Inspection on 06/01/06 for Bradbury Lodge

This inspection was carried out on 6th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 17 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bradbury Lodge 26/06/07

Bradbury Lodge 11/12/06

Bradbury Lodge 03/05/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Bradbury Lodge Claypit Road Whitchurch Shropshire SY13 1NT Lead Inspector Sue Woods Unannounced Inspection 6th January 2006 17th January 2006 1:00pm 10:00am Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 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 Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 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. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bradbury Lodge Address Claypit Road Whitchurch Shropshire SY13 1NT 01948 666916 01948 667011 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) Perthyn Mr Oluwajimi Oluwayemisi Ogundere Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home accommodates service users only between the ages of 18 and 65 years. Mr Ogundere must undertake NVQ level 4 in care within 12 months. Perthyn must supply details, within their statement of purpose, of support networks available to the manager and staff including relevant qualifications, to demonstrate the manager will be appropriately trained and supported. The home may only accommdate service users for an assessment period of a maximum of two years, with a plan to move on developed after the first year. When occupancy at the home reaches four service users Perthyn must consult with CSCI to formally review existing arrangements (including assessments and support plans) and identify future needs of proposed service users by way of staffing levels and individual needs. This is the first inspection of the service since it was registered with CSCI 4. 5. Date of last inspection Brief Description of the Service: Bradbury Lodge is a ‘short term’ assessment unit for adults with ‘or have a history of’ (taken from the statement of purpose) challenging behaviours. It has been identified that the people who will be moving in are people whose needs could not be met in their home county and thus alternative placements further afield have been made. The home is managed by Perthyn and registered to support a maximum of six people with learning disabilities under the age of sixty-five years. The registered manager of the home is Mr Oluwayemisi Ogundere and the Responsible Individual is Mr Richard Halliwell. Conditions of registration apply and are detailed above. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Bradbury Lodge was carried out in two parts. The initial visit took place on 6th January 2006 and involved meeting with service users and staff, review of care files and a tour of the environment. The second visit took place on 17th January 2006 and involved a meeting with the manager and the responsible individual for the home. This visit included discussions in relation to the home’s conditions of registration and a review on actions taken by the manager since the time of the first visit. The inspection took six hours in total. What the service does well: What has improved since the last inspection? This is the first inspection of the home. However it is positive to note that the manager is not willing to accept service users without up to date assessments following the placement of the fourth service user when the manager did not feel fully involved. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 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. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 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 Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The pre admission assessment for one service user does not reflect the service delivered by the home. As a result the home cannot demonstrate it can safely or adequately meet the service users needs. EVIDENCE: Given the background of the re-provision of services and that Bradbury Lodge is a short -term respite facility standard 1 was not assessed. A comprehensive assessment for the latest service user to move to Bradbury Lodge (On 19th December 2005) was seen at the time of the first inspection. The assessment had been completed in April 2005 with a review date of August 2005. There was no review assessment seen and the deputy manager showed the inspector the discharge meeting minutes as an alternative. There was a discrepancy identified in relation to staffing levels and this is detailed in standard 32. As part of the homes registration conditions consultation must take place with CSCI after the fourth service user moves into the home. A meeting took place at the time of the second inspection visit on 17th January 2006. Although initial discussions with the RI identified that a new admission was to take place on week commencing 24th January the manager was able to offer reassurances that this will not happen until the staff team is in place and appropriate assessments and risk assessments have been completed. The manager has Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 9 met with the proposed new admission and is involved in the assessment process unlike the admission of the fourth resident. The manager is insisting upon monthly meetings with placing authorities and social workers to ensue continuity of care and to initiate a discharge plan in good time for the move to a permanent service. CSCI has required that the manager provides risk assessments to support proposed staffing levels and an action plan to cover current service user compatibility issues, how the care assessments fit with the homes statement of purpose and also to detail arrangements for mealtimes (use of kitchen) and parking. This information must all be in place and shared with CSCI prior to the 5th admission. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Managers and staff are proactive at promoting involvement, allowing service users to currently make decisions about all aspects of life within the confines of group living. Service users may be vulnerable if risk assessments are not completed prior to activities taking place and if personal information is not regularly reviewed and updated. EVIDENCE: At the time of the inspection two service users spoke to the inspector about their support and activity plan. It was positive to see support staff encouraging service users to discuss their wishes and identify goals and aspirations. A house meeting had taken place on the morning of the inspection and one service user was talking about outcomes of the meeting. Staff stated that such meetings take place weekly. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 11 One service user was able to show the inspector problems with the building that required prompt action to rectify (See standard 24 for requirements). It was stated that the weekly menu is agreed at the time of the weekly meeting however the inspector felt that once the second ‘wing’ is operational it will be difficult for all to agree on one menu and thus separate arrangements will be required to allow for individual choices and staff support. Staff also commented on the volume of meals to be prepared by staff who will be removed from shift to carry out the task. Any activities that potentially restricts service user independence and choice must be explained and detailed in the homes Statement Of Purpose (See requirement standard 16). The working file was seen for one service user. Assessments and personal details had been completed between May and July 2005. There was no evidence that this information had been reviewed or updated prior to his admission in December 2005. One staff member stated that they aim that all service users go out at least once a day; even if is to the local shop to buy a newspaper. Individual risk assessments were available to support some activities although not all. Changes to care plans have been made on occasion without the support of risk assessments (e.g. one service user is now supported by one staff member although his plan still states he needs two). Following discussion the manager committed to ensure risk assessments support all future changes to plans. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,16, Although individual plans are made around individual wishes and aspirations it is apparent that some house ‘rules’ appear restrictive and do not reflect the ethos of the home. EVIDENCE: On the day of the inspection one service user had gone bowling as per his activity plan. Staff were aware of activities identified by service users and one staff member was discussing how to pursue an agreed goal in the near future. One service user told the inspector that he had used the services of the local barber to cut his hair and commented that he was happy with the results. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 13 Tea break times were noted around the home. It was identified that service users could use the kitchen facilities to make drinks at any time but one service user stated it was cold drinks only in between set times. Through discussions it was identified that the times listed were to support one service user to stagger his drinks however the impact on others living in the house was evident. The deputy manager stated that this arrangement had changed recently upon the arrival of the last service user to move in to the house and would therefore be reviewed and set times removed (with an individual programme to support service users who required the structure). At the time of the second visit to the home the manager informed the inspector that there were no set ‘drinks times’ and it was noted that the ‘posters’ had been removed. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Medication practices in relation to the administration and storage of medication are unsafe and put service users and staff at risk. EVIDENCE: At the time of the inspection two staff, supporting one service user, returned from an opticians appointment in the local town of Whitchurch. It was noted by the inspector that the latest service user to move into the house was not eating much. Staff confirmed that they were aware of this and were monitoring the situation by keeping a record of drinks and foods eaten and also had started a weight record sheet. Medication arrangements were reviewed and a number of concerns relating to current administration and recording were identified. Medication is administered from original boxes. Records of administration are signed by two staff on occasions, by one member of staff on other occasions and there were also omissions of signatures. The administration recording sheets were on a separate sheet from the record of the medication and dosage therefore it was not possible to cross reference entries. Signatures were not recorded next to dates to identify when made. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 15 PRN protocols were seen to be too general to allow an effective decision making process of when to administer. Wording such as ‘give for self harm ’or ‘for severe agitation’ could lead to confusion or inconsistency. The deputy manager confirmed that there is no additional guidance available for them when on call. It was positive to note that a check is made weekly to count medication on site however as the check is only made weekly mistakes could be left un-rectified up for up to seven days. At the time of the second inspection visit 17/1/06 the manager had made attempts to improve the administration of medication procedure by secondary dispensing medication into individual boxes. The manager was advised that this practice is unacceptable. The inspector received an email upon return to the office stating that the manager has contacted the local dispensing chemist and made arrangements for a suitable system to be implemented from that day. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users are safeguarded by systems in place to action complaints or incidents of abuse. EVIDENCE: Service users who spoke with the inspector said that they would speak to the manager if they had a problem. There have been no complaints made about the service offered at Bradbury Lodge. The manager had used the adult protection procedures demonstrating that he is aware of the process and confident to make referrals as appropriate. The issues raised was not in relation to any incident that had taken place at Bradbury Lodge and he was able to confirm that an outcome had been agreed and action taken. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The safety of the environment is being compromised by the number of works remaining outstanding and the lack of robust in-house checks to identify and monitor progress in rectifying them. EVIDENCE: At the time of the inspection the home was clean and tidy. Bedrooms were personalised. Communal areas such as the lounge/diner and the small kitchen were being well used although the ‘quiet rooms’ were, as yet, not. A number of issues were identified by staff and service users in relation to the environment including automatic fire doors not closing properly and a light in the toilet not working. The deputy manager reported that jobs were usually carried out in a timely manner although the light in the toilet was clearly causing frustration. Electrical testing (as per the home’s policy) had been carried out on some new items but not all. The water in the service users kitchen was supposed to be regulated however upon inspection it was found to exceed 49 degrees. There were no systems in place for regular monitoring and recording of faults and ‘snags’ to demonstrate checks are made and prompt actions taken. Following the first inspection visit the manager had noted requirements made and on the Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 18 day of the second visit a representative from the works team was on site to review all outstanding works. Environmental risk assessments have not been carried out. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Staff are committed to offering a good quality service with appropriate support from management and the organisations support services. Staffing levels do not reflect those assessed as being required to safely and adequately support service users. EVIDENCE: In discussions staff stated that they felt well supported by the manager. Staff also felt that they had received a good induction including intensive support from the organisation in relation to supporting behaviours. Staff were seen to interact positively with service users. Staff were sensitive and discreet. During discussions with the inspector staff demonstrated a commitment to the service users they support. Issues relating to staffing levels within the home and in particular at nights were discussed and as a result the manager has been required to produce risk assessments justifying existing and proposed staffing levels within the home. These arrangements will be subject to ongoing review with CSCI. An assessment for one service user stated 2 waking nights were required. The discharge meeting stated that one waking and one sleeping staff member Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 20 would be safe if the sleeping staff member supported the waking night member when supporting the service user to the toilet. This arrangement is not reflected in the care plan as the deputy manager stated that there is an alarm that the waking night staff member carries and wakes the sleeping staff member only if required. There is no risk assessment in place to support this deviation. Overnight staffing levels were not reviewed by the inspector for the other service users although the deputy manager stated at least one other person requires support at night. An urgent review of nighttime staffing levels is required before any further admissions to the home. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The lack of general systems and structures at the home mean that health and safety of service users is not being fully safeguarded. The organisations inhouse support and monitoring process are not supporting the staff and managers to make positive changes. EVIDENCE: CSCI has noted that copies of Regulation 26 reports are not being received. The Responsible Individual confirmed that he was not carrying out these visits as he line manages the manager however existing arrangements are unsatisfactory and therefore the inspector required that until more suitable arrangements are in place that he should carry out these visits. It was also identified that although two Regulation 26 visits have taken place by identified others, the manager has received no feedback and the Responsible Individual could not recall the content of them. A medication error that prompted a verbal Regulation 37 notification to the CSCI could not be referenced at the home. There was no incident report and Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 22 no outcome noted. It is of concern, especially as this was in relation to a medication error, that medication arrangements have not been reviewed or amended to prevent a re-occurrence. The Responsible Individual was required to send copies of both unannounced visit reports and the incident form in relation to medication to CSCI without delay. At the time of the completion of this report no information has been received by the inspector. The manager stated that he has almost completed his NVQ level 4 in Care. Additional evidence to support this standard is found throughout this report. Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 2 17 Standard No 31 32 33 34 35 36 Score x 2 x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bradbury Lodge Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 1 x DS0000063738.V271551.R01.S.doc Version 5.0 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA2 YA2 Regulation 14 (1) 14 (1) (2) Requirement Pre admissions assessments must be current or reflect an indepth review prior to admission No new admissions to the home will take place until risk assessments in relation to staffing levels are completed and an action plan produced to include an appropriate admission procedure and details of how the home will support new and existing service users. (Details in evidence of this report). Information produced under the above requirement must be sent to CSCI before any future admissions the home. Risk assessments must be carried out for all new activities and to support changes to existing assessments. Any activities that potentially restrict service user’s independence and choice must be explained and detailed in the homes Statement Of Purpose The manager must ensure that any restrictions placed upon one service user do not impact on others. DS0000063738.V271551.R01.S.doc Timescale for action 06/02/06 06/02/06 3 YA2 24 (2) 06/02/06 4 YA9 13 (4)(b) 13/02/06 5 YA16 12 13/02/06 6 YA16 12 (1) (a) 06/02/06 Bradbury Lodge Version 5.0 Page 25 7 YA20 13 (2) 8 YA24 23 (2) (b) (P) 23 (4) 13 (4) (a) 23 (2) (b) 23 (2) (b) 9 10 11 YA24 YA24 YA24 12 YA24 13 (4) (c) 13 14 YA24 YA32 23 (2) (c) 18 (1) (a) 15 YA37 26 16 YA37 26 17 YA42 37 (2) An immediate review on the administration and storage of medication must be carried out and outcomes implemented The light in the shared toilet and the fire door that does not close properly must be repaired immediately. An environmental risk assessment must be carried out and outcomes actioned ‘Snagging’ works identified at the time of the inspection must be carried out A system must be developed and implemented to record and monitor works identified within the home and actions taken. The hot water in sinks identified for use by service users must be safely regulated as per the homes policy. Electrical testing must be carried out in line with the homes policy and procedure An immediate review of staffing levels required within the home must be carried out to ensure there are sufficient staff on duty at all times to meet the assessed needs of service users. The Responsible Individual must carry out visits to the home in accordance with Regulation 26 of the Care Homes Regulations 2001 A copy of the report produced following a visit carried out in line with Regulation 26 must be sent to CSCI Records of incidents and outcomes must be kept at the home and appropriate notification sent to CSCI with copies kept at the home. 06/02/06 06/02/06 13/02/06 27/02/06 27/02/06 06/02/06 06/02/06 06/02/06 13/02/06 13/02/06 06/02/06 Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Bradbury Lodge DS0000063738.V271551.R01.S.doc Version 5.0 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!