Inspection on 08/03/07 for Blossomwood

This inspection was carried out on 8th March 2007.

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

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

Other inspections for this house

Blossomwood 23/01/09

Blossomwood 02/02/06

Blossomwood 14/10/05

Blossomwood 21/11/04

Blossomwood 22/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Blossomwood Colchester Road Elmstead Market Colchester Essex CO7 7AZ Lead Inspector Diane Roberts Kety Unannounced Inspection 8th March 2007 09:00 Blossomwood DS0000017774.V332463.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 Blossomwood DS0000017774.V332463.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. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blossomwood Address Colchester Road Elmstead Market Colchester Essex CO7 7AZ 01206 825510 01206 825510 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 Pelandapatirage Gemunu Susantha Dias Mr Ramrup Bolaky Mr Ramrup Bolaky Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 12 persons) 2nd February 2006 Date of last inspection Brief Description of the Service: Blossomwood is a care home providing personal care and accommodation for twelve individuals with learning disabilities, between the ages of twenty-five and forty-five. The service is owned, in partnership, by Mr Dias and Mr Bolaky. Mr Bolaky is also the Registered Manager. The care home is situated between Colchester and Elmstead Market, being within walking distance of the shops and facilities of Elmstead Market. This provides for day-to-day requirements. The dwelling consists of two linked units, a main house and a ground floor annexe. Accommodation in the main house is provided on two floors. All but one of the rooms are single occupancy. There are extensive enclosed gardens to the property. A service users guide is available for prospective residents and the current fees range from £ 727.00 – £1441.00, based upon a needs assessment. Additional charges are made for personal items such as toiletries, hairdressing, holidays and some activities. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over six hours and was carried out as part of the annual inspection programme for this home. The registered proprietor and deputy manager were available throughout the inspection. The home is currently full. Since the last inspection the management team have been working developing their quality assurance programme and person centred care planning. The inspection focused upon all of the key standards. A partial tour of the premises was undertaken. Evidence was also taken from the Pre Inspection Questionnaire completed by the home and submitted to the CSCI. Some of the residents were out of the home on the day of the inspection. It was possible to meet and talk to two residents. Six comment cards were received from residents, eight from relatives and three from healthcare professionals who visit the home. Results and comments from these feedback sheets are incorporated into the report. What the service does well: What has improved since the last inspection? Since the last inspection, the management team have improved the staff supervision and support system and now have a running programme in place. Work has also been completed on the quality assurance programme and in relation to person centred care planning. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 6 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. Blossomwood DS0000017774.V332463.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 Blossomwood DS0000017774.V332463.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents are fully assessed prior to admission, to ensure that their needs will be met. EVIDENCE: The home is full and there have been no new admissions since the last inspection. On discussion, the management team are very keen to ensure that any new residents will settle in well and mix well with the current resident group and have a similar level of ability. They said that when they have a vacancy they do not rush to fill it and like to wait and ensure the right person is admitted to the home, taking both their needs and the needs of the permanent residents into account. The current assessment format was reviewed and discussed. This document is completed prior to and after admission with help from, where possible, the resident, relatives and key individuals. Where appropriate social services assessments are also utilised. The assessment is based upon daily living needs and personal care. It identifies in the first person what an individual’s strengths are and areas where Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 9 they may need some input or support. The assessment also covers communication and future goals including employment. Once complete this document would give a good overall assessment of the prospective residents and their abilities and needs. The care plan is then developed from this assessment. Meetings are also held as part of the assessment process and prospective residents have the opportunity to come and stay at the home at different times depending on their needs and wishes. Residents who commented said that they had enough information prior to admission about the home. Blossomwood DS0000017774.V332463.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a care planning system in place that is developing positively. Residents are assisted to make decisions about their lives, as they are able. Residents are supported to take risks as part of their independent lifestyle. EVIDENCE: Since the last inspection, the management team at the home have been developing person centred care planning. Care plans were case tracked and were seen to be person centred with evidence of input from residents, where possible, outlining their preferences regarding care and lifestyle. Strengths and abilities are identified within the care plan along with residents’ personal goals. Care plans were seen to be detailed and informative. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 11 Records show that care plans are generally reviewed and this process includes the views of the key worker for each resident. Evidence of review could be improved in relation to the care plan and risk assessments. Daily notes and a monthly report are completed and evidence should be available that links these into the care planning system. This was discussed with the management team. Comprehensive risk assessments are also developed following completion of the assessments where areas of need are identified. The assessment is also used as part of the review system and this is updated every year. When full reviews have been completed there are good detailed notes and input from all concerned. Risk assessments cover a wide range of subjects. Many evidence that residents are encouraged to take part in an independent lifestyle with differing levels of support, as required. The team are also completing a lifestyle book, for each resident, which is called a passport. This is linked to a total communication course that care staff have been attending. The passport is in a pictorial format for each resident, depending on their need, and outlines how they spend their time and what they like to do. Resident input is actively sort and the document links in with local centres that some residents attend. Blossomwood DS0000017774.V332463.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in age, peer and culturally appropriate activities. Residents take part in the local community. Residents have appropriate personal relationships. Residents are respected by staff. Residents receive a varied diet and mealtimes. EVIDENCE: Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 13 Residents at the home are able to take part in a wide range of activities. The management team have recently purchased 2 new six seater cars so they are able to take more residents out and facilitate more activities and community access. Staffing is carefully arranged so that the team have enough drivers on duty to cover residents’ needs. Records show that residents attend a wide range of clubs, colleges and day centres where they are able to develop a range of skills in daily living, crafts such as woodwork and gardening and educational subjects. Clubs are attended during the day and more socially in the evening. Some residents take part in work related activities but at the current time, none have paid employment. The home does have active links with employment agencies for people with a learning disability. Records show that residents are able to attend clubs and centres, which are appropriate for their needs and goals in life. The management team are keen to encourage residents to attend courses, which will help them achieve their future goals. Residents who commented said that ‘they are encouraged to do things’ and indicated that they had choice during the day about what they wanted to do. Records show that residents access the local community and make use of a range of local leisure facilities From discussion and records, it is clear that wherever possible residents are helped to maintain friendships from previous placements and with their families and key people in their lives. Family and friends are invited to attend functions at the home and if they are unable to attend, the staff and residents often send photos after the event. Records show that residents have been able to go away on holiday, in the UK and abroad with both family and staff from the home. Where possible residents go and stay with family for weekends on a regular basis. Residents spoken to showed the inspecting officer that they enjoyed a range of pastimes in the home, including music and karaoke. Records showed that each resident has an activity programme in place and these were seen to be quite varied and linked to individual need and preferences. Where residents go for ‘trips out’, the content of the trip should be recorded in order to evidence the value of the trip and help with review and evaluation of the overall programme. Interaction between staff and residents was seen to be relaxed, respectful and age appropriate. From discussion with staff there is a clear recognition of residents rights and individuality. Residents in the independent living part of the home are able to take part in regular meetings with staff, where they can contribute their views on services and arrangements in the home. Minutes of meetings are maintained and show that a range of subjects are covered. Residents who commented said that ‘the management team ensure that care staff listen to us and support us’ and they also felt that staff treated them well. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 14 Whilst the home has a set menu in place, alternatives are available and staff are very aware of residents preferences. There are no special diets needed at the current time. Residents spoken to said that they enjoyed going out to eat and helping to make snacks in the home. Residents are encouraged to make their own breakfast and snacks where possible. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 15 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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive personal care and support in a sensitive and respectful way. Resident’s physical and emotional health needs are met. The home has satisfactory systems in place for the safe handling of medicines. EVIDENCE: Records show that resident’s personal choices and preferences regarding care are taken into account and facilitated as far as possible. The management team are developing a resident ‘passport’, which will identify personal wishes and goals more fully. Residents have key workers and are active in choosing their key workers. Residents spoken to were positive about these relationships. Behaviour management in the home is good and records identify, in detail, residents preferences and how these can affect behaviour. Residents’ personal routines are clearly identified and from discussion with staff it is clear that they know the residents’ well. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 16 Records show that residents’ healthcare needs are met in a proactive manner and good records are maintained. Where possible residents access the local healthcare services in the community including the Learning Disability Consultant. Records evidence that where possible residents have exercised choice regarding their health. Staff monitor residents weight where required and ensure that they attend any appointments with support from staff. Visiting professionals to the home feel that staff have a clear understanding of residents needs and that their advice is incorporated into the care plan. Overall they feel that the home provides a good standard of care to the residents. Relatives who commented felt that they were always kept well informed with regard to the healthcare of their relative. The medication systems in the home were inspected. A blister pack system is used and two residents are able to self medicate with support from staff. MAR sheets were seen to be generally in good order but staff do need to remember to sign in additional medications that are started throughout the month. The team have a returns system in place and stock control was well managed. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 17 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place, which ensure that residents’ views are listened to and acted upon. The home has systems in place, which help to ensure to ensure that residents are protected from abuse. EVIDENCE: The home has a satisfactory complaints procedure in place. This is displayed in the home and is available in alternative formats, such as makaton. The home has not received any complaint since the last inspection. Systems for logging complaints were discussed as the team were reviewing this. Records of compliments were available for inspection from relatives and visitors to the home. These stated that people felt that there was a ‘nice relaxed atmosphere at the home’ and that ‘staff were very welcoming and attentive to residents and their needs’. Residents and relatives who commented were aware of the homes complaints procedure and knew how to make a complaint.. The team facilitate the use of local advocacy services, where appropriate and advocates are invited to placement reviews in order to support specific residents. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 18 A satisfactory, up to date, adult protection policy is in place and local guidance is also available. Records show that all staff have been trained in adult protection and also crisis intervention. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 19 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, homely environment. The home is clean. EVIDENCE: A partial tour of the home was undertaken and some residents allowed the inspection officer to see their rooms. From discussion with residents and from records, it is clear that residents have an input as to the décor of their rooms. Rooms were seen to be personalised and residents spoken to were happy with the facilities in the home. Some bedrooms are more up to date with décor than others. On discussion, the team have plans to work steadily through the home updating and refurbishing rooms. Bathrooms were seen to be of a good size and work was underway to address a problem with flooring Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 20 in one room. Residents who commented said that the home was always clean. The home has a large garden, which is popular in the summer months and both lounges open onto this, so residents have easy access. The management team have undertaken a fire safety risk assessment and all documentation and tests were inspected and seen to be in order. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 21 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, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff in the home are competent to care for the needs of the residents. The home has good recruitment procedures in place that protect residents. Staff training and development is good. The management team supervise their staff well. EVIDENCE: The home has a stable staff team in place and agency staff are not used at the current time. Staffing levels are set at 5 staff morning and afternoon/evening and 2 awake at night. These numbers include the manager and extra staff are put on duty should the need arise. From observation staff and residents interact well with each other and the atmosphere and conversation is very relaxed. Staff at the home have been attending LDAF courses and 15 out of 17 care staff have achieved NVQ level 2 with a further 6 also achieving level 3. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 22 The deputy manager undertook a review of domestic task/hours following a recommendation at the last inspection that are undertaken by care staff and work allocation has been adjusted following this. The home has recruitment procedures in place. Staff files were check at random and found to be in good order with the required checks, references and documentation in place. It is recommended that the application form be reviewed to give a longer career history and that interview records are maintained. Records show that staff are undertaking induction both via the home and through the LDAF training programme. A good staff supervision system and plan is in place to support the staff team. Staff training records show a good overall compliance with both statutory and additional specialist training . Residents who commented spoke positively about the staff team. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 23 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is stable. The quality assurance systems are satisfactory and are developing positively. The health and safety or residents and staff is promoted in the home. EVIDENCE: The management team at the home is stable and from discussion and observation, work well together. The registered manager has attained the registered managers award and NVQ level 4 and the deputy manager is currently undertaking these qualifications. The management team need to ensure that they keep themselves up to date with statutory training such as Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 24 fire safety. Records show that regular staff meetings are held to discuss a range of subjects including developments in the home and the care of residents. The management team have a quality assurance policy in place. At the current time the quality assurance programme primarily consists of satisfaction questionnaires, which are sent out on a yearly basis. A summary of the results is produced along with an action plan, if required. The results are displayed in the home for everyone to see and copies are also given out. The management team are also carrying out monthly audits of services, records and business systems in the home. This covers quite a few subject areas and from discussion it is still developing and this was discussed. The results of the quality assurance questionnaires showed an objective approach and a team who are not afraid to highlight areas that they feel they need to work on. Results from staff questionnaires demonstrate that they are focused on improving outcomes for residents and acting on their behalf. The home has a health and safety policy in place covering both residents and staff. Some safe working practice risk assessments are in place and discussion was held on developing these further. Accident records were inspected and found to have been completed well and there was evidence of follow up where required. Records also showed that staff are working to reduce the incident of accidents by reducing the level of risk. Random sampling of maintenance and safety certificates showed that the management team have systems in place to ensure fixtures and equipment are maintained safely. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 25 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 X 5 X 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 4 33 X 34 4 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 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 2 3 Refer to Standard YA6 YA12 YA34 Good Practice Recommendations The registered person should improve the evidence of reviews in the care planning system. The registered person should ensure that records of activities are detailed in order to evidence a meaningful activity. The registered person should review the application form so that a full career history can be recorded and maintain interview records. Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Blossomwood DS0000017774.V332463.R01.S.doc Version 5.2 Page 28 - 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. 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