Inspection on 11/08/05 for Bridge House

This inspection was carried out on 11th 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 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

Bridge House 22/05/07

Bridge House 27/01/06

Bridge House 03/02/05

Bridge House 26/07/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bridge House 31 Rectory Road Frampton Cotterell South Gloucestershire BS36 2BN Lead Inspector Odette Coveney Unannounced 11 August 2005 09:30 th 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. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bridge House Address 31 Rectory Road Frampton Cotterell South Gloucestershire BS36 2BN 01454 772888 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) Bridge House Residential Home Ltd Miss Rachel Louise Parnell PC Care home 16 Category(ies) of OP Old age (16) registration, with number of places Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 16 persons aged 65 years and over requiring personal care only. Date of last inspection 3-Feb-2005 Brief Description of the Service: Bridge House is a purpose built care home that the owners, Jane and David Parnell, built in the grounds of their cottage. The Brochure states that the home is run by a family, as a family. It is located in a semi-rural position, with the River Frome running alongside the grounds. Bridge House is sited at the end of a quiet residential area and provides a home for sixteen older people. The home also provides day care and will also offer respite care when a vacancy is available. In the grounds there is a model railway and on Bank Holidays the home has open days. The steam engines are available for rides and the home provides refreshments. Although there are small shops available in Frampton Cottrell, the nearest main shops are in Yate, approximately five miles away, and Bristol about ten miles away. There is a bus service from Frampton Cottrell to both places. The home has good community links and is run on Christian based principles. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process to examine the care provided, and monitor the progress in relation to the one requirement and two recommendations from the last inspection that was conducted in February 2005. The inspection took place over four and a half hours. During the process ten residents, two staff, the registered providers and the registered manager were spoken with. The inspector looked around some of the building and a number of records were examined. Following consultation with the manager and the staff team it was agreed that those living at the home would prefer to be referred to as residents within the inspection report, rather than service user and therefore this has been reflected within this report. The Commission for Social Care Inspection has produced a leaflet for those living in care establishments entitled ‘Is the care you need the care you get?’; a copy of this was left at the home to be put on the home’s notice board. What the service does well: Bridge House is very much ‘home’ to those who are living there, the furnishings and environment are comfortable, the home and the garden are maintained to a high standard. All of the staff have created a comfortable and homely environment in which residents feel secure. There is a low staff turnover and residents can therefore be confident that they will receive support from people they know. It was clearly evident that the manager and the staff team are committed to ensuring that all of the needs of individuals at the home are met, this is done through consultation and observation and previous knowledge and an understanding of individuals through a person centred individualised process. Those living at the home appear to have a good quality of life, services are delivered in an individualised way, and those living at the home said they were ‘happy’ and ‘well cared for’. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 6 The staff team are friendly and held in high regard by residents, with many favourable comments made from them about the level of attention and support they receive. Relationships between them are respectful and caring with residents feeling valued, respected and of worth 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. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 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 Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 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, 3, 4, 5 There is sufficient information available for residents to make an informed choice about moving to the home. The admissions procedure includes an initial assessment, which enables new residents to feel confident that the home will have the resources and skills to meet their need. EVIDENCE: There have been a few admissions to the home since the previous inspection. Two residents have only been at the home for two weeks and are currently in the process of their trial period. Both David and Rachel Parnell explained the admission process for these people and told the inspector that the admission process had been tailored to the specific needs and wishes of the individual concerned. The individual’s had visited the home to have a look around, meet the staff and others living at the home. This provided an opportunity for the individual’s to determine whether they would be happy at the home and if the home would be able to meet their needs. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 9 The current assessment period provided an opportunity for the home to build a relationship with the individual, to observe their needs and to gather information on how they interacted with others. Information for the new person to the home had been well documented and a care file of information supplied by the individual and other professionals had been established. The inspector spoke with the two most recently admitted people to the home, one told of the continued relationship with their family and of the new friendships they had made with staff and others living at the home. The other resident told the inspector they had settled in and ‘although it isn’t my own home this was the next best thing!’ ‘I am very happy here’. At the previous inspection the inspector saw that the home has in place a written and costed statement of terms and conditions between the home and individuals living at the home, all individual’s had a copy in place. These documents had been dated and signed by the individual, and the manager of the home. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 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, 9, 10, 11 Individual’s health, personal, medication and social needs are well met, and reviewed on an ongoing basis. Recording of audits for controlled medication requires improvement. Support is delivered in a manner to ensure individuals respect and dignity. EVIDENCE: Records and discussion evidenced that residents are supported to see the relevant health professionals including district nurses, chiropodists and dentists. All those spoken with at the time of the visit were satisfied with the service they received in this respect and said they could see the GP on request. Residents are supported by management and staff at the home to attend hospital and outpatients appointments. A resident told the inspector that they believed their health had improved significantly since their admission to the home due to regular meals and support with their medication and personal care. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 11 Residents spoke warmly about the staff team and positively about the help they gave them. They said they felt they were respected and never spoken to in an abrupt manner. Relationships between staff and residents were observed to be respectful and friendly at the time of this visit. Bridge House operates a monitored dosage system for the administration of medication that is delivered at regular intervals by the local pharmacist. Records held were generally found to be well maintained and met with the requirements of the legislation. One resident who has recently been admitted to the home self medicates; however there was no risk assessment about this. It is required that this is completed in order to fully ensure that this is undertaken in a safe manner. It was also recommended that an accurate stock record be kept of any tablets held by residents on the premises. It is good practice that the home is encouraging residents to maintain their independence if they are able to do so. A small quantity of controlled medication is held at the home and although this was held in a locked cabinet this medication was not stored as required by the Royal Pharmaceutical Guidelines, therefore a requirement was made that this medication must be stored in a double lockable facility. During the inspection the staff present demonstrated an enthusiastic and sensitive approach to individuals and were committed to working in a person centred manner. Staff were observed interacting and supporting those living at Bridge House in their preferred routines, promoting independence and offering choice and control. Of those care records sampled the inspector saw that the home had sought the views and wishes of residents as to what they wanted to occur in the event of their death and these were clearly recorded with important details in place. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 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) 12,13,14,15 Those living at the home enjoy a good level of activity and entertainment and are actively supported to access community resources; individuals are able to exercise personal choice in this area. EVIDENCE: During the inspection some residents were involved with an arts and crafts session undertaking needlework, sewing and beadwork and told the inspector of items they have made and of the pleasure they have from participating in these activities. All of those living at the home who were spoken with during the inspection could not speak highly enough of the care and attention they receive from staff, one lady told the inspector that ‘staff listen and spend time with me’, another told the inspector how happy they were that staff help them to go out and of the varied level of entertainment and social outings provided at the home. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 13 Residents told the inspector that they had recently enjoyed a picnic in the woods at the Forest of Dean and that on their return journey all of the group of twenty had been invited to have tea with one of the resident’s relatives; those spoken with told the inspector that they had a wonderful time and a fabulous meal. Other residents told the inspector they were looking forward to visiting the balloon fiesta (‘with hot pasties being taken for supper’), ‘we have our special spot at the fiesta where we always have fantastic views’. Rachael Parnell told the inspectors that the residents were also having a day trip to Porthcawl to visit her at her holiday home. Posters in the home are in large print and inform residents of forthcoming events; the inspector saw that these were varied and included entertainers to the home as well as fundraising events and trips to places of local interest. The home’s visitors book evidenced that there are a number of regular visitors to the home; residents told the inspector that family and friends are always made welcome. A number of the residents told the inspector that they make decisions about areas that affect them; this enables them to have control over their life and make choices, examples given included going in and out of the home when they want, visiting family and friends and having visitors to the home, attending church and practical and personal assistance. Lunch being served on the day of the inspection was either spaghetti bolognaise or cottage pie, served with sliced green beans and carrots, dessert was bread and butter pudding. Information seen in care records in relation to individuals dietary requirements were well recorded, the inspector saw that these were followed at lunch and staff spoken with were fully conversant with individual needs and the reasons for this. Residents told the inspector that the food served at the home was ‘As good as you will ever get in a hotel!’ ‘Lovely food, nothing too much bother’. Jane Parnell discussed with the inspector the importance of residents rights and their ability to excise choice and control over their lives, this is an area which Mrs Parnell is passionate about and advocates with individuals and their relatives to ensure that this is an area that is respected and that individuals are listened to and their wishes acted upon. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The complaints process in the home is good and there was clear evidence that individual’s views are listened to and acted upon. The risk of individual’s suffering from any form of abuse or neglect is appropriately minimised. The home fosters a positive atmosphere in which residents can air their views without being afraid. EVIDENCE: The home has in place procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of individuals, this includes a protection of vulnerable adults policy. Since May 2005 ten staff members have undertaken Protection of Vulnerable Adults training, a further two staff members are booked to undertake this training in September. Residents said that they would speak with the manager if they had any problems. They spoke openly and did not appear to be afraid to speak their minds. They said that there was a regular monthly residents meeting during which time they were asked their opinions. At this inspection a number of individual’s money and cash records were examined, all were correctly accounted for, with receipts in place. The monies held on behalf of individuals are clearly accounted and are well recorded. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 15 The Commission for Social Care Inspection has received notification of incidents that have affected individual’s wellbeing at the home, the information provided shows that individuals had been supported in an appropriate manner and appropriate action or advice sought as required. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 16 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, 26 Residents’ benefit from living in a homely, well maintained and clean environment. EVIDENCE: There have been no changes in the services and facilities provided at the home since the previous inspection. The location and layout of the home is suitable for its intended purpose. The home was purpose built to accommodate those with disabilities. The home is a large detached building with accommodation set over two floors with lift access to the first floor. Bridge House was found to be well maintained, comfortably furnished and homely in appearance. The lounge and dining room have an array of appropriate furnishings; residents told the inspector that they have found the new lounge chairs to be very comfortable and have benefited from a new large screen television in the lounge. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 17 Opportunity was taken to view a number of bedrooms. Residents are able to bring small pieces of their own furniture with them to remind them of their home. All those questioned said they were satisfied with the quality and quantity of furniture in their rooms. It was observed that they were personalised and reflected individual tastes, indicating that choice and independence are promoted in this respect. Residents confirmed that they could have a bedroom door key if they wished for security and additional privacy. At the previous inspection undertaken in February 2005 two recommendations were made in respect of the environment, a resident’s bedroom had a water stain, this has been repainted, also a ceiling fan had become loose in an upstairs bathroom, at this inspection the inspector saw that this had been repaired and was secure, these recommendations have therefore been met. The home has an extremely pleasant extensive garden to the rear of the home and many residents commented on enjoying spending time there and watching the birds, at the time of the inspection a group of children were visiting and were enjoying the model steam train in the grounds. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 18 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) 28, 29, 30 There are trained staff with the appropriate skills and knowledge to support older people within a residential care environment. EVIDENCE: There is a core of well-established staff with varying abilities most of which are skilled and experienced to meet the needs of those living in the home. There is a stable staff team, there have been minimal changes in the staff group since the last inspection, agency or bank staff are not required at the home. Those living at the home can be assured that staff employed have been done so following clear and robust recruitment practices and the implementation of organisational policies and procedures. The inspector saw that the home has in place employment documents for staff, these were available and viewed at the inspection, this included references, completed application form, a criminal records bureau check and contracts of their employment terms and conditions. Staff members spoken with were able to demonstrate a clear understanding of their role and responsibilities within the team and their own personal role and accountability. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 19 Information is held in relation to each staff member, folders were viewed and information contained within these included a copy of the mission statement and the aims of the home, individuals job descriptions, personal development plans and supervision records. Supervision with staff is undertaken on a daily informal information sharing basis and also on a formal, recorded structured level. Records showed that areas of discussion have included individual’s progress on carrying out their role, individual’s responsibility and personal development of skills. Induction is undertaken with each newly appointed staff member, this is comprehensive and covers all aspects of supporting people on an individual basis incorporating the principles of treating residents with dignity and respect as well as including practical advice and guidance of job responsibility. The inspector saw staff training records and a detailed matrix demonstrating the monitoring of current and future personal skill development of individual staff members and the team needs. Upon examination of this it was clearly evident that staff receive regular appropriate training in relation to the services provided at the home, training undertaken within the past six months has included: Manual Handling, Continence Awareness, Drug administration, First Aid, Principles of Care, Control of Substances Hazardous to Health and Fire Safety. Regular staff meetings are held at the home and provide an opportunity to further discuss the needs of residents to ensure continuity of care, discussion of routines and roles of staff to ensure consistency of service delivery at Bridge House. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 20 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, 33, 35, 36, 38 Bridge house is well managed by individuals who are committed to providing a high level of service to those living at the home within a safe environment. EVIDENCE: The manager of Bridge House Rachael Parnell, and the registered providers, David and Jane Parnell, were welcoming and open to the inspection process. Rachael Parnell, has achieved a National Vocational Qualification at level four, is an assessor for NVQ in care. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 21 The inspector saw evidence that the home ensures as far as is reasonably practicable the health, safety and welfare of those living at, visiting and working at the home. The fire logbook was examined at this inspection; the inspector was satisfied that the home is maintaining regular checks of equipment and that staff are receiving appropriate fire safety instruction. A requirement was made at the previous inspection that the home develops a risk assessment in respect of fire and to incorporate what the home’s procedure was at night, The inspector saw that the home has completed and now has in place a comprehensive fire risk assessment; this document covered areas of identified risk within the homes environment. The fire logbook was examined at this inspection; the inspector was satisfied that the home is maintaining regular checks of equipment and that staff are receiving appropriate fire safety instruction The inspector viewed the home’s policies and procedures, which were in place, these are robust and provide sufficient information in order to direct, and guide staff practice. The policies seen were appropriate to the service provided at the home. There were policies and procedures that were specific to personnel issues, health and safety and resident specific areas. Those seen included; admission/discharge procedures, emergency situations, security of the home, missing persons procedure and dealing with clinical waste. The manager discusses these with staff to ensure they are aware of their contents and how this influences their practice. This is consistent with good practice. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 22 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 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 3 x 3 Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 23 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 OP 9 OP 9 Regulation 13(4) 13(2) Timescale for action Risk assessment to be completed 11/09/05 re use of controlled medication for individual who self medicates. Controlled medication to be 11/09/05 stored and administered as per the Royal pharmacutical guidelines. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP 9 Good Practice Recommendations Clear audit trail to be impletmented for controlled medication. Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Bridge House Dr56_S3316_bridgehouse_V235245_080805.Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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