Inspection on 15/08/05 for Bracebridge Court

This inspection was carried out on 15th August 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bracebridge Court 13/03/09

Bracebridge Court 13/11/07

Bracebridge Court 15/11/06

Bracebridge Court 01/03/06

Bracebridge Court 10/12/04

Bracebridge Court 24/06/04

Bracebridge Court 04/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Bracebridge Court Friary Road Atherstone Warwickshire CV9 3AL Lead Inspector Yvette Delaney Unannounced 15, 19 and 25 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bracebridge Court Address Friary Road Atherstone Warwickshire CV9 3AL 01827 712895 01827 713754 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) Warwickshire County Council, Social Services Department Gordon Fraser Care Home 35 Category(ies) of Old age (35) registration, with number of places Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10 December 2004 Brief Description of the Service: Bracebridge Court is a Local Authority home for older people. It provides permanent care, short stays and day care. The home is situated on a housing estate less than one mile from the town centre of Atherstone. There are local shops, including a hairdresser, an off licence and a newsagent within fifty yards, and a ‘bus stop outside the home. There are car parking spaces to the front and rear of the building.Bracebridge Court provides accommodation on three floors. Fourteen people have bedrooms and communal lounges on each of the two upper floors. On the ground floor there is a large restaurant, a conservatory, used mainly by day care and short stay residents, and a bar. The home has a hairdressing salon and a shop. Short stay service users have their bedrooms and lounge on the ground floor. All bedrooms have en-suite lavatory and wash hand basin. On each floor there are bathrooms and lavatories suitable for people with physical disabilities. The kitchen, laundry and staff offices are on the ground floor. As well as front and rear staircases, there is a shaft lift to the upper floors. The home is staffed over 24 hours. It has a management team of a manager, an assistant manager and three care officers. There is also a full time clerical officer and a full time activities organiser. In addition there are 32 people who provide care or domestic services. The home does not provide nursing care. Service users who require nursing attention at a level, which can be provided, by community nurses receive this as they would in their own homes. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over 3 days between the hours of 10.30am and 18.30pm. A small tour of the home was carried out with the clinical manager and a number of the resident’s rooms were visited, communal areas and gardens viewed. During the inspection the inspector had the opportunity to meet with the residents and two residents relatives, observe the interaction between residents, staff and their environment, tour the home and examine documents relating to the residents care and management of the home. Staff were observed to take time to speak with relatives and residents. Throughout the inspection residents’ were observed to be relaxed and settled in the home. Two relatives were spoken with at this inspection, both were positive about the home. Conversations were held with eighteen residents, who all expressed that they were happy in the home and found staff helpful and attentive towards them. Observation and polite conversation took place with other residents. What the service does well: What has improved since the last inspection? What they could do better: The main areas in which improvement is needed is in ensuring that staff attend ongoing training related to the health and mental problems associated with the elderly. Statutory training must be brought up to date and all staff should attend a minimum of two fire related training sessions annually. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 6 Daily written statements in care plans should reflect care related statements which reflect residents health, personal and social care needs with information about how the resident have spent their day and any concerns followed up and the outcome documented. 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. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 7 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 Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 8 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 and 5 Residents have the information needed to help them and their families make a choice about where they live. Written contracts/statement of terms and conditions are issued to residents or their relatives, fees payable are not stated in these documents and therefore do not ensure that residents are aware of and accept all the terms and conditions prior to signing the documents and moving into the home. EVIDENCE: A Statement of Purpose and Service User Guide is now available. The documents were examined and both outline the aims and objectives of Bracebridge Court. A copy of the Statement of Purpose is available to residents, relatives and other visitors and a copy of the Service User Guide has not been issued to residents. These documents provide residents and potential residents with information, which will help them to make an informed choice about moving into the home. Discussions with residents and relatives confirmed that they had the opportunity to visit the home before making a decision to move in. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 9 Contracts and statement of terms and conditions for three residents were seen and examined, the documents provide residents with the terms and conditions for moving into the home, and outlines their rights. One of the documents was not signed and details of fees payable are not stated in the documents. Two relatives spoken with spoke about their experiences in looking for a care home for their relative. Both relatives said they had been given the opportunity to view and ask questions about the home before accepting a place for their relative. The majority of residents in the home are capable of making their own decisions and choices. Some of the residents have received day care or respite care prior to moving into the home permanently and were aware of the services the home has to offer. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 10 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, 10 and 11 The residents’ health, personal and social care needs were not consistently described in care plans, which could result in the oversight of care and possible harm to residents. Information contained in care plan records does not reflect care given to residents and therefore does not support staff to consistently meet the health and personal care needs of residents in their care and could lead to omission in care. Residents’ rights to privacy and dignity are respected resulting in an increase in self-esteem and general wellbeing. The death of a resident is treated with respect and sensitivity resulting in appropriate support being given to their family. EVIDENCE: Five care plans were examined the contents of which show that they lack detail and do not describe the specific needs of residents. Daily statements were read these did not reflect the care observed to be given by staff or provide written evidence of an evaluation of the care given. Examples of entries include the following statements ‘Light off’, ‘Light switched off, door shut’ Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 11 ‘Washed dressed, came down for both meals, out in the lounge before and after tea, took him/herself to be.’ There was the occasional reference to health or personal issues, which include ‘has a sore bottom’, ‘resident said feels terrible’, ‘has not passed urine this shift’. These were one off comments with no indication of action taken to address these issues. Staff have commenced entering the time a written entry was made. There was evidence of completed risk assessments in all the care plans examined. Risk assessments examined include nutritional risk of resident’s and the risk of a resident falling. There is evidence in the care plans of access and advice being obtained from specialist nurses, which include District Nurses, Community Psychiatric Nurses and the GP on the care and treatment of residents. The dependency of residents was observed to be variable, some residents required the support of more than one carer and the majority required the support of one carer. Specialist equipment and aids, which includes aids to support resident when mobilising such as wheelchairs, Zimmer frames and hoists are available to support meeting individual needs. Residents in the home are dependent on care staff to support them in maintaining privacy and dignity. Staff were observed to be attentive to residents individual needs. Residents looked cared for with attention to their personal appearance and personal hygiene, which includes oral hygiene. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 12 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) 12, 13, 14 and 15 A good lifestyle is offered to residents related to social, cultural, religious and recreational interests resulting in a high level of well being and quality of life. Residents are encouraged and supported to maintain contact with their family, friends and local community resulting in supporting their social skills and increase in their mental well being. Residents are encouraged and enabled by staff with the support of their family to exercise control over their lives resulting in increased self-esteem and quality of life. Residents receive suitable meals three times per day in pleasant surroundings, which promote social interaction and wellbeing. EVIDENCE: Relatives, friends and other visitors are encouraged to visit throughout the day and maintain contact and involvement in the care of their relative. Visitors were observed to visit the home at the time of inspection, two of which were spoken with. Visits took place in the lounge areas or their own bedrooms. Times of visiting were varied throughout the day and there were no restrictions. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 13 Two relatives spoken with were happy with the home and the care provided by staff. Relatives commented that they were free to visit their relative at any time and were able to take them out if they wished. Proactive links are well established with the local community. Some residents are able to leave the home on their own and continue with their day-to-day life in the community. Relatives and residents spoke about plans for a coffee morning, which was due to take place at the weekend in the home. Some relatives and residents had been involved in planning and taking part in the fete. Residents were easy to talk to and obtain their views on living in the home. Residents were seen to be relaxed, smiling and happy to be living in the home. Eighteen residents were spoken with comments made include, ‘I like living here’, ‘the staff are helpful’, ‘everyone smiles’, ‘he’s nice’ he being the home manager. Posters or information detailing advocacy services available to residents were not evidenced. The inspector ate a meal with the residents, the meal was well presented, appetising and enjoyed by all residents. The lunchtime was seen to be a social event, the dining room is designed as restaurant and arranged so that residents can sit in small groups allowing them the opportunity to socialise. Choices were available for the main course and a variety of sweets had been prepared. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 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, 17 and 18 Procedures are in place to ensure that complaints are dealt with promptly, in a structured manner, objectively and within stated timescales. Local adult protection procedures, which support staff in dealing effectively with allegations of abuse occurring in the home, are not in place. This potentially leaves residents who use the service at risk. EVIDENCE: A complaints procedure is available and accessible to residents, staff and visitors in the home. Relatives spoken with advised that they would speak to the manager or other members of staff if they had any concerns. The Commission have not received any complaints since the last inspection and the manager advised that they have not received any complaints at the home. Written details of complaints received are maintained with details of any investigation carried out and action taken to address the findings. Residents are encouraged and supported to exercise their legal rights. The opportunity to vote in the May General Elections was made available to all residents by attending the local polling station. The protection of vulnerable adults procedure examined is dated September 2002. There is no in the document seen of reference to whistle blowing, the Department of Health guidance ‘No Secrets’, the Care standards Act or the Commission for Social Care Inspection. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 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, 23, 24, 25 and 26 The home is well decorated and presented providing a well-maintained homely environment with sufficient and suitable equipment and facilities, which ensure safe and comfortable surroundings, are provided for all residents. EVIDENCE: A tour of the home evidenced that the location and layout is suitable for the services offered and meet the needs of residents living in the home. The home offers gardens to the side and back of the home. The garden area at the side of the home has been landscaped and offers an accessible and pleasant area for residents to sit. Residents’ accommodation is provided on three floors all floors are accessible by using a lift or stairs. Some of the bedrooms were viewed with the Deputy Manager. Observations of bedrooms visited indicate that residents are encouraged to bring in personal items to individualise their own space and that bedrooms are furnished based on their individual needs. The home was observed to be clean and free from offensive odours. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 16 Lighting in the home is appropriate natural lighting being provided by appropriately placed windows in individual bedrooms and communal areas and throughout the home. The home provides adequate communal space, which encourages residents to socialise. Residents and relatives were observed to be sitting in the lounge areas, bedrooms, the foyer and the conservatory area. Records detailing cleaning procedures to be carried out in the kitchen were available. It was not clearly identified how often areas should be cleaned. Based on the information available to staff cleaning procedures have been maintained consistently in the kitchen area and records were examined to confirm this. Temperature checks are maintained of the fridges and freezers foods received in the home and cooked meals served to residents. Written records were noted to have been completed in pencil. The kitchen is clean and standards of hygiene maintained. Ample, fresh, frozen and dried foodstuffs are maintained in the home to provide residents with nutritious and suitable meals. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 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, 29 and 30 The numbers and skill mix of staff meets the needs of residents accommodated in the home, which would support the individual well being of residents and the delivery of appropriate care leading to a good quality of life. The procedures for the recruitment of staff are robust to ensure that all safeguards are accessed to offer protection to residents living in the home. Staff were observed to be competent to do their jobs but training is not up to date, which could result in inappropriate care being given and a deterioration in the quality of life for individual residents. EVIDENCE: It was evidenced from duty rotas and the number of staff on duty at the time of inspection, that suitable and separate core staff is available to support the services provided by the home. Training records examined show that statutory training is not up to date; this includes fire, manual handling, health & safety and food hygiene. It was noted that infection control was not included in the statutory training requirements. Records examined providing details on induction training for new staff indicate that the contents meet the National Training Organisation targets. Evidence was not available to confirm recent attendance at training sessions related to care topics, which would support staff to meet the needs of residents accommodated in the home. Two staff files were examined these show that they are appropriately maintained and that checks have been completed, which include checks with the Criminal Records Bureau to ensure the protection of resident. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 18 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, 32, 35 and 36 The home has got an effective management structure in place, which has resulted in effective leadership and a clear ethos, which safeguards the rights and best interests of residents and protects their welfare. Records detailing how resident’s monies are handled are not appropriately maintained to confirm that residents are safeguarded from financial harm. Supervision procedures implemented, monitors care practices delivered by staff ensuring that residents’ health, safety and welfare is maintained at all times. EVIDENCE: Observations made indicate that the manager is approachable, has good interaction with residents and relatives and maintains an involvement in the care of residents. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 19 Residents and relatives expressed positive comments about the manager and were happy with the way the home is run. An open door policy for residents and relatives is practised. Relatives spoken with stated that they found the managers, care staff and other staff in the home approachable. Records examined include care plans, accident details, policies and procedures, staff files and supervision documentation. Records were found to be maintained and up to date. Some records were observed to have been completed in pencil, which over time could easily be erased. Resident’s personal monies were seen and checked, the process for issuing monies was not robust and all receipts to cross-reference monies spent were not available. The auditing systems were evidenced as needing to be more robust. Safe storage is appropriate and the manager has access. Staff spoken to and practices observed, particularly in relation to the environment and care planning indicates that there are varying levels of knowledge and understanding of health and safety issues in the home. Care staff said that they are receiving supervision, which is carried out by their line manager. Records were examined to confirm that supervision sessions had taken place. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 20 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. 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 3 2 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 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 3 2 3 3 x x 2 3 x x Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 21 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. 2. Standard OP2 OP7 Regulation Schedule 8 14, 15 Requirement A record of the care homes charges to residents must be available in the home. Residents care plans must set out in detail changes in their needs with documentation of action taken to meet and address any change in circumstances. A policy/procedure, which addresses adult protection, must be in place. Reference must be made to whistle blowing, Public Interest Disclosure Act and the Department of Health guidance ‘No Secrets.’ The Registered Manager must ensure that an appropriate ongoing training programme is implemented for all employees, which addresses conditions related to care of the elderly and ensures that staff are up to date with statutory training requirements. The Registered Provider shall visit the home in accordance with Regulation 26 and prepare a written report on the conduct of the care home, supply a copy of the report to the Commission for Timescale for action 30:11:05 30:11:05 3. OP18 13(6)(7) (8), 14(1)(a) 30:11:05 4. OP30 18 31:12:05 5. OP33 26 31:10:05 Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 22 6. OP35 Schedule 9 Social Care Inspection and the Registered Manager. (Previous timescale of 30:04:04 has not been met). The Registered Manager must ensure that accurate and appropriate records are maintained of all transactions involving residents monies or valuables deposited with the home for safekeeping. 31:10:05 7. 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 OP2 Good Practice Recommendations It is recommended that the statement of terms and conditions be revised to include all the information highlighted in the standard. (Outstanding from inspection dated 10th December 2004) The staff training strategy should include understanding and managing challenging behaviour and an awareness of mental health needs. (Outstanding from inspection dated 10th December 2004) Daily health related statements, should be completed consistently to demonstrate care prescribed and care given. It is recommended that up to date information about how to access advocacy services is displayed in a prominent position in the home. (Outstanding from inspection dated 10th December 2004) 2. OP4 3. 4. OP7 OP14 5. Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Bracebridge Court E53 S35064 Bracebridge Court V244546 150805 Stage 4.doc Version 1.40 Page 24 - 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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