Inspection on 12/09/05 for Callands Care Home

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Callands Care Home 19/04/07

Callands Care Home 30/10/06

Callands Care Home 23/05/06

Callands Care Home 12/04/05

Callands Care Home 27/09/04

Callands Care Home 20/05/04

Callands Care Home 11/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Callands Care Home Callands Nursing & Mental Nursing Home Callands Road Callands Warrington Cheshire WA5 5TS Lead Inspector A Gillian Matthewson Announced Inspection 12th September 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 Callands Care Home DS0000042162.V252346.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. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Callands Care Home Address Callands Nursing & Mental Nursing Home Callands Road Callands Warrington Cheshire WA5 5TS 01925 244233 01925 413433 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) Southern Cross Home Properties Limited Care Home 120 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (60), Learning disability over 65 years of age of places (1), Old age, not falling within any other category (30), Physical disability (30) Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 120 service users to include:* Up to 30 service users in the category of PD (Physical disability) who may be accommodated in Lakeside Unit * Up to 30 service users in the category of OP (Old age, not falling within any other category) who may be accommodated in Coniston Unit * Up to 1 named service user in the category of LD(E) (Learning disability over 65 years of age) who may be accommodated in Windermere Unit * Up to 60 service users in the category of DE(E) (Dementia over 65 years of age) who may be accommodated in Grasmere, Ullswater and Windermere Units * Within the 60 DE(E) beds (Dementia over 65 years of age), 1 service user in the category of DE (Dementia under 65 years of age) may be accommodated Service users who require nursing care may not be accommodated in Windermere Unit The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 12th April 2005 2. 3. Date of last inspection Brief Description of the Service: Callands is a care home providing personal and nursing care and accommodation for 90 older people, 60 of whom have dementia, and 30 younger adults with physical disabilities. The home is located in the Callands area of Warrington, close to shops, a post office and a pub. Gemini retail park is close by, as is the Westbrook Centre which has a large supermarket, more shops, a restaurant and cinema complex. Callands is on a bus route and close to the M62 motorway. The home is a two storey, purpose built home and is divided into five units. Three of the units, including the younger adults’ unit, are located on the ground floor. All bedrooms are single with an en-suite shower. There is a passenger lift. The home has extensive grounds, which are easily accessible. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by three inspectors of the Commission. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over seven hours and included a tour of the building, inspection of records and discussion with sixteen residents, six relatives, fourteen staff and three community nurses. Since the last inspection the previous manager had been promoted and a new manager was in post. Residents commented favourably on the home. One resident said ‘I can do just as I like’ and another said ‘ this is a very good home, I am treated very well and I’ve never seen anything amiss’. Relatives interviewed said ‘staff are very patient’ and ‘they keep us fully informed of all developments concerning our relative and the home in general’. Feedback was given to the General Manager and Clinical Nurse Manager immediately following the inspection. What the service does well: Good information is provided to prospective residents and they are actively encouraged to visit the home and stay on a trial basis prior to making a permanent choice. Full and comprehensive assessments are carried out and care plans are in place to ensure the home will be able to meet the residents’ needs. Medicines are well managed, ensuring that residents receive their prescribed medication. Staff are mindful of service users’ privacy and dignity. Residents are consulted about their hobbies and interests and a varied programme of activities is available, which includes activities outside the home and holidays. Staff recruitment, training and supervision ensure that residents interests are promoted and protected. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The home should request that residents are reviewed by a GP on a more regular basis in order to identify any medical problems. Residents should all be weighed on admission to establish a baseline to measure weight loss or gain. There is room for further improvement in the staffing numbers on Lakeside Unit, to further enhance the quality of life of service users on that unit. Records of monies held on behalf of residents need improvement to ensure that residents’ financial interests are safeguarded. Work is ongoing to ensure that hot water temperatures are maintained at a safe level. Please contact the provider for advice of actions taken in response to this Callands Care Home DS0000042162.V252346.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. Callands Care Home DS0000042162.V252346.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 Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. The home provides service users with the information and access they need to make an informed choice about whether they wish to live there. Full assessments are carried out to ensure that service users know the home will be able to meet their needs. EVIDENCE: The home had a satisfactory statement of purpose and service user guide, which were on display in the reception area of the home. Residents confirmed that prior to admission a nurse from the home had visited them and given them information about the home. They were then able to visit the home and stay on a trial basis before making a decision to take up residence. Relatives visiting Ullswater Unit said they had been invited to visit the home prior to their family member being assessed for admission and had been impressed with the information provided to the them. Case files were examined on all units. All contained evidence that preadmission assessments had been carried out by an appropriately qualified nurse prior to admission to determine whether the home could meet the Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 10 individual’s needs. These assessments covered all aspects of physical, psychological and social need. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Residents’ health, personal and social care needs are met by staff who enable them to maintain their privacy and dignity. EVIDENCE: Samples of twelve residents’ care records were seen during this inspection. The plans were completed in line with each resident’s needs. These were divided into four sections, admission, assessment, care plans and supplementary. All contained information covering all areas of personal and health care and risk assessments. They also included records on visiting professionals and the daily report sheets. Most of the care plans were very comprehensive and well documented, providing staff with all the information they would need to care for the resident. However, in one instance a care plan had been poorly written and was difficult to understand. This was pointed out to the general manager and clinical nurse manager who said that care plans were audited on a regular basis. When deficiencies were found they would issue corrective actions and had provided staff with written examples of satisfactory care plans. They said that further training was already planned. There was documentary evidence that residents were consulted about their care plans. Discussion with residents and relatives also confirmed this. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 12 Daily record sheets showed day-to-day activities of each resident and state of health. A good account was recorded and these were signed by nursing and care staff. Information on the visiting professional sheets showed that GP’s had visited each resident, however, some of these visits had not been in recent months. (See Recommendation 1.) Details of visits from other health care professionals, for example opticians, district nurses, speech therapists and chiropodist were seen. During the inspection a GP liaison nurse, a nurse assessor and a respiratory nurse specialist visited the home. All said that they were currently satisfied with the service provided to their patients at Callands, and one said there had been much improvement in the previous twelve months. Risk assessments were completed in relation to pressure areas, moving and handling, nutrition, continence and falls. Control measures were identified to minimise risk, and in most cases these had been implemented. However, in one case a resident who had been admitted three weeks previously was identified as being at risk nutritionally because of breathing difficulties and a poor appetite. The care plan said that they should be weighed weekly, but there was no record of weight since admission. Staff said they were aware that the resident was at risk, had identified the resident’s dietary preferences and tried to encourage a healthy diet. (See Recommendation 2.) Other residents who were identified as being at risk nutritionally were seen to have gained weight. Medications were managed separately for each unit and storage arrangements were satisfactory. The home used a monitored dosage system. Staff were seen administering medication to residents in an appropriate manner. Medication Administration Record Sheets were completed appropriately. Audits were carried out for medicines liable to abuse and were found to be in accordance with the records. During the inspection staff showed respect for the residents by the way they spoke to them. Staff acted in a friendly and warm manner towards residents. Personal care was conducted in the privacy of their own bedrooms. Each bedroom had its own en-suite, which contained a shower and toilet. Wash hand basins were situated in the bedroom. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 14. The routines of daily living and activities available are flexible and varied to suit residents’ expectations, preferences and capacities. Residents are able to have visitors at any reasonable time and links with the local community are maintained. Residents can exercise personal autonomy and choice. EVIDENCE: Residents’ daily preferences were recorded in the care plans. The interests of residents were recorded in the care plans. Discussions were held with the activities organiser who works full time. A weekly programme of events was prepared and included bingo, massages, manicures, sing-a-longs, reminiscence work and swimming. Once a month each unit picked a different place for them to visit. This was chosen during residents’ meetings. The residents had access to a mini bus and the local dial-a-ride service. A quarterly newsletter was published that showed details of events that had taken place and future planned events. During the afternoon a “memory” session was held with some of the residents. On discussion afterwards residents said they had enjoyed the session. The activities organiser also held monthly meetings for the “Friends of Callands” group. A different speaker was invited each time and then future events were discussed and volunteers requested to help with these. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 14 The residents’ religious preferences were noted in the care plan. It was said that residents could see a minister of their choice. Church representatives were visiting the home and they said that they “liked visiting the residents” and “were welcomed by the staff and assisted by them as needed”. Staff said that residents could see visitors in private or in the shared areas. Residents spoken with confirmed this. There were no restrictions on visiting. Residents they said they were able to go out and about as they preferred and that they chose what they wanted to do. During this inspection a partial tour of the units was undertaken and bedrooms seen were personalised with mementoes, photographs of families and friends and small pieces of residents’ own furniture. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of these standards were assessed at this inspection. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. Recent investment has significantly improved the appearance of this home, creating a comfortable environment for those living there and visiting. However, until the plumbing work is completed, there remains a risk to residents from hot water. EVIDENCE: A partial tour of the units was undertaken. All the shared areas and a selection of bedrooms were seen. The home was furnished in a domestic style with additional equipment such as grab rails, raised toilet seats and hoists provided as necessary to meet the residents’ needs. A good standard of décor was evident. The lounge/dining areas had a variety of seating affording choice of style of seating. Bedrooms were entered with the consent of the residents. They were all single and were personalised with residents’ own furniture and mementoes. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 17 (One lounge/dining room on Coniston unit was closed to residents because the ceiling was bowed following a recent water leak. The general manager said that arrangements had been made to repair it.) The gardens were well maintained and new garden furniture had been purchased this year, making a very pleasant environment for residents to enjoy good weather. The heating and lighting was sufficient throughout the home. New light fittings had been provided in several areas since the last inspection and visibility was much better in the corridors and communal areas. On Windermere unit hot water temperatures taken at sinks in four residents’ bedrooms were between 49 – 55 degrees centigrade. This is above the recommended temperature of 43 degrees. It was also noted that three of the four rooms needed the shower to be turned on to enable hot water to flow into the wash hand basin. Following a previous inspection a requirement had been made that control measures be put in place to limit the hot water temperatures. Plumbing work was ongoing at the time of the inspection to address this. As the home is so large, completion was anticipated by the end of October. A further visit will be made to ensure compliance. (See Requirement 1.) All areas seen were clean and free from any unpleasant odours. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30. Staffing levels and skill mix are sufficient to meet the needs of most residents, the exception being evenings on Lakeside unit, where staffing is insufficient to give residents freedom of choice. Residents are protected by the home’s recruitment practices and staff training. EVIDENCE: Staff were welcoming and helpful. Service users confirmed that staff were always pleasant. Rotas revealed that staff numbers complied with agreed minimum staffing levels, with the exception of evenings on Lakeside Unit where, after 7pm, there were usually only three staff on duty. At the last inspection residents had said they sometimes had to wait for staff to assist them with personal care at this time and were unable to go out of the home if they wished without prior arrangement. The registered provider had agreed to provide an additional member of staff to cover four hours in the evening to assist younger residents with their personal and social care needs. The general manager said that it was difficult to recruit staff for this shift, but some existing staff would work extra hours to cover. This was an outstanding requirement from the previous inspection. It is suggested that, as it is difficult to recruit for a shift that ends at 11pm, additional staff are recruited to work all night or consideration be given to changing shift patterns. (See Requirement 2.) Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 19 Since the last inspection two more registered nurses with a mental health qualification had been employed, enabling twenty four hour cover for those residents with mental health needs. The general manager, clinical nurse manager and ancillary staff supported the care team. Ancillary staff comprised catering, domestic, administration and maintenance support. Eight staff files were examined. These included personal information, application form, Criminal Records Bureau checks, references, health questionnaire, contract of employment and a copy of their job description. A quality manual for recruitment was available and included all areas of recruitment and associated forms for example, application forms, sickness monitoring and contracts. Copies of courses undertaken were also seen on the files. These included moving and handling, health and safety, fire awareness, pressure sores, food hygiene and COSHH courses. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 33, 35, 36 & 37. The systems for resident and staff consultation are good with evidence that indicates that residents’ views are both sought and acted upon. At the moment residents’ monies are at risk due to poor recording of transactions. EVIDENCE: The home had various quality assurance systems in place. Audits were carried out in relation to maintenance, cleaning and domestic duties and catering. All had action plans showing improvements to be made. A monthly medication audit was seen showing the receipt, administration and disposal of medication. Surveys were carried out with residents, staff and outside agencies. Two had been carried out during May and August 2005. Some of the comments made by residents included “staff team are good”, “would like a new carpet and bathroom”, “lighting is poor” and “food sometimes poor”. Some of the staff Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 21 comments included “enjoy working at the home”, “improvement needed in staff attitude” and “the manager is very good”. Two responses were received from outside agencies and they commented that the service provided was good. Quality manuals were available for maintenance, human resources, care, administration and finance. These covered policies and procedures and associated records. Resident’s personal finances were held in a locked filing cabinet. Four residents’ monies were examined. Records were kept of transactions made, but records did not reflect the amounts held. This was due to an error in recording when monies were transferred into a bank account if over £100. (See Requirement 3.) Day to day supervision was good and staff said they were well supported. Formal supervision was given to staff and records showed that the supervisor and staff member signed these. A selection of staff and manager sessions were seen. Some of the issues raised included use of agency staff , access to a photocopier, problems with lack of hot water and problems with cleaning. All records, policies and procedures seen were up to date and accurate. These were kept secure within the home. During discussions some residents confirmed that they had access to information kept about them. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 3 3 3 3 1 3 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 4 X 1 3 3 x Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 23 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 OP25 Regulation 13(4) Requirement Timescale for action 31/12/05 2 OP27 18(1)(a) 3 OP35 17(2) Sch. 4 The registered person must ensure that the hot water system is regulated to eliminate the risk of scalding, giving priority in the first month to showers with a hot water temperature exceeding 43 degrees Celsius.(Previous timescale not yet reached) The registered person must 31/10/05 ensure that another member of staff is employed in the evenings for Lakeside Unit.(Timescale of 30.06.05 not met) The registered person must 31/10/05 ensure that residents’ records reflect the monies kept within the home, that transfers of funds to the bank accounts are recorded and that monies held in bank accounts are recorded on a separate sheet. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 24 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 OP8 OP8 Good Practice Recommendations GPs should be requested to visit their patients at least six monthly. All residents should be weighed on admission and weekly thereafter if identified as being at risk of malnutrition. Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Callands Care Home DS0000042162.V252346.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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