Inspection on 07/03/07 for Brookfields

This inspection was carried out on 7th March 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brookfields 20/12/05

Brookfields 13/07/05

Brookfields 22/03/05

Brookfields 19/10/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Brookfields 81 Dogkennel Lane Oldbury West Midlands B69 9LZ Lead Inspector Ms Linda Elsaleh Key Unannounced Inspection 7th March 2007 10:00 Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 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 Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brookfields Address 81 Dogkennel Lane Oldbury West Midlands B69 9LZ 0121 544 6715 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) Milbury Care Services Limited Vacant Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: `Brookfields` is a converted and extended residential dwelling owned by Milbury Care Services. The property is two storey with residents accommodated on the ground floor only, the first floor is used for meetings and office space, and it also provides the laundry area and staff toilet. The home provides nursing care for up to 6 persons with a learning and physical disability. Aids and adaptations are provided which meet the assessed needs of the service users. The home is located in a quiet residential area of Oldbury, with local shops-amenities a short distance away. There is limited off road parking to the front of the house with a large spacious garden to the rear. Each of the rooms is single occupancy, and a communal lounge, dining kitchen and activity area are available. The home does not offer en-suite facilities. Overall the home is decorated and maintained to a good standard. Service users are enabled to participate in a wide range of `in -house` and community based social and recreational pursuits, plus a healthcare programme, which utilises various resources within the local area. The home has its own wheelchair-adapted vehicle. The fee for this service is £1108.84 per week. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 7th March 2007. The purpose was to assess the home’s performance against the key standards in the National Minimum Standards for Care Homes for Adults (18-65) and report on the progress made to address requirements made at the previous inspection. The inspection process included information received about the home, comments received from relatives, discussions with staff, observations of care practices and examination of relevant documentation and records. Since the last inspection the registered manager and a number of staff have left. An acting manager has been appointed to carry on the day-to-day running of the home. Two of the three requirements made at the last inspection have been addressed. Six requirements have been made following this visit. What the service does well: What has improved since the last inspection? The National Vocational Qualification Level 2, or above, is held by the majority of the staff team exceeding the 50 target set in the National Minimum Standards. The acting manager has implemented a team development programme to ensure care needs are met in a flexible, yet consistent manner. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 6 Mealtimes continue to be a social event. The home has revised it menus to provide service users with more nutritious, varied and balanced meals. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 Quality in this outcome area is good. Information about the service is available for prospective service users and their representatives. The current fees and any additional charges need to be included in the individual service users contract/statement of terms & conditions. The home has a system in place for assessing the needs and aspirations of prospective service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a recently reviewed its Statement of Purpose and Service User Guide. Copies of these documents have been provided to the Commission for Social Care Inspection (CSCI). The Service User Guide is available to service users and includes the use of pictures and/or symbols. A copy of the “Service Agreement” is available on each service users files. The information needs to be reviewed to reflect the current fee and include all additional charges to be paid by/on behalf of the service user, such as Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 9 payments towards the running cost of the home’s vehicle and holidays arranged by the home. The manager is referred to the specifications detailed in Standard 5 of the National Minimum Standards. The home has been fully occupied since the last inspection. Current service users files contain details of assessments carried out prior to their admission. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Quality in this outcome area is good. Service users care needs and personal preferences are detailed in their individual care plans and are regularly reviewed. They are supported to make their own decisions and to take responsible risks. Limited records are available of decisions made on a service user’s behalf. Generally, the service users records are appropriately and securely stored. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual care plans and risk assessments are available on the service users files. Detailed information is provided with regards to the individual’s personal and health care needs and the action to be taken by care staff. However, limited information is available of arrangements for managing medication and personal allowances on behalf of the service users. The home is in the process of reviewing its care plan formats and re-organising how this information is Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 11 presented. The majority of service users records are securely stored to ensure confidentiality is maintained. Appropriate arrangements must also be made for storing records accessed by staff on a daily basis. The files contain evidence to show service users are consulted about their individual likes, dislikes and personal preferences and are reviewed regularly. The home is evaluating its consultation process and has identified areas where improvements can be made. The inspector observed staff encouraging and supporting service users to make every day choices; such as what they would like to eat and what activities they wish to participate in. The nurse in charge stated decisions are made on behalf of some service users. For example, the home made the decision to include a service user in the forthcoming holiday. A comprehensive process for making this decision was described to the inspector, but not been included in the service user’s records. The home needs to ensure a record is kept of any instances when decisions are made on behalf of service users, and why. The home has good processes for identifying, assessing and managing risks and risk-taking. Comprehensive risk assessments are contained in the service users care plans. The information provided details the level of any potential risk; action to be taken by staff and the date the risk assessment was last reviewed. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Service users preferred routines are respected and they are assisted by staff to access local facilities and participate in a wide range of activities. They are supported in maintaining contact with family and friends and in developing new relationships. Service users are provided with a healthy and nutritious meals and mealtimes are pleasant and social occasions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users have an individual plan for daily living. They are assisted to take part in the activities they enjoy and helped to develop new interests and individual skills. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 13 Opportunities are available for service users to participate in shared activities, such as the music session taking place during this visit. Each activity is assessed against the service user’s preferences and feelings on the day. Activities for the day are modified or changed, where applicable, to ensure the service users are provided with a positive experience. Activity plans are regularly reviewed to ensure they continue to meet the service user’s needs and personal preferences. Discussions held with staff and observations made during this visit confirm that staff recognise the need to apply a flexible approach in respect of identified routines. Outdoor leisure activities include swimming and trips to the cinema. Staff are familiar with the local amenities and provide service users with support to access these. The home has its own transport that accommodates wheelchair users and ambulant passengers. Individual outings and group trips are also arranged and include shopping and pub lunches. As previously mentioned, the home also arranges short breaks and holidays. Service users are supported to maintain links with family and friends. Visitors are welcomed into the home at any reasonable time. Visits take place in the communal lounge, dining/activity area, the garden area, or service users bedrooms. The home continues to maintain a good relationship, with neighbours/the locality, and the property is in keeping with the local area. Care staff are responsible for carrying out all household tasks. The inspector observed service users participating at various levels in preparing the mid-day meal. The menu for the day is displayed in the dining area of kitchen. Service users are encouraged to consider the benefits of healthy eating and there is plenty of fresh vegetables, fruit and fruit drinks available in the home. Drinks and snacks are provided throughout the day. The inspector is informed that service users have benefited from recent improvements made to menus and cooking methods. During the mid-day meal service users and staff sat together in the dining area and support was provided where required. There was a social and inclusive atmosphere throughout the meal. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21 Quality in this outcome area is good. Service users receive personal and health care support in accordance with their care plans and in a way that meets their individual preferences. Service users are protected by the home’s policies, procedures and practices in the safe handling and administration of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users are registered with a local general practitioner and are supported by staff to visit the surgery for consultations and routine check ups. Records of all healthcare appointments are detailed in the service users files. Healthcare risk assessments are available and reviewed regularly. A physiotherapist was visiting the home to carry out a re-assessment of need with a service user. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 15 The service user’s right to privacy is observed when personal care is being provided. Staff have a good awareness of the service users individual needs, how these are to be met and their preferred routine. The inspector was informed a Living Skills Assessment programme was being piloted with a view to improving the support provided to service users in maintaining and developing their independence. The home has procedures for the safe handling and administration and suitable storage facilities are provided. The manager and nursing staff are responsible for all aspects of managing medication. Medication has recently been reviewed with the local GP. The nurse in charge stated that following changes in the home’s arrangements for meeting dietary needs, the service users GP no longer prescribes some medication. There is evidence on the medication administration records to support this. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. The home has suitable procedures for managing concerns raised by service users and/or their representatives. Service users are safeguarded from physical and emotional abuse by suitably trained staff. A review of policy and practice in respect of the management of service users finances will ensure their interests are fully protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One concern has been raised with the home and is being dealt with under the home’s complaints procedure. This procedure is referred to in the Statement of Purpose and more detailed information is included in the Service User Guide. The home has relevant procedures for safeguarding and protecting service users. The records show adult abuse training has been provided to staff. As referred to earlier in this report, the files examined show three service users have paid/made additional contributions to services provided by the home. These are not identified in the individual’s contract/statement of terms of conditions. This needs to be addressed to ensure the service users interests are fully protected. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. Service users live in a homely, comfortable environment. Some remedial work needs to be addressed to ensure these good standards are maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment continues to be maintained to a good standard. The furniture and fittings are domestic in style, homely and comfortable. The reception area is welcoming with information about the home and a pay phone. Visitors are asked to sign the visitor’s book on their arrival and departure. The inspector was informed one service user is able to communicate by telephone and prefers to use the home’s handset. A tour of the premises found all rooms to be clean, tidy and free offensive odour. Each service user has their own bedroom decorated and furnished to Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 18 meet individual preferences. equipment. Three bedrooms are fitted with sensory Bathrooms have appropriate aids and hoists and are pleasantly decorated to provide a relaxing atmosphere. Separate toilets are also available. The locks fitted to some of the doors do not work properly and need to be repaired or replaced. An office, training room and laundry are located on the first floor. A passenger lift is not provided and therefore the majority of service users are unable to access this floor. The laundry is appropriately equipped. However, as identified at the previous inspection, the wall finishes need to be easy to clean. Written procedures are available at the home for infection control, continence promotion, substances hazardous to health and disposal of clinical waste. There is a rear garden accessible to service users. Arrangements need to be made to repair or replace the damaged slabs. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. Service users safety and welfare is protected by the home’s recruitment policies. A competent and qualified staff team, the majority of whom hold a nationally recognised professional qualification, cares for and provides support to service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A minimum of one nurse is on duty at all times. Three care workers are on duty during the day and one at night. The inspector was informed the home has suitable procedures for managing staff absences. At the time of the assistant home leader was making arrangements for a bank/agency worker cover for the absence of a support worker. Since the last inspection six staff have left the service and replaced by an assistant home leader (who is a qualified nurse) and four care staff. have been appointed and commenced . The files examined contain appropriate recruitment details including satisfactory Criminal Record Bureau (CRB) checks Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 20 and references. A copy of the individual’s employment contract and terms and condition are also available. The current staff team comprises of an acting manager, seven assistant home leaders and ten support care workers. The manager and assistants are all trained nurses and are qualified and/or experienced in working with people with learning disabilities or mental health issues. The National Vocational Qualification (NVQ) Level 2 is held by five of the care workers. Six are in the process of completing the Learning Disability Accredited Framework (LDAF) training. Individual staff records show most staff have attended other training courses within the last two years; such as first aid, basic food hygiene, health & safety, manual handling and fire safety. A training schedule is displayed on the wall in the office. Dates have also been planned for team training and development. A recently appointed member of staff stated she had been provided with induction booklets for the company and the home. Newly appointed workers are allocated a mentor to support them throughout their induction period. Staff commented positively on this process. The inspector was informed the manager operates an ‘open door’ policy and staff confirmed the manager is available to discuss any concerns or queries they may have. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. Service users benefit from a well run home. The home’s policies and systems promote and protect their health, safety and welfare. The home is in the process of consulting with service users and/or their representatives to ensure individual needs continue to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is going through a period of change. Since the last inspection the registered manager has transferred to another service within the company. An acting manager, who is suitably qualified and experienced, is carrying out the day-to-day running of the home. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 22 Records are available of the routine servicing and maintenance checks carried out on equipment and appliances. Regular tests are carried out on the fire alarm system and fire safety training has been provided. Regular meetings are taking place with staff to discuss practices and identify the training and development needs of the team. A detailed examination of the home’s quality assurance systems will be carried out and commented on at the home’s next key inspection. At the last inspection it was recommended that the home would benefit from access to e-mail and web site facilities to assist with communication and researching current guidance and good practice. The inspector was informed it is hoped this provision would be available in the near future. An application for the registration of a manager has yet to be forwarded to the Commission for Social Care Inspection (CSCI) – Central Registration Team. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 2 X Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA5 Regulation 5 Requirement Current fees and any additional charges must be included the service user’s contract/statement of terms & conditions. Arrangements for managing medication and personal allowance on a service user’s behalf must be detailed in the care plan. A record must be kept of any decision made on a service user’s behalf, and why. All service users information must be securely stored. Privacy locks in bathrooms and toilet must be repaired/replaced. Slabs in the rear garden must be repaired/replaced. The laundry room floor finishes must be impermeable and these and wall finishes need to be readily cleanable. (This is an outstanding requirement from 30/04/06). 7. YA37 8 A manager’s registration application must be forwarded to CSCI. DS0000004823.V329734.R01.S.doc Timescale for action 02/07/07 2. YA6 15 02/07/07 3. 4. 5. YA7 YA10 YA24 12 17 23 04/06/07 04/06/07 02/07/07 6. YA30 23 01/08/07 02/07/07 Brookfields Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 6. Refer to Standard YA41 Good Practice Recommendations It is recommended that the home is enabled to access and use e-mail and web site facilities to assist with communication and researching current good practice and guidance. Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brookfields DS0000004823.V329734.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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