Inspection on 31/10/06 for Brambles

This inspection was carried out on 31st October 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 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

Brambles 08/01/10

Brambles 20/10/05

Brambles 04/05/05

Brambles 18/10/04

Brambles 10/05/04

Brambles 23/02/04

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 Brambles Birchfield Road Redditch Worcestershire B97 4LX Lead Inspector Mrs Yvonne South Unannounced Inspection 31st October 2006 08:40A X10015.doc Version 1.40 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 Brambles DS0000028579.V310181.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 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. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brambles Address Birchfield Road Redditch Worcestershire B97 4LX 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) 01527 555800 01527 548888 www.heart-of-england.co.uk Heart of England Housing and Care Limited Mrs Margaret Frances Hook Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (60) Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Home may accommodate one person under 65 years of age who has a physical disability and a mental disorder The Home may also accommodate one person over 65 years of age with a learning disability. The home may accommodate one person under 65 years of age who has a physical disability. 20.10.05 Date of last inspection Brief Description of the Service: Brambles is a purpose built home for older people who may have a physical disability and/or mental health needs associated with old age. Additionally the home has registration for one older person with a learning disability and registration for one person under 65 who has a physical disability and mental disorder. The home is set in a residential area of Redditch which is about half a mile from local amenities and convenient for public transport. It is on three floors, there is a passenger lift to all levels and handrails fitted where necessary. All bedrooms are single and have en-suite facilities. Communal adapted toilets and bathrooms are available on all floors. There is also a garden area, which can be accessed by residents. The home is owned by Heart of England Housing and Care Ltd, for whom the responsible individual is Mr John McCarthy. The home manager is Mrs Margaret Hook who is supported by Ms Amy Troth the Customer Service Manager and Mr Rod Mills the Home Service Manager. The email address for the home is: brambles@heart-of-england.co.uk In the pre inspection questionnaire submitted to the Commission for Social Care Inspection (CSCI) on 10.09.06 the manager stated that the current scale of charges was £1720. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection incorporates information received by the Commission for Social Care Inspection since 20.10.05 and the information obtained during fieldwork on 31.10.06. The fieldwork took place over nine hours during which the inspector spoke to three residents, one relative, three staff, the home manager, the customer service manager and the home service manager. Documents were assessed and a partial tour of the premises was also undertaken. Two phone calls were also made to relatives seeking their opinions of the service provided. Prior to the fieldwork the home was asked by the Commission for Social Care Inspection to distribute questionnaires to the residents, relatives and health care professionals. To date fifteen responses have been received from residents, five from relatives and six from health care professionals. The focus of this inspection was on the key National Minimum Standards and the requirements and recommendation that arose out of the previous inspection. What the service does well: The home provides a warm friendly welcome to everyone. It is clean tidy and well maintained. A resident described it as ‘Very nice and tidy.’ A relative stated that ’Cleanliness and comfort, food and responsiveness are a credit to all concerned’. A choice of meals is always available with further alternatives if desired. A resident said; ‘Very satisfied with dinners’. Personal and health care is provided as needed by each resident and in addition there is a wide range of in-house and community activities for those who wish to participate. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Brambles DS0000028579.V310181.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. (An intermediate service is not offered by this home.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with information and opportunities to visit and try the home before they make a decision on their future care. Everyone is assessed by someone from the home prior to admission in order to ensure their needs can be met. EVIDENCE: It was observed that copies of the Statement of Purpose and Service Users’ Guide and inspection reports were readily available in the reception area of the home. The manager and relatives confirmed that all inquirers and new residents were offered copies of the documents. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 9 In the questionnaire responses received from residents the following statements were made; ‘I had about 4 choices and after I spent a day here I decided to make Brambles my home’. ‘My family came and looked round and said it was the best place they had visited’. ‘Completely satisfied. Made the right choice to be at Brambles’. The care records of a resident living on each floor were assessed during the fieldwork. These demonstrated that they had all been assessed prior to admission to ensure the home was able to meet their needs. It was noted that pre-admission assessment documents specifically considered the need for written information in different formats and cultural requirements relating to diet. One resident required written information in a large print format. The manager showed the inspector documents that demonstrated that, in addition, the home undertook a monthly analysis of diversity within the home. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the information they need so that the personal and health needs of the residents are monitored and addressed. Medication is generally well managed so that residents are able to safely receive prescribed medication. Residents are treated with respect and kindness. Full information is not always available so some residents cannot be sure their end of life wishes will be complied with. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 11 EVIDENCE: The care record demonstrated that information was available to guide staff in the care of the residents. Assessments had been undertaken and care plans drawn up to address the needs that had been identified. Risk assessments had been carried out where concerns had been identified. It was recommended that these be clearly supported by care plans that advised staff how the risks should be managed, reduced or eliminated. Daily records and information relating to visits by health care professionals were detailed and useful. All care documents were reviewed monthly to ensure the information was current and acceptable. The reviews should also record any progress or deterioration experienced by the resident and how the care plans and risk assessment have been altered to address the changes. The cover of care files had been signed by the appropriate resident but there was no further evidence of their involvement in their care planning. Residents commented in the questionnaire responses that; ‘The care suits me fine’. ’The care is wonderful’. ‘I always receive the full medical support I need’. A relative wrote; ‘Every effort is made to look after my mother to the highest standard’. Another relative wrote; ‘Everyone at the home treats my mother with the respect and care I would wish for myself’. Health care professionals commented; ‘The clients we see all appear to be extremely well cared for’. The inspector spoke with three residents and they all confirmed that they were happy with their care. A relative said that she always felt welcome. Her grandmother received very good care. Communication between the home and the family was good. There was a lovely atmosphere. She could speak to anyone. The managers were approachable and always knew what was going on. Medication was generally well managed. Storage and security was acceptable. The requirement made following the previous inspection had been met. All medications received into the home had been checked and recorded. Handwritten records had been double signed. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 12 However it was noticed that one handwritten medication record did not record the quantity of medication brought into the home, some instructions for administration were not clear and where a variable dose was prescribed the amount administered was not always recorded. Handwritten amendments must be clear, double signed and complied with. An assessment of understanding and ability had not been undertaken for someone who managed their own inhaler. This should be undertaken for any degree of self-administration and be supported by a care plan. Privacy and dignity was respected. This was observed and confirmed by staff during the fieldwork. A health care professional stated in the questionnaire response that they were able to see residents in private and assistance was available if needed. There was limited information available regarding the residents wishes at the end of their lives. It is acknowledged that this is a sensitive subject. However staff need to have the information in order that wishes can be complied with without added distress, Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to live the style of life they prefer and participate in a range of in-house and community activities if they wish. They are able to express their views and be involved in decisions that concern the home. They are provided with a choice of good quality meals that they enjoy. EVIDENCE: It was observed that the home was decorated for Halloween and the staff were joining in with the event. The pre-inspection questionnaire stated that in house activities included a library service, bingo, arts and crafts, dominoes, skittles, music and movement, church services, a shop, gardening, reminiscence sessions, fetes, sales and coffee mornings. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 14 Community activities involved shopping, garden centres, theatre, luncheon clubs, church meetings, and meals out. Notice boards on each floor advertised coming events and displayed a full programme. The manager said that the residents’ representatives talked to others and gathered ideas that they wished to propose. These were taken to the activities coordinator for action. Residents said in the questionnaire responses ‘I go on trips in the coach visiting other homes. I enjoy this very much’. Another person said; ‘I am offered the chance to join in but choose not to. I’m asked though’. The manager said that there was a residents’ committee with a representative from each floor. Meetings were held, issues discussed and relayed back to management for action. Residents were also involved in the recruitment process and participated in interviews for new staff. The visitors’ book indicated that there was a steady stream of visitors during the day. This was confirmed by residents who also maintained contact with their family via the mail and telephone. Although their privacy was respected they said that assistance was always available where needed. A menu choice was offered each day. A member of staff demonstrated that a record was maintained of choices and confirmed that extra portions were always available for those people who changed their minds on the day. The three residents who spoke to the inspector said that they enjoyed their food. In the questionnaire responses one person said; ‘Sometimes I do not like any of the choices on the menu but I am always offered something else I do like’. Other comments made included; ‘I would like to see more curries. At least twice a week’. ‘A hot choice in the evenings would be nice. Perhaps soup or a baked potato as an alternative to sandwiches’. ‘The food is good’. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is good access to the complaint procedure and people confidently use it and receive an acceptable response. Staff are appropriately recruited and trained to protect the residents in the home. EVIDENCE: The questionnaire responses indicated that residents, relatives and health care professionals would raise any concerns they had. Residents said in the questionnaire responses; ‘I feel I could speak to anybody if I am not happy’. ‘I know how to make a complaint’. ‘The staff listen to me’. The CSCI had not received any complaints since the last inspection. Assessment of the complaint record in the home indicated that five complaints had been received since April this year. These had concerned food, security, activities and the environment. The records showed that each one had been investigated and appropriate action had been taken. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 16 The manager said that they welcomed complaints and concerns as a means of identifying where their service could improve. Three staff were interviewed by the inspector and their records were assessed. They demonstrated that they had been appropriately recruited and trained to support and protect the vulnerable people in the home. This was confirmed by their records. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable clean home that meets their needs. They have access to the garden for fresh air, exercise and recreation. The risks of cross infection are reduced as much as possible by the equipment and systems in place. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 18 EVIDENCE: It was observed that the home was clean and well maintained. The preinspection questionnaire indicated that since the last inspection 20 bedroom carpets had been professionally cleaned, and seven others had been replaced. Twelve bedrooms had been redecorated. On the day of the inspector’s visit the decorators were working on the corridors of the top floor repairing and redecorating the walls. A programme was in action to re-floor many of the showers and bathrooms. In the garden the fencing had been repainted and the garden was being redesigned to include a sensory garden and new bedding. The harvest of apples and greengages had been successfully incorporated into the menus. Questionnaire responses indicated that the residents and their relatives appreciated the high standards of the environment. One person said; ‘The home is fresh and clean’. Two people said that it was ‘Very good’. One person said that the hygiene was ‘100 ’ and another that the home was well run, clean and efficient’. One relative said that on occasions cleaning under the bed was necessary. Three residents’ bedrooms were well decorated and furnished. Residents were surrounded by their own person possessions such as ornaments and photographs. Where necessary special care equipment was either in use or available for use. The laundry was well organised and equipped with commercial machines. Personal protective equipment, liquid soap, disposable hand towels and waste disposal systems were available to reduce the risks of cross infection and staff and records confirmed that training had been undertaken. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 19 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Suitable staff are recruited and employed to care for the residents. There is a strong commitment to training so staff are knowledgeable and skilled and provide a good service. EVIDENCE: The duty rotas and staff confirmed that there were sufficient staff available to meet the current needs of the residents. The questionnaire responses from residents were; ‘Staff are very busy’. ‘They are usually available when needed and will help when they can’. ‘Staff listen to me’. ‘Quite happy with the care and support I receive’. ‘No request is ignored by staff’. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 20 Although eleven staff had left since the last inspection there were no staff vacancies at the time of the fieldwork and the relief team had been increased by five people, which enabled annual leave and sickness to be covered without the employment of agency staff. A relative said in the questionnaire response that;’ ‘Developments and long established staff on the top floor have an excellent rapport with the residents’. Another relative commented that she had noticed that there was a strong core of staff that had worked in the home for several years. This meant that the residents were experiencing stability and consistency in their care. The care staff team numbered thirty-seven persons. There had been a successful effort to update all mandatory training. In addition five staff were qualified and fifteen staff had commenced National Vocational Training (NVQ). Nineteen staff had first aid training. Ten of these were in basic first aid and nine people had qualified as first aiders by successfully completing the Fourday First Aid at Work course. The inspector was assisted by the Registered Manager, the Customer Service Manager and the Home Service Manager. In addition three staff were interviewed and their records were assessed. It was apparent that everyone was knowledgeable and confident in their work. An acceptable recruitment process had ensured that people were checked to ensure as far as possible their suitability for working with vulnerable people. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 21 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed in the interests of the residents. Health and safety systems protect those in the home. The quality assurance system needs to be formally organised in order that an annual audit can more easily identify areas that could be improved and develop the service further. Residents’ personal monies are well managed in their best interests. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 22 EVIDENCE: The Registered Manager was experienced and competent to manage the home. Relatives said that the management was ‘approachable’ and ‘knew what was going on’. Staff said that she was; ‘Nice’. ‘Approachable’. ‘Easy to get on with’. ‘Lovely’. All staff received regular supervision/support sessions and this was recorded. Quality assurance questionnaires were distributed by the home and analysed monthly. Evidence was seen that where necessary responses had been made and action taken. The analysis was available with the Statement of Purpose in the reception of the home. Monthly meetings were held with all staff groups that provided a good forum to discuss and resolve concerns and plan how to improve the service further. In addition monthly reviews were held of other areas of practice such as accidents, complaints, equality and diversity. This enabled weaknesses and concerns to be identified and addressed. All these quality checks appeared to be operating in isolation. It was recommended that they be drawn together to enable the annual audit to be more readily undertaken. Residents’ money held in safekeeping and managed on their behalf was stored securely and appropriately receipted and recorded. It was recommended that personal items held in safekeeping also be receipted in and out. The health and safety and maintenance manual demonstrated that equipment and services were regularly monitored and serviced. This was endorsed by the information in the pre-inspection questionnaire. The fire risk assessment was available for the home and checks were regularly undertaken of the fire safety systems. Staff received training in health and safety matters including fire safety. Training records were seen and staff confirmed that they had had the training. Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 2 X 3 3 X 3 Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13 Risk assessments must be supported by a care plan describing how each risk is managed. 2 OP7 15 Residents’ or with their consent, their representatives should be involved in the planning of their care and the drawing up of their care plans. 3 OP11 12 The resident’s full wishes regarding religious needs, terminal care and arrangements after death must be discussed with them or with their consent their representative, and recorded in order that they can be carried out. 4 OP9 13 Medication must be managed in accordance with the policy and procedure of the home. 31/12/06 01/01/07 31/12/06 Requirement Timescale for action 31/12/06 Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 25 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 Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Brambles DS0000028579.V310181.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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