Inspection on 23/11/05 for Brook Care Home

This inspection was carried out on 23rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Brook Care Home 18/06/07

Brook Care Home 06/06/06

Brook Care Home 02/06/05

Brook Care Home 07/02/05

Brook Care Home 16/04/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Brook Care Home 17 Brook Close Rochford Essex SS4 1HN Lead Inspector Mrs Nikki Gibson Unannounced Inspection 23rd November 2005 09:30 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 Brook Care Home DS0000018074.V267969.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. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brook Care Home Address 17 Brook Close Rochford Essex SS4 1HN 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) 01702 549499 01702 549499 Mrs Vijay Luxmi Rattan Care Home 20 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (20), Mental disorder, excluding learning of places disability or dementia (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (20) Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Personal care to be provided to no more than 20 service users with dementia over the age of 65 years. Personal care to be provided to no more than 20 service users with a mental disorder, excluding learning disability, over the age of 65 years. Personal care to be provided to no more than 20 service users with dementia over the age of 55 years. Personal care to be provided to no more than 20 service users with a mental disorder, excluding learning disability, over the age of 55 years. Total number of service users accommodated not to exceed 20. (Total number 20). 2nd June 2005 Date of last inspection Brief Description of the Service: Brook Care Home is registered to provide care and accommodation for up to twenty people over the age of 55 years who have dementia or a mental health disorder. The premises were purpose built and have been extended in recent years. Accommodation is provided on two floors and access is provided to all areas via stairs and passenger lift. There are ten single and two double rooms with en-suite facilities; there are an additional three double rooms without ensuite facilities. There are separate lounge, visitors room and dining room. There is a spacious conservatory, which is used by residents and staff who wish to smoke and there is a large garden. Brook Care Home is situated on a bus route near to the centre of Rochford and it is half a mile from the railway station. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which lasted seven and a half hours. During the inspection there was a tour of the premises and records and documents were looked at. Time was spent in the lounge and conservatory and with residents in their own rooms. Six residents were spoken to about life at Brook Care Home. Two visitors, the acting manager and five members of staff were also spoken with. The staff, and residents were most helpful and this was greatly appreciated. Discussion of the inspection findings took place with the acting manager during the inspection and guidance and advice was given. The Home is going through an unsettled period. The acting manager who was working to make improvements in the home has tended her resignation. An allegation was made in June 2005 that there was an unacceptable time delay by care staff in obtaining medical assistance and two residents had not received appropriate care. This was fully investigated and upheld. In her action plan the proprietor stated, “I am committed to improving the standard of care provided to all service users and to move forward. The health and welfare of each service user is paramount and this will continue to be the case.” What the service does well: What has improved since the last inspection? Staffing levels have been reviewed and staff working in the kitchen in the morning and afternoon are not included in the care staffing level. Locks are gradually being fitted to doors so that residents have the choice of privacy if they wish. Although not served on the day of inspection fresh vegetables were in the storeroom. Some redecoration has taken place. Adequate facilities for washing and drying hands are available in all but one bathroom. Staff moral was good and staff spoke well of the new acting manager. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 6 The range of activities on offer to the residents is developing and all staff are involved Staff contact the GP or other medical professionals promptly when residents health changes. 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. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 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 Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 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 the following standard(s): 3, 4, 6 The home is going through an unsettled period and actions to improve standards have been slow to take place and putting residents at continued risk. EVIDENCE: A recent Protection of Vulnerable Adults investigation has highlighted areas of concern in the home and local authorities have for the time being suspended future placements, until there is reassurance that residents needs can be met. The home is registered to care for people from the age of 55 years with dementia or mental disorder. This is a very specialised and challenging field of care, which requires considerable outside support, which the home needs to obtain. Some residents are also physically frail or in poor health and again staff need more training and skills to provide the required level of care and support. Brook Care Home does not provide intermediate care Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 9 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, 9, 10, 11 When studied in detail as part of a POVA investigation Care Plans were found not to provide an accurate account of the residents needs. Concerns raised at the last inspection regarding the management of medication remain outstanding. EVIDENCE: The home acknowledged during the POVA investigation that the writing of care plans had become a repetitive exercise and was not a true reflection of the residents present needs or wishes. Work had begun to review all the care plans. The acting manager said that two care plans had almost been completed and these were studied. Care must be taken to ensure that this is not a paper exercise of just rewriting the care plans. Relatives and residents need to be involved in the drawing up of the care plan and in the monthly reviews. One placing authority following a visit to the home in August 05 wrote to the acting manager with concerns, questions and advice and to date has not received a response. A meeting has therefore been arranged by local authority with the proprietor to discuss their concerns. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 10 There should be care plans, which deal specifically with residents’ mental health needs. There should be guidance for staff on triggers to ill health and the actions to be taken. The home needs to monitor residents’ wellbeing and obtain support from the community mental health team when changes in a resident are noted. Medication was observed to be administered correctly and the residents were observed taking their medication before the Medication Administration Record (MAR) sheet was signed. Other shortfalls raised at the last inspection regarding medication had not been addressed. Patient information leaflets were not available for all medications. Where there was a choice of one or two tablets the number given was not recorded. There were no protocols for medication that was prescribed ‘as and when required’ (PRN). The staff giving out medication were not aware of the Royal Pharmaceutical Society of Great Britain guidelines for ‘The Administration and Control of Medicines in Care Homes and Children’s Services’. A copy can be obtained by contacting 0207 572 2409 or e-mailing ifearon@rpsgb.org.uk The content must be known to staff and the good practice followed to reduce the risk of errors occurring. During the visit staff were observing treating residents with courtesy and respect. A member of domestic staff was observed knocking and waiting to be invited into a bedroom. The bell of the residents’ telephone in the hallway cannot be heard by the residents in the lounge. If staff hear it they inform the residents, an extension bell would resolve this problem. The small quiet lounge which doubles as a visitor’s room is now also used as an office. This is inappropriate as confidential information about residents is filed on open shelves. The release button for the locked front door is also in this room. When being used by visitors, for medical treatments or reviews by social workers, the meetings have to be interrupted when anyone wants to come into or out of the building. Staff said that there was no override at the front door and in an emergency they could not open the front door without going back to the visitors room. This is unsatisfactory and must be addressed as a matter of urgency. A recent event in the home which lead to an investigation indicates that the home and staff need to give greater thought to the needs of residents who are in failing health to ensure they get appropriate attention and pain relief. Changing needs of residents must be reviewed and recorded and staff must be fully aware of these changes. The acting manager said that since the investigation staff refer residents to the GP promptly and if in doubt seek other medical advice. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 11 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, 13, 14, 15 The range of social activities is improving which will benefit the residents. Facilities for visitors have deteriorated and residents’ confidentiality is being compromised. Residents need greater assistance to make choices and maintain control over their lives. An adequate choice at most meal times is being provided. EVIDENCE: A new and experienced member of staff is introducing a wider range of activities and she is supported by other care staff. The activities described were wider ranging than previously and included cooking, art and craft, chair exercises and monthly special evenings. On the day of the inspection Bingo was seen to take place. Visitors to the home said that they were made to feel welcome. One resident said that he had made contact with a local church who had made him very welcome. Some residents felt that they had very limited choices and the acting manager said she would talk to staff about this. One resident said he was not allowed out of the building and had to get up and go to bed when instructed. Another said they felt rushed at meal times and there was no choice if ‘late’ for Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 12 breakfast. These may have been real or imagined restrictions and it is important that the ethos of the home promotes choice and autonomy. Staff need to be aware and sensitive to residents views and take action if mental health issues change. Residents were generally positive about the meals provided. The cook left several months ago and care staff have covered as a temporary measure. On the day of inspection all the vegetables were frozen although there were some fresh vegetables in the food store. Residents said that breakfast was cereal and toast and fruit or fruit juice was not an option. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 13 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): 18 Staff were aware of the correct procedure to follow after any allegation of abuse, but had difficulty locating the written policy. EVIDENCE: A recent allegation of abuse was poorly managed. Meetings were held with the proprietor and the level of detail to be included in the action plan was discussed. A timescale for submitting the action plan was also agreed. Due to unforeseen circumstances the dead line was over run, and when the action plan was received it did not fully cover all the areas to be improved in adequate detail. At this inspection it was noted that some progress had been made such as improved staffing levels, however staff recruitment and training remained poor. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 14 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, 20, 21, 24, 26 The home struggles to maintain a homely environment and some areas are worn and poorly lit. EVIDENCE: Brook Care Home is conveniently situated and in keeping with houses in the locality. The porch door was damaged and other areas of poor maintenance all detracted from the homely feel of the place. The privacy curtains in one room were hanging loose and a number of tiles were missing in one bathroom. A maintenance person was busy throughout the inspection, however it is hoped that standards will improve. There was a large patio and lawn area for use by the residents. Some areas of the home were poorly lit. Staff agreed the lighting in the dining room made the dispensing of medication and the reading on Medication Administration Records difficult. Improved lighting such as appropriately placed standard lamps would be beneficial for residents and staff and improve the homely atmosphere. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 15 Sufficient numbers of bathrooms and toilets are positioned close to communal areas Individual bedrooms were clean and personalised to varying degrees. Appropriate locks have not been fitted to all bedroom doors. One resident who holds the key to his room was very pleased to have this level of privacy provided. There are plans for all bedroom doors to be fitted with appropriate locks. Work on the boiler has taken place and at the time of the inspection the home was comfortably warm. Since the last inspection paper towels and liquid soap had been provided in some bathrooms, however a communal terry towel was still in place in one bathroom and remained a source of possible spread of infection. Liquid soap was missing from a first floor bathroom. A number of toiletries, some old and dusty were noted in one bathroom were seen in a bathroom. The laundry was seen to be clean and tidy and residents said that they were pleased with the laundry service. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 16 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, 29 Staff shortages have been addressed and residents feel more reassured and relaxed. Staff training is increasing although gaps remain. Poor recruitment practice continues and this could puts residents at risk. EVIDENCE: Four weeks rosters were studied and an improved staffing level was noted. Concern has been raised at previous inspections that staffing levels were inadequate for the needs of the residents. It was pleasing to be told that this has now been addressed. Staff working in the kitchen are in addition to the care staff. The minimum staffing level for the home is: One shift leader or manager plus three care staff 8 am to 9pm. Two awake staff at night one of whom must be a senior. Staffing levels should not be reduced in the afternoon or at weekends. Care staff should not be undertaking domestic or catering duties, which take them away from the care of the residents. The manager needs supernumerary hours to undertake her management duties. Staff should not work excessive hours and trained and experienced agency staff should be used when necessary. A staff-training matrix was studied. This showed big gaps in training that put residents at risk. Only a quarter of staff had NVQ level 2 training. Of the fourteen care staff only 3 had First Aid, only 1 had Health and Safety training, only 1 had Fire Training, only 3 had Infection control training and only 3 had training in the care of residents with dementia. The record showed that one Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 17 member of staff working at night had not received any training. It was said that they refused until they were assured they would not be out of pocket. In recent months the home has accepted more of the training that has been offered and there is an expectation that this will continue. The proprietor stated in her action plan that she was arranging staff training on various topics from outside professional bodies. Training levels will be reviewed at the next inspection Two staff files were inspected and were found to contain very little. They lacked the documentation required by legislation and this included the lack of any references or police checks. Poor recruitment practice put residents at risk and this has been raised with the home on previous occasions. The acting manager produced a blank check list, which will be introduced when interviewing. Also the home was introducing a new Application form, however it did not provide adequate space for detailing previous employment. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 35 The home lacks a registered manager however residents and staff are adjusting to the new management structure and feel positive. EVIDENCE: The acting manager informed the inspector that she would not be applying to register as the manager as she and the deputy were going to serve their notice. They felt that the home was under resourced and they lacked the authority to make all the changes they felt were appropriate. This will be a disappointment to the other staff, residents and proprietor. The home requires a qualified Manager who has experience of this specific client group and advertising and recruitment needs to underway. Staff spoke very positively of the new management style. They said that they felt more involved and enjoyed when tasks were allocated to them. They said that the acting manager was approachable and listen to their views. One Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 19 resident said it had taken time to adjust to the new acting manager but he felt that it was ‘working out well’. The home holds money in safe custody for residents. Some residents receive a limited amount when requested to help them budget. Accounts were not study at this inspection. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 2 11 1 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 1 2 2 3 X x 2 x 2 STAFFING Standard No Score 27 3 28 2 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X 3 X X X Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 21 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 Standard OP7 Regulation 15 Requirement Timescale for action 13/01/06 2 OP8 13(1)(b) 3 OP9 13(2) 4 OP11 12(1) The Registered Provider must ensure that care plans have sufficient detail to provide clear guidance to staff on the actions to be taken to meet the residents health and welfare needs. Care plans must be kept under review with consultation with the resident as to how their needs will be met. The Registered Person must 13/01/06 ensure that service users receive where necessary treatment, advice and other services from any health care professional and changes in mental health are recorded and advice obtained 13/01/06 The Registered Person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. (Previous timescale of 7.7.05 not met) The Registered Person must 13/01/06 ensure that sick and dying residents receive appropriate care DS0000018074.V267969.R01.S.doc Version 5.0 Brook Care Home Page 22 5 OP14 12(2) 6 OP16 17(2) 7 OP18 13(6) 8 OP19 23(2) 9 OP20 23(2) 10 OP26 16(2) 11 OP28 18(1) 12 OP29 19(1) The Registered Person shall as far as is practical enable residents to make decisions with regard to their care, health and welfare. This refers to a choice in daily routines, particularly times of getting up and going to bed. The Registered Person must maintain a record of all complaints and any action taken. (Not inspected, carried forward to the next inspection) The Registered Person must make arrangements to prevent residents from being abused. This refers to taking appropriate action when an allegation has been made and meeting timescale agreed with the CSCI. The Registered Person must ensure that the home is adequately maintained, decorated and furnished. Advice must be taken from the fire service on the suitability of the front door lock The Registered Person must ensure that lighting is suitable and positioned to facilitate reading and other activities. The Registered Person must make arrangements to prevent the spread of infection and ensure satisfactory standards of hygiene. This refers to the provision of liquid soap in all bathrooms. (Previous time scale of 14.03.05 not met) The registered Person must ensure that staff receive training appropriate to the work that they perform The Registered Person must ensure that all staff are fit to work in a care home. This refers to undertaking a DS0000018074.V267969.R01.S.doc 13/01/06 13/01/06 13/01/06 13/01/06 13/01/06 13/01/06 13/01/06 13/01/06 Brook Care Home Version 5.0 Page 23 13 OP31 38 robust recruitment procedure that protects residents and ensuring that all documents required by legislation are available for inspection. (Previous time scale 14.03.05 not met) The Registered Person must 13/01/06 ensure that at all times there are suitably qualified, competent and experienced persons working at the home. This refers to the proposing of a person suitable to be registered to manage the home. (Previous time scale 07.07.05 not met) 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 1. Refer to Standard OP10 OP15 OP24 Good Practice Recommendations Arrangements should be made so that residents can hear their telephone bell. Arrangements should be made for more flexible meal times and a greater supply of fresh fruit and vegetables Suitable bedroom door locks, which suit the capabilities of the residents and can be accessed by staff in an emergency, should be fitted to maintain the privacy and dignity of the residents. Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Brook Care Home DS0000018074.V267969.R01.S.doc Version 5.0 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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