Inspection on 20/09/05 for Brockhurst

This inspection was carried out on 20th September 2005.

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

Brockhurst 30/09/08

Brockhurst 13/06/07

Brockhurst 12/04/06

Brockhurst 18/04/05

Brockhurst 07/10/04

Brockhurst 14/04/04

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

CARE HOMES FOR OLDER PEOPLE Brockhurst Brox Road Ottershaw Surrey KT16 0HQ Lead Inspector Helen Dickens Announced Inspection 20th September 2005 10:00 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 Brockhurst DS0000033514.V252417.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 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. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brockhurst Address Brox Road Ottershaw Surrey KT16 0HQ 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) 01932 872635 01932 872862 Surrey County Council - Adults & Community Care Mrs Tina Marie Davis Care Home 46 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (32), of places Sensory impairment (1) Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Intermediate Care may only be provided in Aster Unit for up to a maximum of 4 Service Users Camellia and Carnation Units will be used solely by Service Users who require Dementia Care. Accommodation and Services may be provided to named persons aged 60 - 65 years with the prior written agreement of the NCSC. Respite Care may be provided to a maximum of 5 persons at any one time, these persons should be grouped into the same unit. A maximum of 6 Services Users with Dementia may be cared for in other parts of this Home. 18/04/05 Date of last inspection Brief Description of the Service: Brockhurst provides care and accommodation for older people over the age of 65. It was purpose built in the 1970s and is owned and managed by Surrey County Council. It is located in Ottershaw, near Addlestone, in a quiet residential area, close to local amenities. Accommodation is arranged in seven units on two floors, all rooms being single. Each unit has its own bathroom and toilet facilities, a kitchenette, and a communal lounge/dining area. The reception area, main kitchen and laundry are on the ground floor and there are offices on both floors. There is a lift and stairs to the first floor. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over seven and a half hours and was the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. The inspection was carried out by the Lead Inspector for the service, Helen Dickens. Regulation Manager Raj Gokhool was present until 2pm. Tina Davis, Registered Manager, represented the establishment. Doug Ettridge, Service Manager for Adults and Community Care in Runnymede, joined the inspection briefly during the morning. A tour of the premises took place. Four residents and two members of staff were interviewed and the inspector met most of the other residents during the day. Files and documents were examined including 4 care plans. In addition, a pre-inspection questionnaire and 25 comment cards (from residents, relatives and professionals) where also used in writing this report. This was a positive inspection. The inspector would like to thank residents, relatives and the staff for their time, assistance and hospitality. What the service does well: The service continues to improve and offers a homely and pleasant environment to its residents. Both on the day of the inspection, and in the comment cards returned beforehand, residents were complimentary about the home and its staff. One resident said she is ‘Happy with the people I share my life with.’ Another said her son ‘appreciates all the tender, loving care given to his Mum.’ Staff were enthusiastic about their work and knowledgeable about resident’s needs. One senior staff member said she loved working at Brockhurst. Staff were commended in the independent audit of dementia care, for the way they were providing dementia care services in the two specialist units. The intermediate care unit, assisting temporary residents back to independence, was also commended by those who were having rehabilitation there. Brockhurst has a very enthusiastic activities co-ordinator who involves the care staff in the provision of activities; this means residents can enjoy assisted leisure opportunities, even when the co-ordinator is not on duty. The chef works hard to provide a high standard of cuisine for residents at Brockhurst. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Though care plans and risk assessments have improved, there is more work to be done to ensure these are fully completed and regularly reviewed. There are still a high number of falls at Brockhurst, including unwitnessed falls. This was discussed with the registered manager and the service manager and a number of suggestions were made and agreed. The registered manager was also asked to use the Residential Forum matrix to calculate staff to resident ratios. There was no up to date Surrey vulnerable adults policy in the home on the day of the inspection and this needs to be acquired and cascaded to staff. A number of complaints, including a vulnerable adults issue, have been raised since the last inspection and this is detailed later in the report. The fridge temperatures on individual units were being monitored but some were significantly outside the recommended range. There were a number of minor maintenance issues on the day of the inspection and requirements will be made in this regard. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 7 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. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 8 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 Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 1,3,4 and 6 Prospective residents have the information they need about Brockhurst to make an informed choice about whether this home would be suitable for them. Resident’s assessments provide a good overview of their needs. The success rate in the intermediate care unit is good and ensures residents will have the opportunity to maximise their independence and return home. EVIDENCE: The statement of purpose and service users guide provide the necessary information to prospective residents. They include an outline of the premises, the ethos of the home, the care services provided, an outline of the staff and management structure and information about meals and mealtimes. There is also an outline of the social activities available. Section 5 of the statement of purpose contains details of the complaints procedure; details of the local CSCI office and its role in complaints should be included. Assessments examined showed a good overview of resident’s needs. Conversations with the registered manager highlighted that the home have refused to admit some residents until up to date and thorough assessment Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 10 documentation is available from the community. In addition, the home carries out its own assessment prior to admission. Residents admitted for intermediate care are in dedicated accommodation with specialist facilities and staff. In addition to specialist rehabilitation staff, staff from Brockhurst who work in the unit have had one weeks training both at the hospital and in the community, with physiotherapists and occupational therapists. Six weeks rehabilitation is offered and progress is reviewed on a fortnightly basis. This is not a shortcut for entry into a long-term bed at Brockhurst and those residents who do not benefit from the rehabilitative programme may need to return to hospital for further assessment of their needs. The registered manager said there was an 85 success rate on the unit. One of the residents interviewed told the inspector he was happy with the progress he had made. Another highlighted an issue about the weekend staff ‘who don’t know where anything is’ and this was raised with the registered manager. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 7,8, and 10 Resident’s health and social care needs are well met at Brockhurst but further work needs to be done to ensure the safety of residents. EVIDENCE: Care plans and risk assessments have improved since the last inspection. The format has been revised and there is more evidence that staff are coping with the administrative tasks involved in maintaining these. The needs and wishes of residents are now more likely to be properly identified and met. However, more work needs to be done to make sure these plans are completed in full, and kept up to date. Residents at Brockhurst appear to be well cared for and records show the input from community health professionals. The registered manager has worked hard to build up good relations with local G.P practices and has started to have regular meetings with one practice on a variety of issues which will benefit residents. Though generally the health and social care needs of residents are well met in this home, there are still a high number of falls recorded at Brockhurst and this is discussed under health and safety. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 12 The inspector observed that residents were treated with respect by staff and no negative issues were raised by residents on this matter. Indeed one resident did make a written comment before the inspection that the staff and manager at the home always treated her with respect. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 Brockhurst works hard to identify and meet resident’s social and recreational interests. The residents are given opportunities to exercise choice and control over their lives. The arrangements for meals and mealtimes give residents nutritious meals and a pleasant environment in which to enjoy them. EVIDENCE: The activities co-ordinator was interviewed as part of the inspection and records of her activities were examined; an activities session was also observed. The co-ordinator was extremely enthusiastic and this was commented upon in the independent consultants report on dementia care at the home. Her dog accompanied her during activities and provided a good opportunity for residents to have some interaction and diversion with a very well behaved pet. There were good records of the daily activities, and who took part, and anything noteworthy regarding each resident’s participation was also noted. This was transferred to individual residents care records to make sure care staff were kept up to date. The care staff were involved in the provision of activities and continued with certain activities in the absence of the coordinator. Resident’s comments on activities were rather mixed and some felt there were not enough appropriate activities. The registered manager and the Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 14 activities organiser are keeping activities under review and appreciate the difficulties of providing activities for residents with such diverse needs. An interesting range of activities were currently being provided and included arts and crafts, storytelling and mythology, quizzes, and a large screen TV for matinee afternoons. Special events (as requested by residents) included Irish coffee to accompany some Irish dancing, and shopping expeditions. The coordinator said she needed a proper ‘craft’ table, as opposed to the dining table they were currently using, and this was highlighted to the registered manager. The chef at Brockhurst is also very enthusiastic and committed to giving a high standard of service to residents. Home cooked food including carefully prepared (i.e. steamed) fresh vegetables and home made chicken pie were on the menu on the day of the inspection. Homemade puddings are also served and the marmalade and butter pudding was said to be particularly popular. There were two alternatives for the main meal each day, with salad or omelette as additional alternatives. Special diets were catered for and the chef was particularly knowledgeable on catering for diabetics. The standard of cleanliness and record keeping in the kitchen was very good. Again, there was a mixed reaction about food from a few residents and this was raised with the chef and the registered manager. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints and protection are taken seriously at Brockhurst but further work needs to be done meet these standards in full. EVIDENCE: Seven written commendations have been received since the last inspection but also three complaints, one of which was reported anonymously to CSCI. This was discussed with the registered manager and suggestions made about dealing with anonymous complaints in the future. The issues raised were dealt with satisfactorily and CSCI required no further investigation. One complaint which should have been resolved and responded to some time ago, is still outstanding and the registered manager was reminded of the importance of dealing with issues within the home’s own published timeframe. A vulnerable adults issue had been raised since the last inspection and investigations were ongoing. So far the investigation has been carried out in a satisfactory manner and is likely to be resolved in the near future. The way this has been dealt with should reassure residents that such issues are taken seriously and dealt with appropriately. However, on the day of the inspection there was no copy of the 2005 Surrey multi-agency procedures for the protection of vulnerable adults in the home. The inspector asked for the procedure to be acquired and cascaded to staff. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 The residents at Brockhurst live in a homely and well-maintained environment, which is clean, pleasant and hygienic. EVIDENCE: The environment has improved since the last inspection and a number of decorative improvements in bedrooms and some communal areas have added to the homely ambience of Brockhurst. New curtains had been fitted in several rooms including in one of the lounges and residents had chosen these themselves. Some residents commented favourably on their surroundings, one gentleman saying ‘it is a lovely place.’ A few outstanding maintenance issues needed attention including two missing light fittings in the hallways, a bedroom with damaged walls needed decoration, a loose hand basin fitting needed repair, and a small area of the garden looked rather neglected and needed attention. One bathroom, currently not used, needed cleaning and minor decoration. Some of the fluorescent light fittings needed cleaning as flies and debris had accumulated within them. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 17 On the day of the inspection the home was clean and hygienic and free from offensive odours. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 and 29 Staff numbers and skill mix have been calculated to meet residents needs. Recruitment practices protect residents. EVIDENCE: The staff to resident ratios have been calculated to meet resident’s assessed needs. Staff duty rotas were examined as part of the pre-inspection information required from the home. However, the number of staff should be calculated using the Residential Forum matrix and this needs to be kept under review especially in the light of the number of falls currently recorded at the home. The number of staff likely to have completed NVQ 2 or above by the end of 2005 is likely to be in excess of the 50 required to meet this standard. Responsibility for recruitment practices and activities at the home are shared with Surrey County Council in that job descriptions and CRBs are handled centrally. The registered manager sends out the recruitment packs and interviews candidates. CRBs are always taken up and gaps in work histories explored. Recruitment policies, including equal opportunities, are devised centrally. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36 and 38 Brockhurst is well managed and residents benefit from the ethos and leadership approach of the home. Supervision of staff is now more regular and this ensures staff are well supported to care for residents. Some health and safety issues need further work in order to safeguard residents. EVIDENCE: The registered manager at Brockhurst is competent and very experienced in the management of care homes. She undertakes training herself and she and the senior staff are very knowledgeable about the health and social care needs of the residents. There is an open approach and a homely atmosphere at Brockhurst and both staff and residents have a say in the day-to-day running of the home. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 20 There are a number of quality assurance tools used at the home including questionnaires in the service users guide, and regular residents meetings. Staff also meet regularly and have the opportunity to comment on quality assurance issues. Regulation 26 visits are carried out on a monthly basis. The in-house quality assurance audit, usually carried out on an annual basis, is behind schedule and this needs to be addressed. Residents mainly looked after their own money and the policies of the home protect the financial interests of residents. Moving on to health and safety matters, the inspectors have previously requested that all incidents or events which impact negatively on the wellbeing of residents should be reported to CSCI on Regulation 37 notices. The home’s staff have coped with this well and a good picture of these events has been formed. However, in order to move this forward, the inspector has asked that from now on staff should use their own professional judgement regarding which notices should be sent to CSCI. At the same time, a record of any falls, witnessed or unwitnessed, and irrespective of whether residents sustained any injuries, should be kept. The registered manager suggested sending this to CSCI on a monthly basis. As a small number of residents seem to be having more than the average number of falls, the home needs to concentrate specifically on their needs. Another falls audit must be carried out to review the situation and allow comparison with the previous audit last year. A recent audit by ‘Dementia Care Matters’ showed Brockhurst had improved their positive communication with dementia residents, but the focus was on social interaction, not specifically the environment. Further specialist advice on the environment may shed further light on the issue of falls, particularly on the dementia units. The administration of medicines was not assessed at this inspection but it was noted that there are now fewer medication errors than during the first part of the year. Window restrictors were in place at upstairs windows, and the inspector found hazardous substances cupboards were locked. Assisted baths and hoists had been regularly safety checked and serviced. Some issues needed attention including one window restrictor upstairs needed repair, and fridge temperatures on the individual units showed fluctuations way in excess of recommended safe limits. In the interests of food safety, these appliances need to be maintained in good working order and operating at safe temperatures, or they should be replaced. On the day of the inspection water temperatures were within 43C but the monitoring sheets showed that this was not always the case. The registered Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 21 manager said that the pipe work and water pressures were currently being reviewed in order to rectify the ongoing problems. One resident’s commode was being used as a table and a number of items placed on it, including an electric lamp. The registered manager said she would look into why this had happened. The Environmental Health Inspection of the main kitchen was favourable, and the inspector suggested the EHO be approached to advise on the home more generally. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 3 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x 3 3 x 2 Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 23 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 15(1) Requirement The work on completing care plans and risk assessments must continue until all residents have a fully completed and up to date plan of care. Complaints must be investigated and responded to within the set timescales. The home must obtain the February 2005 Surrey multiagency procedures for the protection of vulnerable adults. The policy must be cascaded down to all staff. The following maintenance issues must be rectified: replacement of the 2 missing light fittings; fluorescent light fittings to be cleaned; the fitting under one sink needed repair; ground floor bathroom to be cleaned; grass to be cut as outlined in the report. The Council’s internal quality assurance processes must be restarted within a reasonable time frame. The registered manager must DS0000033514.V252417.R01.S.doc Timescale for action 20/11/05 2 3 OP16 OP18 22(4) 13(6) 20/10/05 20/11/05 4 OP19 23(2)(b) (d) 20/11/05 5 OP33 24(1)(a) 20/11/05 6 OP38 13(4)(a) 20/11/05 Page 24 Brockhurst Version 5.0 (b)(c) arrange a falls audit and act on any recommendations, which result. The home should also consider specialist advice on the environment as outlined in the final section of this report. The faulty window restrictor must be repaired, and fridge temperatures must be maintained within safe limits. 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 OP15 OP27 Good Practice Recommendations The chef should continue with the training of staff on each unit with regard to food handling and the hot trolley service. The registered manager should use the Residential Forum matrix to calculate staff to resident ratios. Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Brockhurst DS0000033514.V252417.R01.S.doc Version 5.0 Page 26 - 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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