range of aids ans adaptations to assist with mobility which include level access, hoists including ceiling tracking, toilet and bath aids, adapted beds, and other equipment to assist with eating. The home maintains high standards of clenliness, decoration and maintenance and appears comfortable and homely. There is a a garden at the rear of the home that is secure and has been organised so respite service users can enjoy it during fine weather.
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Inspection was undertaken between the hours of 10:30 am-19:00pm. During this time the Inspector was able to speak to the Registered Manager and interviewed two members of staff. Three service users’ care plans were sampled during this inspection. Other records were examined by the Inspector including those such as service users’ medication, staff recruitment files and maintenance records with regard to health and safety. A number of policies and procedures were also seen by the Inspector. There were two service users present at the time of this visit and the Inspector was involved in observing staff interactions with the service users along with other care practices. The Inspector also carried out a partial tour of the premises. What the service does well: What has improved since the last inspection?
The manager was recently registered by the CSCI and had addressed all but one of the previous inspection requirements. Radiators had been covered to ensure safety of service users with control of the radiators still being individually adjustable by service users and staff. The ground floor was now bright and airy since re-decoration.
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 6 Staff members said that they found physical intervention training, arranged by the manager, to be beneficial and enable them to reflect on their current practice. The manager has put in place a periodic review of the views of service users, their families and other representatives. Views of satisfaction about the level of care were shown to the Inspector. Positive relationships between staff and service users were further demonstrated through the positive daily recording undertaken by staff. Staff spoke of the manager bringing stability back, feeling supported and finding her approachable. Service users needs are appropriately met, demonstrated through a sample of service users records and from discussion with the manager. The manager has greatly improved staff recruitment records. With the addition of evidence of training and qualifications. It was good to see six care staff now registered for NVQ Level 3 training. 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.
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 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 standard(s) 2, 3 & 4 Service users needs are assessed prior to admission to the home. They are able to visit the home for a pre-admission visit. The home is able to demonstrate its capacity to meet the needs of service users in their care through the maintenance of detailed service users records that show how the needs of service users are to be met. EVIDENCE: There was evidence that service users had been admitted to the home with a needs led assessment and initial care plans that had been completed by social workers. One file had a detailed assessment completed by the manager for a prospective service user that was detailed covering all aspects with regard to the individual’s circumstances. There was documented evidence to confirm that the service user had undertaken a number of teatime visits as part of the home’s introductory process. There are procedures in place with regard to admissions to the home. There were two service users who were staying for a short time and had limited means of communication. However, one service user did put his thumb up to indicate that he liked the food in the home. Observations found that staff were providing appropriate means of communicating such as the use of makaton. Service users were observed to be dressed in clothing, which were well cared for. There are detailed care records for each service user that set out clearly how their needs are to be met.
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 9 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 standard(s) 6, 7 &9 How service users are to be met is detailed in the care plans. Staff encourages service users to make decisions with regard to their day to day routines. Detailed risk assessments cover any restrictions with regard to service users independence. These will need to be reviewed and any changes are recorded. EVIDENCE: Staff communicate with service users appropriately and encourage them to make decisions with regard to their meals or where they wanted to go. Two members of staff were interviewed and were able to demonstrate a very good knowledge of those service users who were able to make choices about their daily living activities. The care plans had detailed information with regard to specific likes and dislikes and of service users daily routine. Care plans sampled showed that one service user required to have a highly structured routine and was very sensitive to sudden changes, specific guidelines with regard to one service user who had difficulties with eating and drinking. that one service user was allergic to nuts and needed to eat a specific type of bread. The manager was updating the care plans at the time of this inspection. A sample of service users’ records demonstrated that there were detailed risk assessments in place covering areas such as manual handling, nutrition
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 10 pressure care relief and when taking service users out. The Inspector noted that one risk assessment for one service user who was using bed rails had been updated following an incident where the service user had been trapped between the rails. The risk assessment demonstrated action such as ensuring greater security and ensuring the rails were adequately protected. While the risk assessments were detailed there was no evidence to confirm that these had been reviewed. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 11 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 standard(s) 11, 12, 13, 16 &17 Service users have access to leisure activities in the community and also receive organised activities provided by other agencies. Service users routines are not subject to any unnecessary restrictions subject to their individual risk assessment. Service users have a varied and nutritious menu. EVIDENCE: Service users did not have any restrictions with regard to accessing the home and their daily routine. Staff encourage service users to communicate their needs either verbally where possible or through the use of sign language such as makaton. One service user file did have a risk assessment in place to state how many staff were required to accompany him when going out to pursue an activity in the community. Other service users’ files viewed found that most had daytime activities provided by the Local Authority and an independent company. Service users are able to pursue activities in the community such as ten pin bowling, going to the local pub and shopping in Birmingham and Solihull. Public transport or adapted private hire cars are available. Service users are provided with varied a varied nutritious diet and that a record is maintained of the meals eaten by service users. It was evident from an
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 12 examination of service users’ care plans that specific dietary requirements are recorded and followed. One service user’s care plan had showed that the home had been following guidelines issued by a Speech and language therapist with regard to problems with swallowing. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 13 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 standard(s) 18, 19, &20 Service users receive flexible care and support. Service users healthcare is appropriately arranged by the home. Medication management in the home is good with some improvements required. EVIDENCE: A sample of service users’ care plans found that service users are registered with a GP. It was also evident from the records seen relationships are kept with other multi-disciplinary services such as Speech and Language Therapist, Community Nurse, Consultant Psychiatrist and Dietician. A sample of one individual’s care plan found that the manager had consulted with a Community Nurse and the service user’s parent with regard to the individual’s behaviour. Another care plan viewed by the Inspector identified one service user who had epilepsy and there was a record being maintained for when seizures had occurred. Staff working in the home had received specialist training for the use of rectal Diazepam. Medication management in the home was found to be good although the Inspector did note that the exact dosage of individual service user’s medication had not been recorded on the Medicines Administration Record (MAR Chart). It was also noted that one service user was still using medication that indicated on the Pharmacist’s label that this was prescribed in January 2005. The manager must ensure that service users entering the home are prescribed medication that is up to date. Staff working in the home have received accredited medication training. The Inspector was pleased to see that
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 14 the daily recording of service users was written by staff in a positive manner confirming that there was a good relationship between the service users and staff. There was also confirmation where personal care tasks had been carried out by staff. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 15 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 standard(s) 22 &23 There is a complaints procedure which should be available to service users in a suitable pictorial/symbol format. There is an adult protection policy and procedure that is line with the D.O.H. Guidance No Secrets. EVIDENCE: Neither the provider nor the CSCI have received any complaints since the last inspection. A complaints procedure in place that is available in audiotape and in different languages. However, work is required to provide a procedure that is available in a suitable pictorial format. Since the last inspection staff working in the home had received training in physical intervention. This was confirmed by two staff members and in examining staff files. The manager stated that they were waiting for certificates to go on the files. There is a policy and procedure with regard to adult protection and physical intervention. However, the policy and procedure for physical intervention will require updating to state that the CSCI must be informed where physical intervention had been used and that any planned means of physical intervention must be discussed within a multi disciplinary service group. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 16 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 standard(s) 24 & 30 The premises are maintained to a high standard and provide a clean, safe environment for service users. Since the last inspection the manager had taken to ensure that all the radiators has appropriate covers in place. These had gaps enabling service users and staff to control the temperatures of the radiators. There are appropriate procedures in place for the control of infection. EVIDENCE: The home was found to be clean, tidy and well maintained. The manager stated that since the last inspection the ground floor area had been decorated. The home is closed during the Christmas holiday period and this enables any refurbishments to be carried out. A sample of the home’s policies and procedures found that there are guidelines for the control of infection. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 The organisation offers and provides training to all staff employed to enhance their development. Staffing levels in the home provide service users with a continuity of care. Recruitment records for staff are maintained to the requirements of Schedule 2 Care Homes Regulations 2001. Supervision is provided to staff but this needs to be undertaken on a more frequent basis. The interactions between staff and service users were positive providing a relaxing environment. EVIDENCE: Two members of staff demonstrated a clear understanding of the needs of the service users in their care. Service user’s routines were known and respected. Requirements from the previous inspection for the completion of physical intervention training and the LDAF programme had been addressed. This was confirmed when sampling three staff files. Staff were up to date with training in areas such as first aid, manual handling, fire awareness, food hygiene and accredited medication training. The manager informed the Inspector that six members of staff had commenced NVQ Level 3 training. It was noted that although staff receive supervision this needs to be undertaken on a more frequent basis. Copies of the staff rota for the previous four weeks were sampled and it was found there were four care staff on duty throughout the day with two night waking staff. At the time of this inspection the manager had to arrange cover for one member of staff who was ill and this had been filled
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 18 by an agency worker. There are a team of bank staff. Records with regard to staff recruitment were found to be satisfactory. Three sampled by the Inspector had evidence of job applications, two references, CRB checks, proof of identity and contracts. The manager had taken action since the last inspection to update the staff files with certificates to evidence training that had been completed. Observations were made of both service users being assisted with drinks after their arrival form their daycentre and staff were observed to be talking to the service users in a relaxed and friendly manner. It was evident that the service users felt at ease with them. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, & 42 Service users live in a home that is run by a competent manager. There is an open and relaxed atmosphere that benefits service users and staff. The records held in the home were generally up to date for the safety of service users. There are a range of policies and procedures in place but these will need to be reviewed and updated to reflect current practice. The manager and staff promote and maintain the welfare of service users, but some improvements are required with regard to fire safety. EVIDENCE: The manager demonstrated an awareness and detailed knowledge of the service users in her care. It was evident from talking to her that she cares a great deal for the service users and is always looking at different ways to improve the service they receive. She has had a long and wide ranging experience of working with adults who have learning disabilities in the NHS mostly at a senior level. The manager maintains her current registration with the NMC. At the time of this inspection the manager had commenced training
Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 20 to achieve the Registered Managers Award. Staff spoken to by the Inspector stated that the manager had provided stability and was always supportive. They also stated that there was a positive working relationship between staff. The service users appreciated the friendly and relaxed atmosphere in the home. While it was difficult to obtain specific views from the service users it was noted that the manager had recently sought feedback from their relatives and representatives via satisfaction surveys and the responses were shown to the Inspector and all expressed positive views about the service. A number of policies and procedures did not reflect current practice and required a review. The records being maintained were found to be generally up to date. Records with regard to health and safety were found to require some action. There was documented evidence that the fire alarm was being tested on a weekly basis but it was noted that the emergency lighting in the home was not being tested every month. Staff had not undertaken a fire drill nor fire training for nearly twelve months, which the manager must address as a matter of urgency. There was written evidence that the equipment for gas, electric, lifts and fire fighting had been tested and serviced. The risk assessment was found to be in need of review. The main kitchen was found to be clean, tidy and with daily records being maintained for the temperatures of the refrigerator, freezer and probing cooked meats. Prior to this visit an inspection had taken place from the Local Authority’s Environmental Health Department whose report did not have any issues of concern. The accident book was found to be recorded appropriately. There was one area of the premises that the manager must address with regard to the exposed hot water pipe in bedroom 2. The manager stated there had been problems with hot water from the shower next door. But action must be taken to risk assess this and cover if necessary. Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 21 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 x 3 3 x x Standard No 22 23
ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 2 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Greswolde Park Road, 4 Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 2 x E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 22 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 9 Regulation 13(4) Requirement The home must ensure that it reviews all risk assessments for service users including manual handling assessments. The home must ensure that the Medicines Administration Records (MAR Charts) must have details of the prescribed amount. The medication policy and procedure must be reviewed and updated. The home must ensure that checks are undertaken to ensure that medication being brought into the home is up to date. Any concerns must be followed up with the service users GP The complaints procedure must be available in a suitable pictorial format for service users. The home must ensure that its physical intervention policy and procedure is updated to reflect current practice. It must state that if physical intervention is used then the CSCI must be notified. The home must ensure that staff receive supervision every two months. The manager must be qualified Timescale for action 27 June 2005 From 27 April 2005 2. 20 13(2) 3. 20 13(2) From 27 April 2005 4. 5. 22 23 22(2) 13(7) 27 July 2005 27 July 2005 6. 7. 36 37 18(2) 9(2)(b) 27 July 2005 27 March
Page 23 Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 8. 40 17(2) 9. 42 13(4)(23) (4)(d) 10. 42 13(4)(23) (4)(e) 13(4)(23) (4)(v) 13(4) 11. 12. 42 42 to NVQ Level 4 in Management by 2005. The Registered Provider and Manager must ensure that the policies and procedures in the home are reviewed and updated to reflect current practice. The home must ensure that all care staff working in the home receive up to date training in fire awareness. This must occur every six months. The home must ensure that it undertakes an up to date fire drill. This must be completed every six months. The home must ensure that it reviews its risk assessment for fire prevention. The home must ensure that action is taken to cover the exposed piping in bedroom 2 in order to reduce the risk of scalding. 2006 27 August 2005 27 May 2005 27 May 2005 27 June 2005 27 May 2005 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 Good Practice Recommendations Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Greswolde Park Road, 4 E54 S16989 Greswolde Park Road 4 V223698 270405 Stage 4.doc Version 1.30 Page 25 - 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!
