Inspection on 21/04/05 for Barrowhill Hall

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 but made no statutory requirements on the home.

Other inspections for this house

Barrowhill Hall 11/02/08

Barrowhill Hall 23/08/06

Barrowhill Hall 15/11/05

Barrowhill Hall 30/09/04

Barrowhill Hall 27/05/04

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

CARE HOMES FOR OLDER PEOPLE Barrowhill Hall Rocester Near Uttoxeter Staffordshire ST14 5BX Lead Inspector Sue Mullin Unannounced 21 April 2005 12:45 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Barrowhill Hall Address Barrowhill Rocester Near Uttoxeter Staffordshire ST14 5BX 01889 591006 01889 591512 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) Staffordshire Property Investment Fund Ms Nada Evans Care Home 41 Category(ies) of PD (5) registration, with number DE (41) of places PD(E) (5) MD (E) (5) DE(E) (20) MD (10) Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 10 MD over 45 years 41 DE over 45 years 5 PD over 45 years Date of last inspection 30 September 2004 Brief Description of the Service: Barrowhill Hall is registered to care for 41 adults and provides both long term and respite personal care. The home, a detached, spacious property, in it’s own extensive grounds, is situated in an elevated position on the outskirts of Rocester, near Uttoxeter and is surrounded by attractive open countryside and farmland.The home is managed by Staffordshire Property Investment Fund Ltd, who have a number of care establishments nationwide. The home provides accommodation for Dementia (41), Dementia - over 65 years of age (20), Mental disorder, excluding learning disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (5), Physical disability (5), Physical disability over 65 years of age (5) Some categories can be admitted at a younger age ( 45years and over).The accommodation for service users is available both in the main house, which is two storey and served by lift and wide staircase, and in a smaller part known as The Stables. All 13 bedrooms in this part of the home are single occupancy and provide en-suite facilities. There is a separate lounge and dining room and an attractive courtyard area with seating for the better weather. In the main house there is a spacious main lounge with a separate dining area. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The statutory unannounced inspection took place over a period of almost 5 hours by one inspector. The home have an approved care manager who was an annual leave at the time of the visit. The deputy care manager was in charge of the home and assisted throughout the inspection. Several members of staff and residents were engaged in conversation throughout the inspection. The views of those residents spoken with were very positive about the care they were receiving and can be found throughout the body of the report. The inspection undertook a tour of most of the areas of the home and a number of records and documents were examined. Conditions in the home were determined by direct observation and sampling other facilities provided such as catering, laundry, provision of activities and aspects of health and safety measures. There have been no complaints made to the home since the last inspection on 30th September 2004. The home can take up to four residents on a day care basis. What the service does well: Health care awareness was evident, with the importance of any deterioration or change in mental health status, monitored by diligent staff through pertinent training and experience. Individual identified personal hygiene requirements were well met with dignity and respect. Daily routines are flexible and individual preferences are considered. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: Further development is urgently required in relation to some health and safely issues. The home must ensure the safety of residents accommodated in the home, as many areas have unguarded radiators and pipe work. This is hazardous and may cause injury to residents and although requirements have been made to this effect in the past, the proprietor has still not complied. The commission are now serving a statutory enforcement notice to ensure this standard is fully met. Hot water temperatures must be recorded monthly, where there is full body immersion, which does not exceed 43.C. All emergency lighting must be tested in, line with the Fire Authorities requirements, recorded and available for inspection when requested. The fire alarm system must be fully operational in all areas of the establishment. The registered person must assess the fire risk in the home, to ensure minimum fire standards are maintained in the home at all times. This must be documented reviewed regularly and produced at all inspections. Night staff must receive four fire a drills per year. The proprietor must complete a fire risk assessment which is reviewed annually. The commission are now serving a statutory enforcement notice to ensure this standard is fully met. The door at the top of the main stairwell has still not had a key pad replaced or baffle handles applied. This is a very potentially dangerous hazard as many of the residents are suffering with varying forms of dementia and mental health problems and this situation now requires urgent remedial action. The Commission are now serving a statutory enforcement notice to ensure this standard is fully met. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 7 Adequate arrangements must be in place for suitably trained/qualified staff to complete all health and safety requirements required previously and again at this inspection forthwith. The carpet outside the kitchen is very uneven and hazardous and needs replacing as previously required. Mechanical sluicing must be installed and foot operated clinical bins must be available in all bathrooms/toilets and clinical rooms, in line with infection control guidelines. Adequate assisted bathing facilities must be available and commodes must not be used in place of appropriate shower chairs. Exact sizes or rooms in the home must be sent to the Commission and included in the statement of Purpose. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3. Standard 6 is not applicable to this home Information contained in the homes Statement of Purpose and Residents Guide about services provided was readily available to residents, relatives and professionals. The home had pre admission assessment systems in place before residents were admitted. EVIDENCE: The statement of purpose was seen and meets most of the criteria laid down in schedule 1, Regulation 4(1)(c) with the exception of exact room sizes. This was discussed during the inspection and the information is to be sent to the Commission and subsequently included in the statement of purpose. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 10 Contracts of terms of residency were seen for Local Authority funded and private paying residents. Those seen contained suitable and sufficient information as required in standard 2.2 and detailed any additional charges for personal sundries. Records evidenced that comprehensive pre admission assessments were undertaken and this was also confirmed by the deputy manager of the home. Local Authority assessments were on those files where residents were funded. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Appropriate arrangements are in place for identifying and meeting the health and personal care needs of residents in the home. Service users feel that they are treated with dignity. EVIDENCE: A random selection of care plans were inspected and it was evidenced that the individual health, personal and social cares needs had been established and were being met by staff, which individually and collectively had the necessary skills and experience. Personal hygiene care needs of residents had been well documented and were being met, with good standards of care being delivered. There was a safe system for the receipt, storage, administration and disposal of medicines. MAR sheets were checked and found to be all in order. Each resident had a photograph on their file and medication seen in the clinical room corresponded to the blister packs provided by the chemist. CD drugs were checked against the register and tallied with stock levels. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 12 During the inspection process residents were seen to be treated with great respect and privacy was upheld. All doors were knocked on prior to entry and staff waited for consent to open the door. All residents had full access to all NHS entitlements and this was clearly recorded in the main body of the care plans. GP visits were carried out in the residents own rooms and then documented into the care plan. The vast majority of residents in the home were suffering from varying forms of dementia and could not all hold a meaningful conversation. However, throughout the inspection there was a happy atmosphere with laughter and camaraderie throughout the home and staff were seen interacting professionally at all times. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15 Contact had been maintained with relatives and friends of residents. Residents experienced a lifestyle where they moved freely in and around the home Opportunities to access the local community had been made available. Catering aspects were very good with balanced nutritious meals being served, along with resident consultation and choice. EVIDENCE: By direct observation it was seen that the home provided a relaxed and friendly environment. Individual hobbies and preferred activities were encouraged (were possible) and facilitated by care staff. The home has a Chef and inspection of the kitchen were found to be very satisfactory. There was a varied choice of menu, with alternatives served where requested. Plentiful supply of stacks were seen all stored correctly. No relatives were seen in the home on the day of the inspection. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Complaints or grumbles are listened to and resolved. The home policies, procedures and staff training, protected residents from aspects of abuse. EVIDENCE: The home clearly displays its complaints procedure that is easily understood by residents/relatives and visiting professionals. The deputy care manager stated that where residents or relatives have had areas of concern they are able to discuss these with the management of the home who always look for speedy local resolution. No incident of neglect or abuse of any kind has been reported. The home have robust policies in place and cascade training down to staff to ensure residents are protected from all forms of abuse. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,25,26 The home was clean, warm and tidy, and had a homely atmosphere and individual areas were personalised. However, the home does not provide a safe and well-maintained environment for all residents (further concerns are outlined under standard 38 in this report). Gardens were not considered safe for residents to enjoy unsupervised. Clinical waste was not disposed of correctly and there were no mechanical means of disinfecting and cleaning commode pans. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 16 EVIDENCE: The home enjoys extensive views over the countryside and generally provides a pleasant area for residents to sit and wander around in warmer weather. However, all residents need to be observed closely when in the garden areas, as there is a deep slope which is hazardous to residents and staff alike. This part of the garden needs to be made safe and secure. The carpet area outside the kitchen remains a hazard to residents and staff and needs to be replaced in the very near future. There were no foot operated clinical waste bins available in the lavatories/bathrooms or clinical rooms in the home. These must be installed in line with Infection control guidelines. Staff should not be wandering around the home looking for receptacles in which to place soiled incontinent pads. The staff in the home explained that they had no means of cleaning and disinfecting commode pans throughout the home. Manual cleansing is not acceptable and the home must install a mechanical sluice to limit the likelihood of cross infection. All radiators and pipe work must be guarded or have low temperature surfaces, this has been a requirement on previous inspection and now needs urgent attention. Assisted bath/shower facilities must be available on each floor of the nursing home. Currently, there is only one assisted bathroom and one small shower room on the ground floor and the staff are using a commode for residents to sit on when being showered. This is an unacceptable practice which must cease immediately. Shower chairs must be used when using the shower room. There is a well appointed bathroom on the first floor of the home however this is redundant as there are no means to assist residents in and out of the bath. A requirement has been made to install an assisted bathing area on the first floor level of the home. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The assessed needs of service users had been met by an adequate number of care staff. Recruitment procedures had been correctly addressed which had contributed to the protection of service users. Staff training was ongoing but not completed. EVIDENCE: At the time of inspection care staff on duty were competent and satisfactory in number to meet the needs of individuals in their care. The home provide personal care only and on the day of the inspection there were 39 residents (including one in hospital and one on respite). There were two day care places at present throughout the week. • • • Early shift 7.30 am – 2.30 pm was covered with 6 care staff Late shift 2.30 pm – 9.30 pm was covered with 6 care staff Night shift 9.30 pm – 7.30 am was covered with 4 care staff Kitchen, laundry and domestic staff was sufficient but it was noted that recruitment is ongoing. During two evenings per week there is a kitchen assistant who prepares hot suppers. The rest of the time the day kitchen staff prepare sandwiches and soup which the care assistants serve out. There was an activity organise employed for 15 hours per week. The home also provide a mini bus with tailgate support for outings etc. Administration staff is employed for 30 hours per week. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 18 Personnel files selected for inspection were found to be robust and included all information required. CRB and POVA checks were underway for all new staff. However, the 40 hours per week of maintenance employment in the home was clearly not sufficient to meet all the homes requirements. Night staff must receive 4 fire drills per year in line with the Fire authorities requirements, this has still not been met. Following a conversation with the maintenance man he stated that he did not have enough time to undertake this duty. Alternative arrangements must be put into place to comply with this requirement. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,36,38 The Proprietor did not ensure as far as is reasonably practicable the health safety and welfare of residents. The care manager will need to improve procedures and records in relation to ensuring the promotion of health and safety in the home. EVIDENCE: Records relating to the servicing and maintenance of fire detecting and fire fighting equipment did not conform to appropriate serving and testing required. No annual checks had been carried out. One area of the home the fire zone did not operate at all and this had been known for some time by the Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 20 staff in the home and still no remedial action had been taken. The fire alarm system must be fully operational in all areas throughout the home. Not all night staff had received sufficient fire drills. Hot water testing where there is full body immersion had not been recorded appropriately and seen to be undertaken on an ad hoc basis. Emergency lighting testing had not been recorded for monthly, 6 monthly or three yearly checks. Following a discussion with the maintenance man, he responded stating that he did not have enough time to complete all theses tasks and that no one had shown him how to undertake these health and safety duties. He stated the ‘He had picked them up as he went along’. He stated that he did not have a formal induction. Clearly this is a serious issue which needs urgent attention from the company’s health and safety training department. The provider must complete a fire risk assessment which is reviewed annually and available for inspection when required. The door at the top of the main stairwell must be made safe, by either a replacement of the broken keypad or baffle handles installed. Many of the residents are at risk of injury without this safety mechanism in place. Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 4 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 2 x x x 1 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x 3 x 1 Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19) Regulation 13(4)(a) Requirement The carpet outside the kitchen area towards the shower room is worn and hazardous to residents and staff. This must be replaced Previous time scale of 10/01/04 has not been met The registered person must ensure that the keypad at the top of the main staircase is replaced or baffle handles fitted to reduce the risks of injury to residents. Previous time scale of 30/06/04 has not been met The registered person must ensure that all radiators and pipework in residents areas are guarded or have guaranteed low temperature surfaces. Previous timescale of 30/11/04 has not been met Night staff must receive 4 fire drills per year. Previous timescale given with immediate effect has not been met. The registered provider must complete a fire risk assessment and review annually. Previous timescale of 17/07/03 not met. Emergency lighting must be tested in line with Fire Authorities requirements Timescale for action 01/06/05 2. OP38 13(4)(a) 01/06/05 3. OP25 23(2)(p) 01/06/05 4. OP30 23(4)(e) 01/06/05 5. OP38 23(4)(a)( b)(c) 23(4)(c) 01/06/05 6. OP38 with immediate effect Page 23 Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 7. OP38 13(4)(a) 8. OP27 18(1)(a) 9. OP21 23(2)(j) 10. OP26 23(2)(k) 11. 12. OP38 OP26 13(4)(a) 16(2)(k) Previous timescale given with immediate effect has not been met. Hot water temperatures must be tested and documented. Previous timescale given with immediate effect has not been met. Adequate maintainance hours must be employed to meet all the health and safety requirements. Previous timescale of 10/07/04 not met Assisted bathing/shower facilities must be available on both floors of the home. Shower chairs must be provided The registered person must ensure that the home have adeuate mechanical sluicing facilitites available in the home The fire alarm system must be fully operational in all areas with immediate effect 01/06/05 01/07/05 21/07/05 13. 14. OP1 OP19 4(1)(c) 13(4)(a) Foot operated clinical bins must be available to dispose of waste in accordance with infection control guidelines. The statement of purpose needs 01/06/05 to include exact room sizes Garden areas must be made safe 01/07/05 and secure for resdients use with immediate effect 01/06/05 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 Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Barrowhill Hall E51 E09 S4913 Barrowhill Hall V221967 210405 Stage 4.doc Version 1.20 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. 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