Inspection on 03/01/07 for Abbeyfield Grange

This inspection was carried out on 3rd January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Abbeyfield Grange 14/02/06

Abbeyfield Grange 09/08/05

Abbeyfield Grange 26/01/05

Abbeyfield Grange 21/09/04

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME ADULTS 18-65 Abbeyfield Grange 148 Burngreave Road Sheffield South Yorkshire S3 9DL Lead Inspector Marina Warwicker Key Unannounced Inspection 3th January 2007 10:00 Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield Grange Address 148 Burngreave Road Sheffield South Yorkshire S3 9DL 0114 275 9482 0114 275 9996 none Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Kenneth Trevor Brack Ms Zofia Sabina Janina Britain Ms Zofia Sabina Janina Britain Mrs Rachel Kirsty Coates Care Home 26 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (26) of places Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15 February 2006 Brief Description of the Service: Abbeyfield Grange Care Home comprises two houses. Numbers 143 and 148 Burngreave road. Number 148 is the main care home with extensions and has room for twenty beds and the second building number 143 which is across the road, has room for six beds. The manager said that the weekly fee is around £340.00. The home caters for people with mental health problems. It is registered to provide personal care and support to men and women between the ages of 18 – 65 years. However, the clients are all male. The home is in a residential area of Burngreave and near a GP surgery, a hospital, day centres and other amenities. There is regular public transport to the city centre and other areas from Burngreave. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on 3rd January 2007 between 10am and 5pm. Seven residents consulted and five staff were interviewed. Ten relatives were contacted by post to obtain feedback about the service. The management will be informed of the comments received from the survey. Time was spent observing and interacting with staff and the service users. Both managers were present during the inspection. The premise was inspected which included bedrooms of service users and the communal areas inside and outdoors. Samples of records were checked. They were care plans, medication records, some service reports and staff recruitment & training files. During the inspection the managers were informed of the findings. I would like to thank the service users, the managers, and all the staff for their honest and constructive contribution to this inspection report. What the service does well: Service users are invited to visit the home prior to moving in so that the prospective service users are able to test-drive the service. At the same time the other service users at the home are able to meet and find out how they get on with the prospective service user. The service users know that information about them is handled with the strictest confidence by staff. Family links and friendship circles, inside and outside the home are encouraged as outlined in the individual care plans so that service users are able to maintain their contacts. Subject to what is agreed in the care plan the service users’ rights are respected by promoting independence, choice and freedom of movement. Service users receive a healthy diet, which they enjoy. The registered managers ensure that there is a clear and effective complaint procedure, which is accessible to the staff and the service users. Thereby people know how and to when to make a complaint. The service users have access to local amenities, local transport and relevant support services to suit the personal and lifestyle needs of service users. The premises are in keeping with the local community and reflect the home’s purpose. The home is kept clean and hygienic. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 6 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. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 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 Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are admitted only on the basis of a full assessment undertaken by their care managers and supported by the allied professionals. The care managers involve the service users and their next of kin and/ or their advocates so that the assessments undertaken are appropriate for the individuals’ needs. Service users are invited to visit the home prior to moving in so that the prospective service users are able to test-drive the service. At the same time the other service users at the home are able to meet and find out how they get on with the prospective service user. All service users are supplied with individual statement of terms and conditions so that the service user, contacting authority and the provider of the service are in agreement of the service to be provided. EVIDENCE: Three care plans were checked and five staff were consulted with regards to the admission process and the involvement of multi agency professionals. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 9 There was documentation from the care managers and the referring medical officers with regards to the service users’ medical, psychological and the physical needs. The staff said “Before the residents are admitted for permanent stay they are invited to spend half days where they spend time in the home and have a meal with the other service users. They are also given the opportunity to stay overnight”. One service user said, “I can’t remember how I got here”. And another said, “I am settled her and it’s alright”. All three service users tracked had copies of their Terms & Conditions of stay and out of three two were not signed and dated. The lack of evidence with regards to the contract agreement was discussed with the managers. It was explained that if the service users are unable to sign then their advocates or the care manager should be approached. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 &10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan, to reflect their assessed and their changing needs. So that the staff are able to demonstrate how they are to use the facilities to meet the service users’ needs. The staff help service users make decisions according to their choices. Action is taken by the staff to minimise identified risk and hazards to avoid any limitations. The service users know that information about them is handled with the strictest confidence by staff. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three care plans were checked and there was information with regards to the service users’ personal, social, mental and physical needs. The care plans also established individualised procedures for service users likely to be aggressive, challenging in their approach and cause harm to themselves, others and self. The management of such situations were focused on positive behaviour and passive management methods. During staff interviews and feedback from the surveys it was confirmed that service users are treated as individuals and their wishes were respected and were given choices in what they do. Through direct observation and when speaking to staff it was established that service users were encouraged to take responsible risks, such as using public transport, doing shopping at the local shops and attending clubs. The staff said that they responded promptly when there was an unexplained absence of a service user. Service users’ records are kept in a secure place and the information kept on individual files was accurate. One service user said, “I like my key worker and I like her to know everything about me.” Another service users said, “I tell them what they need to know”. Staff were able to verbalise how they maintain service user confidentiality and when they share information with the management. They also were aware that there was a policy on confidentiality. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Service users are able to continue their education, training, find jobs and take part in valued and fulfilling activities. These arrangements enable them to maintain an independent life style. Family links and friendship circles, inside and outside the home are encouraged as outlined in the individual care plans so that service users are able to maintain their contacts. Subject to what is agreed in the care plan the service users’ rights are respected by promoting independence, choice and freedom of movement. Service users receive a healthy diet, which they enjoy. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 13 EVIDENCE: Seven service users were observed and three service users were consulted about their life style at the home. A service user said, “I enjoy going to the pub and going shopping”. Another service user said “I go to town most days and I like going to town” and the third service users said, “ I like going to the shopping centre and the pub but someone has to come with me. It is not possible.” Care staff said that service users visited gardening groups and other community activity centres. The care staff also said that every opportunity was taken by them for the service users to integrate into local communities. However, some residents did not want to participate and that they respect the individual’s wishes. The service users were supported by the staff; so that they were able to maintain the friendships they had before entering the home. There was documentary evidence in the care plans that staff had helped the service users to keep in touch with their families if they so wish. The service users were seen going out of the home to do shopping and also for recreation. The staff said that they open the service users’ mail only when they are asked by the service users and read out to them if they wish. The staff were seen knocking on the service users’ bedroom doors before entering the rooms. The staff were seen interacting with the service users and among each other in an appropriate manner. The service users were offered a choice of menu and they said that they enjoyed their meals. The service users said that the food was good and they were offered an alternative if they wanted. The care staff said that the kitchen staff always offered service users fruit and healthy options to encourage them to eat well. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users receive sensitive and flexible personal support so that they are able to maximise their privacy, dignity, independence and control over their lives. The senior care workers use the health care support facilities in the community to address the service users’ health care needs. Thereby the service users are able to access health care according to their requirements. The present client group is unable to self medicate. Therefore the key workers help them with the administration of medication. Ageing, terminal illness and death of service users are addressed within staff training. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 15 EVIDENCE: The care plans had assessments of personal care needs of the service users and how they plan to deliver the care. Service users had seen the General Practitioner when needed, and the staff said that they do not hesitate to contact medical or allied professionals when they need help. There were cards and letters with hospital appointments for service users and the manager said that the key workers made arrangements and helped them attend. Records of medication were maintained for all current service users. On the day of the inspection there were no controlled drugs kept at the home. There has been a pharmacy audit, which was positive. Palliative care practical assistance and advice was sought from the general practitioner and allied services. Some staff said that they had received training on death and dying and palliative care. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered managers ensure that there is a clear and effective complaint procedure, which is accessible to the staff and the service users. Thereby people know who and how to make a complaint. The management of the home ensures that there are policies, procedures and staff training - on Abuse, discrimination, neglect, self-harm and degrading treatment of service users- for the staff so that the service users are safeguarded. EVIDENCE: There was a book available for recording complaints and compliments. This was empty. The service users said that they don’t complain since staff do their best to help them. The staff were aware of recording any complaint and they said that they had not had any formal complaints. During staff interviews it was established that some staff had received training on Protection Of Vulnerable Adults and aware of the procedures. However, not all staff have had the training. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have access to local amenities, local transport and relevant support services to suit the personal and lifestyle needs of service users. The premises are in keeping with the local community and reflect the home’s purpose. The home is kept clean and hygienic. EVIDENCE: The two houses belonging to Abbeyfield grange are suitable for its stated purpose. They were accessible safe and maintained. The service users and the staff said that the home was able to meet the individual and collective needs of the service users in a comfortable and homely environment. During the tour of the premise, the home was clean, and free from offensive odour and hazards. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 18 The premise was accessible to disabled people and wheelchair users. The furnishings, fittings and the equipment used were of a reasonable quality. There was a maintenance person employed who carried out daily maintenance work. The laundry facilities were sited on the ground floor. The washing machines had the specified programming to meet disinfection standards. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a formal service specific training for staff to prepare them to meet the needs of the service users i.e. Mental illness, challenging behaviour, Schizophrenia training and other related disorders. The manager as far as possible allocates a sufficient number of staff to support the people who use the service, in line with the terms and conditions of the service users. There are gaps in the information in the staff files. Therefore the recruitment procedures are not robust; required to protect service users. The induction training for the newly appointed staff is not satisfactory, since the present training programme does not prepare the staff for the specific care provision. The manager carries out regular supervision of staff. This is to find out staff needs and offer support. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 20 EVIDENCE: A number of new staff have been recruited from different backgrounds. Therefore the home is able to supply the correct numbers of staff to support service users. Three staff files were checked and the following gaps were observed. • Not all staff had a reference from the last employer. There were references from the deputy manager from the last employer. One of the managers explained why this was accepted. Such information should be recorded on the staff files. • Two staff health declaration forms were not fully completed. • There were some gaps in the employment histories. Generally there has been a marked improvement in the information kept on the staff recruitment files. Four staff training files was checked. • The records on training were poor and the management were unable to access the relevant paper work. • The training should include an ongoing programme of staff training needs analysis according to their background, experience and ability. The training programme should reflect the speciality. • Not all the staff had attended mandatory training i.e. Moving & Handling, Health & Safety, Fire Safety, Protection Of Vulnerable Adults, First Aid. • Although those staff contacted said that they had received training recently, but the records did not confirm this. The care staff have had regular supervision and there were records to support this. During staff interviews they said, that at their supervision they were: • Constructively criticised for any incidents that may have happened, • Listened to their concern/comments and useful suggestions were made • Given assurance about any future training they may have requested. In recent months due to senior staff turnover the management had to reorganise senior staff responsibilities. It was noted that management had not carried out formal supervision with these staff. However this was rectified within 48hrs hours after the inspection visit. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by two individuals who job share. The registered managers are competent and experienced in the running of the service. Therefore the home is able to meet the aims and objectives of the home. There is a quality monitoring system to seek the views of the service users, relatives, staff and any significant others who are involved in the care of the service users. This is to check how the home is achieving its stated purpose. The managers have systems in place to monitor and train people who work at the home to maintain health & safety, safe working practices and compliance with the relevant legislations. Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 22 EVIDENCE: The managers share the day-to-day running responsibilities. They said that they undertake training and updates as they see required for their job. The management have commenced actively seeking feedback from service users and staff about the service they provide. One of the managers said that she had gathered the information from the last survey and was to analyse the results and feedback to the service users and the staff. Training on health & safety has been covered under staff training. However, during the tour of the premise no hazards were identified. The managers said that they ensure regular checks and services were carried out on equipment used at the home including gas and electricity. Abbeyfield Grange DS0000002931.V325754.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 4 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 4 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA5 Regulation 5 Requirement The home must be able to evidence that all service users have received copies of their terms and conditions in respect of accommodation provided including the amount and method of payment. Previous timescale 15/04/06 All service users must be consulted about their social interests and activities. The management must make every effort to accommodate individual requests. The documentation maintained by the home on staff recruitment must comply with the regulations and the schedule. Staff must receive structured induction training within 12 weeks of employment. There must be formal documentation available to support this. Previous timescale 15/04/06. All staff must receive training and must be competent on topics such as moving & handling, health & safety, fire safety, adult protection and DS0000002931.V325754.R01.S.doc Timescale for action 15/03/07 2. YA14 16 15/03/07 3. YA34 19, Schedule2 12,18 15/03/07 4. YA35 15/03/07 5. YA35 12 15/03/07 Abbeyfield Grange Version 5.2 Page 25 Infection control. The home must keep evidence of staff training. 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 YA27 Good Practice Recommendations The residents would benefit from a ground floor toilet. Residents who experience problems with continence would benefit greatly. The residents’ rooms should have a form of identification. 2. YA25 Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Abbeyfield Grange DS0000002931.V325754.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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