Inspection on 08/12/05 for Burger Court

This inspection was carried out on 8th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Burger Court 21/08/07

Burger Court 05/09/06

Burger Court 13/04/05

Burger Court 11/11/04

Burger Court 14/09/04

Burger Court 17/06/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

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

CARE HOMES FOR OLDER PEOPLE Burger Court 131 Barkerend Road Bradford BD3 9AU Lead Inspector Mary Bentley Unannounced Inspection 8th December 2005 09:45 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 Burger Court DS0000029144.V270172.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. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Burger Court Address 131 Barkerend Road Bradford BD3 9AU 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) 01274 726826 01274 726826 Mr B W Vincent Mrs H M Vincent Mrs Ann Van Lelyveld Care Home 24 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (24), of places Physical disability (4), Physical disability over 65 years of age (4), Terminally ill (4) Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of four places in total to be occupied by PD and PD(E) service users 13th April 2005 Date of last inspection Brief Description of the Service: Burger Court is registered to provide personal and nursing care for up to 24 older people. The home has 18 single and 3 double rooms, privacy screening is provided in the shared rooms. None of the bedrooms have en-suite facilities. The home has two communal bathrooms, one of which is equipped with an assisted bath, and one disabled access shower. Bedrooms are located on three floors and access is provided by means of a passenger lift and a stair lift. There are lounges on the ground and first floor and there is a dining room on the ground floor. It is a converted property situated close to Bradford city centre and is easily accessible by public transport. The home is within easy reach of a number of local amenities including shops and a public house. A small number of car parking places are provided at the front of the building. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections; these may be announced or unannounced. This was the second unannounced inspection of this home; the first inspection was also unannounced and took place in April 2005. There have been no further visits to the home until this unannounced inspection. One inspector carried out the inspection between 9.45am and 4.30pm, before the visit time was spent planning the day. The purpose of this inspection was to assess the home against a predetermined selection of the National Minimum Standards for Older People and to check what progress had been made on meeting the requirements from the last inspection. The home prefers the term “resident” to “service user” therefore that is the terminology that will be used in this report. The methods used in this inspection included discussions with residents, staff and management, observation of daily routines, examination of records, and a partial tour of the home. Comment cards were left at the home for residents and relatives; these cards provide an opportunity for people to share their views of the service with the CSCI. Comments received in this way are shared with the provider without revealing the identity of those completing them. What the service does well: The home provides a clean and comfortable environment and the atmosphere is informal and friendly. The needs of prospective residents are assessed before admission and residents and/or their representatives are encouraged to visit the home before making a decision about admission. Overall the home is good at meeting the health and personal care needs of residents and staff are kind and caring. Residents said they enjoyed the food. It was evident that staff were aware of residents food preferences and took them into account when preparing meals. Two recently appointed staff gave a good account of the induction training they had undertaken when they started work. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: During the inspection in April 2005 concerns were raised about the numbers of staff available throughout the afternoon and evening. The concern was that there were not enough staff available during this time to meet residents’ needs. This inspection found that the staffing arrangements for the afternoon and evening shifts had not improved. Following this inspection a letter was sent to the owner informing him of our concerns and a meeting has been arranged to discuss this matter. Linked to the concerns about staffing levels are concerns about the quality of life experienced by residents in the home, although staff are kind and well intentioned the approach to care is task orientated. This approach limits the opportunities for residents to exercise choice and control over their lives as well as limiting the opportunities to engage in social and leisure activities. The policies and procedures for the safe management of medicines are not consistently followed and this potentially puts residents at risk. Requirements and recommendations have been made about these and other issues identified in the report. Please contact the provider for advice of actions taken in response to this Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Burger Court DS0000029144.V270172.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 Burger Court DS0000029144.V270172.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): 3 The needs of prospective residents are assessed before they move into the home. EVIDENCE: Completed pre-admission assessments were seen in the files looked at however it was not always clear who had carried out the assessment, when it had been done and who had been involved. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Overall the home is good at meeting residents’ health and personal care needs despite some shortfalls in the record keeping. However, improvements are needed to make sure that the psychological and social needs of residents are identified and met. Current practices relating to the storage and administration of medicines place residents at risk. EVIDENCE: The care records of three residents were looked at. Pre-printed care plans are used and the degree to which they are personalised to reflect the needs and preferences of individual residents continues to improve. However there is scope for improvement, for example the care plans relating to sleeping do not include information on peoples’ preferred times for going to bed and getting up. One care plan stated that the resident could be aggressive when disturbed but did not give any information on how staff should deal with this. Two of the three care plans looked at showed evidence of involvement by residents and/or their representatives. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 11 Risk assessments were completed for pressure area care, nutrition, moving and handling and the use of bed rails. Where the risk assessments identified a resident as being at risk, for example of developing pressure sores, care plans were in place. The manager said that none of the residents in the home had a pressure sore. A falls risk assessment had been completed for one resident identified as being at risk in this area. Residents looked clean and well cared for but the recording of personal care is still inconsistent. The records show when residents have had a bath/shower, which is usually once a week, but do not show how personal care needs are met on a daily basis. The daily entries in the care records continue to focus on nursing care given and there was little or no information about how residents spend their time. These points were discussed at the last inspection. The records showed that residents have access to other health and social care professionals as needed. When I arrived at the home the rack of morning medicines, (containing the blister packs with a number of residents’ morning medication) was left unattended on top of the medicine trolley in the dining room. The nurse in charge was elsewhere in the home. A medicine pot containing a number of tablets was left on one of the dining room tables, the nurse was asked about this and then took it and gave the tablets to a resident in the lounge. It was not clear how the nurse was able to be sure those were the right tablets for that resident. The medicine chart showed that the medicine had been signed for before the resident took it, this is not good practice and not in keeping with the NMC (Nursing & Midwifery Council) guidelines on the administration of medicine. The home has a small fridge that is used to store medicines, however is not designed specifically for the storage of medicines. A number of boxes of insulin were found in the main kitchen fridge. The kitchen fridge is not secure and is easily accessible to both staff and residents. The manager said this was because the insulin would not fit in the medicines fridge. With some rearranging it was possible to store the insulin in the locked fridge however this meant that other medicines had to be stored in the kitchen fridge. It is not appropriate to store money/valuables in the medicines cupboard. The manager said that a new system for the safe disposal of medicines, to comply with recent changes in the law, is in place. At the last inspection concern was expressed that the telephone in the dining room was being used to discuss confidential information in the presence of other residents, a cordless telephone has been provided so that telephone calls can be made in private. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 14 For the most part the daily routines are centred on a series of care tasks to be completed rather than on the preferences and expectations of residents. EVIDENCE: The activities organiser had just returned to work following a long period of illness and it was not clear what, if any, arrangements had been made for residents to take part in social and leisure activities during her absence. The activities organiser works 16 hours a week and outside of these hours opportunities for residents to take part in social and leisure activities are limited. A current activities programme was displayed and an entertainer visited the home on the afternoon of the inspection. Social care plans were seen in some of the care records examined but as stated previously the daily records give very little indication of how residents spend their time. Throughout the morning staff were busy attending to physical care needs of both the residents who were up and those who were nursed in bed. Many residents spent their time in the lounges with the television on and their contact with staff was limited to those occasions when they needed physical care. After the entertainer left staff were busy with the evening meal and Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 13 attending to physical care needs and it was evident they had little time for social interaction with residents. The staffing levels on the afternoon and evening shifts are such that there is little opportunity for residents to be encouraged and supported in exercising personal choices. (Further details are provided in the staffing section of this report) Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has the required policies and procedures in place to make sure that complaints’ are dealt with appropriately and that residents are protected from abuse. EVIDENCE: The manager said the home has not received any complaints since the last inspection in April 2005 and no complaints have been made to the CSCI. At the last inspection some relatives said they were unaware of the complaints procedure, the manager said that copies of the Statement of Purpose and Service Users guide are now posted to the relatives of all new residents, these documents include information on the complaints procedure. The local authority Adult Protection procedures are available in the home. The manager is booked to attend Adult Protection training next year, the training is organised by Social Services and focuses on the multi-agency approach to the protection of vulnerable adults. The home has purchased a training video on the subject of abuse and Adult Protection and approximately half of the staff have been trained using the video and a questionnaire. Staff were aware of how to report any concerns they have about the abuse of residents. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 15 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, 21, 22, 26 The environment that residents live in is generally comfortable and safe however some improvements are needed to make sure that standards are maintained. EVIDENCE: The home was clean despite the fact that the vacuum cleaner had been out of action since Tuesday evening, (the inspection was on Thursday), however two vacuum cleaners were provided before the inspection ended. The home does not have a carpet-shampooing machine; the manager said one had been ordered. The kitchen was clean but is in need of refurbishment, most of the cupboards are looking the worse for wear and tear and parts of the work surfaces are badly worn. A number of wall tiles were cracked and the skirting board had come away from the wall in some places. The most recent Environmental Health report showed that standards of cleanliness in the kitchen were satisfactory but recommended improvements to the environment. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 16 There are two domestic type cookers; both are in a poor state of repair and one of the ovens does not work properly. The most recent gas safety check showed the cookers are safe to use but recommended replacement. The home has one assisted bath and a disabled access shower. The seat of the hoist on the assisted bath has an area of rust on the surface making it unpleasant for residents to use. No progress has been made on the plans to refurbish this bathroom. There are two communal toilets on the ground floor however one of these is not suitable for use by residents who need assistance. There is an ongoing programme of redecoration, the ground and first floor corridors have been decorated and new carpets have been fitted. One bedroom has been refurbished since April. At the time of the inspection another room was being upgraded to include an en-suite facility. Four adjustable height beds and two electric profiling beds have been provided; there are plans to provide more adjustable height beds. All but two of the care staff team are currently doing infection control training using a distance-learning package. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 17 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 The staffing numbers on the afternoon and evening shifts are not sufficient to meet residents’ needs. Staff are supported in developing their skills and knowledge. EVIDENCE: At the last inspection in April 2005 concerns were raised about the staffing levels on the afternoon and evening shifts and the situation remains unchanged. The duty roster shows three care assistants on duty until 6.00pm but one of these is allocated to kitchen duties leaving one nurse and two care assistants to provide care to residents throughout the afternoon and evening. The home employs housekeeping staff but they also finish work at 2.00pm leaving care staff to attend to any necessary housekeeping and the laundry. These numbers are not sufficient to meet the needs of residents and do not take account of the layout of the building which has accommodation on three floors. Staff were seen to be kind and caring but they have, of necessity, adopted a task-orientated approach to the delivery of care and this limits the opportunities for residents to exercise personal choice. Relatives who completed a quality assurance questionnaire for the home earlier in the year commented that they were reluctant to approach staff because they were always so busy. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 18 The National Minimum Standards recommend that 50 of care staff should be qualified to NVQ (National Vocational Qualification) level 2 by December 2005, 38 of the care staff at Burger Court are qualified to NVQ level 2 or above and NVQ training is ongoing. The home has purchased a training video on the subject of caring for people with dementia so that this training can be provided in house; four staff completed this training in August 2005. Burger Court DS0000029144.V270172.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, 33, 35, 36 & 38 Taking into account the concerns about staffing levels and the impact this has on residents’ quality of life the overall impression is that the home is not run in the best interests of residents, despite the fact that staff are kind and well intentioned. Residents’ financial interests are safeguarded. Overall the health and safety of residents and staff are protected. EVIDENCE: The manager is a registered nurse and is working towards achieving the Registered Managers Award; she hopes to complete her training by February 2006. Throughout the year the home has issued questionnaires to a selection of residents, relatives and other professionals involved with the home. The Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 20 information received now needs to analysed and made available to residents and their representatives. Residents meetings are scheduled to take place every month although attendance is usually low. The home has made progress with involving residents and/or their representatives in care planning. Staff meetings are held approximately every three months. A senior manager visits the home at least once a month and audits aspects of the service, the CSCI is provided with a report following these visits. The home collects pensions on behalf of five residents, these are long standing arrangements and the manager is continuing her efforts to find independent advocates to take over this responsibility. The home will not be taking on this role for any new residents. Residents monies are dealt with at the company head office, money collected on behalf of residents is paid into a separate bank account. Personal allowance money is sent to the home where it is either given to individual residents or held on their behalf. Records are kept of all transactions and invoices are issued for sundry services provided to residents such as chiropody. The staff supervision records showed that most staff had attended supervision 2 or 3 times this year, the National Minimum Standards state that staff should have supervision at least six times a year. Training records showed that the majority of staff are up to date with moving & handling training and food hygiene. Two members of staff are trained in First Aid. The records showed the most recent fire drill was in March 2005 and six staff took part. Records of accidents/incidents should be kept in the individual residents’ files to comply with Data Protection law. An audit of accidents should be carried out at least once a month. The maintenance records were up to date and in good order, they showed that all the required safety and maintenance checks are carried out. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 2 X X X 3 STAFFING Standard No Score 27 1 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 X 2 Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 22 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 OP7 Regulation 15 Requirement The care plans must set out in detail how all the needs identified during assessment will be met. The registered persons must make proper arrangements for the safekeeping, administration and recording of all medicines. A suitably sized medicines fridge must be provided. The registered persons must ensure that daily routines are varied and flexible and take account of the needs, preferences and capabilities of service users. Timescale for action 31/03/06 2 OP9 13(2) 31/03/06 3 OP12 12 & 16 31/03/06 4 5 6 OP22 OP26 OP27 23(2) 13(3) 18 Previous timescale of 15/07/05 not met. The seat of the bath hoist must 31/01/06 be repaired or replaced. A carpet-shampooing machine 31/01/06 must be provided. The registered persons must 31/01/06 ensure that there are at all times suitably qualified, competent and experienced staff in sufficient numbers to meet the needs of DS0000029144.V270172.R01.S.doc Version 5.0 Page 23 Burger Court service users. Previous timescale of 15/07/05 not met. The quality assurance system 31/03/06 based on seeking the views of service users and other stakeholders must be maintained and the findings must be made available. The staff supervision programme 31/03/06 must be maintained. All staff must receive fire training 31/03/06 at least twice a year and must be given the opportunity to take part in regular fire drills. 7 OP33 24 8 9 OP36 OP38 18 23(4) 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 OP3 OP7 Good Practice Recommendations The pre-admission assessment forms should make it clear who carried out the assessment, when and where it was done and who was consulted. Care staff should be encouraged and supported in recording details of personal and social care in the service users plans. Carried forward from the last inspection. The current systems for dealing with breakdowns of essential equipment should be reviewed. The kitchen should be refurbished and the existing cookers should be replaced. Consideration should be given to improving the availability of disabled access toilets on the ground floor. Carried forward from the last inspection. Valves to control the temperature of hot water should be fitted locally, rather than centrally, to hot water outlets accessible to service users. Carried forward from the last inspection. Progress should continue to achieve the target of having DS0000029144.V270172.R01.S.doc Version 5.0 Page 24 3 OP19 4 5 OP21 OP25 6 OP28 Burger Court 7 8 OP35 OP38 50 of care staff qualified to NVQ level 2 or above. Residents should be asked to sign to confirm they have received their personal allowance. An audit of all accidents/incidents should be done at least once a month. Accident records should be kept in individual residents’ files to comply with the laws on Data Protection. When residents are found on the floor the accident records should state the time they were last seen. Burger Court DS0000029144.V270172.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Burger Court DS0000029144.V270172.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!