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Inspection on 05/11/05 for Collingwood

Also see our care home review for Collingwood for more information

This inspection was carried out on 5th November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This home has a homely relaxed atmosphere and residents spoken with all gave positive comments regarding staffing and care practice. Residents feel at ease and are able to exercise choice. One resident said `the place has a good atmosphere and ambience`. Another said `the staff care for all us ladies very well indeed`. A relative visiting the home said `my mother wonders why she didn`t do this sooner but not all homes are like this one`.

What has improved since the last inspection?

This is the first visit carried out by the inspector.

What the care home could do better:

Recruitment practices must improve to ensure resident safety. The immediate requirement left at the home directs the manager to ensure CRB clearance and POVA first checks are carried out before staff are employed to work at the home. All existing staff must gain CRB clearance and the manager must inform the CSCI of the outcome. Practice around health and safety including staff training and medication administration must be improved in order to satisfy residents of their safety. The care plans must be improved and set out in detail the action, which needs to be taken by care staff to ensure all aspects of health, personal, and social care needs are met. Residents will benefit from care plans that are adequately reviewed on a regular basis and contain adequate details relating to the prevention of falls and other information as detailed in Schedule 3 of the Care Homes Regulations 2001.

CARE HOMES FOR OLDER PEOPLE Collingwood 78a Bath Road Longwell Green South Glos BS30 9DG Lead Inspector Karen Walker Unannounced Inspection 09:30 5 November 2005 th 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 Collingwood DS0000003320.V254321.R02.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. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Collingwood Address 78a Bath Road Longwell Green South Glos BS30 9DG 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) 0117 9324527 NONE Mrs Frances Stephanie Bailey Mrs Wendy Ann Pullin Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 21 persons aged 65 years and over requiring personal care only 31st December 2004 Date of last inspection Brief Description of the Service: Collingwood is a privately owned care home registered to provide accommodation and personal care for up to 21 older people. The home is situated in a cul-de-sac in the residential area of Longwell Green. It is within walking distance of nearby shops and other amenities including medical services. The area is well served by public transport. There is easy access to Bristol and Bath. The M4 and M5 motorways are within easy reach. The property is stone built on two storeys with an additional extension to the side. There is a passenger lift. There are attractive, well maintained gardens which are fully accessible to the residents. Accommodation is provided on two floors comprising of 21 single rooms and one double room. All rooms have en suite toilet facilities and wash hand basins. There are two lounges and a dining room on the ground floor. Assisted bathrooms and toilet facilities are situated on both floors. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector carried out this unannounced inspection on Saturday and was able to meet with most of the residents currently living at the home. There were 9 visitors who also gave opinions and information regarding care practice at the home. The inspector was made to feel welcome and the manager and staff were all approachable and helpful. The inspector would like to thank all the residents for their time and valued input. The manager and 3 staff members supported this inspection and the inspector was able to case track 4 residents and examine records in respect of them. Other records relating to the home were examined and findings discussed with the manager. What the service does well: What has improved since the last inspection? This is the first visit carried out by the inspector. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 6 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. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-6 Residents and relatives have the opportunity to view information about the home before moving in. Residents needs are assessed prior to moving in and the statement of purpose ensures residents and relatives are aware of the admissions procedure. EVIDENCE: The inspector saw that there were contracts in place that have been updated. It was noted that some of these have not been signed by the resident in question or their representative. It is recommended that residents sign contracts as a way of evidencing they have been informed of and agree to the content. One resident spoken to confirmed she was aware of her contract. The statement of purpose has been updated to include information required by legislation. The service user guide is in the format of a ‘brochure’, which was not examined on the day of this inspection. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 9 It was noted through case tracking that assessments of need are in place and seen by the home prior to the resident moving in. The manager confirmed that the moving in process was a gradual one. The inspector spoke with residents regarding care provision and received positive comments. One resident said ‘we are all cared for very well’ another said ‘I am registered with the doctor and the dentist and see them when I need to’. One assessment and care plan contained a statement regarding the sharing of information with the resident and relatives had agreed that this would be detrimental. This home does not provide intermediate care. Collingwood DS0000003320.V254321.R02.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): 7-10 Residents’ healthcare needs are assessed and met utilising the support of allied healthcare professionals. Care plans lack specific detail necessary to address all assessed needs and medication practices require review. Residents are treated with dignity and respect and records of a confidential nature are stored appropriately. EVIDENCE: The care plans were examined and discussed with the manager. The manager explained she was in the process of updating care plans and care information. It was noted that care plans lacked the detail necessary to fully support residents with their care needs. It was further noted that there was unnecessary information kept which was routinely reviewed although provided no detail on care. This was discussed with the manager who agreed that a new format was needed. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 11 It was noted through records and on speaking to residents and their relatives that health care needs were assessed and met. For ease of reference it is recommended that ‘quick view’ healthcare sheets be used to record visits by healthcare professionals. Residents confirmed they could see the doctor or dentist of their choice and some residents confirmed they had the same dentist for 30 years. The manager said there were no residents who required pressure area care although if dressings were needed the district nurse would provide input and support. Residents are empowered to administer and retain their own medication. Residents confirmed they had a lockable facility. Medication administration was observed at lunchtime and it was noted that all medication records were signed at once. Medication was administered via a ‘blister pack’ provided by the chemist. It was noted on one occasion that medication had been signed as administered remained in the pack. Gaps in the records were also noted. This was discussed with the manager who said medication training was due in January 2006. The inspector advised that she would contact the pharmacy inspector at the CSCI and arrange a separate visit where professional advice will be offered. Staff members were observed knocking on bedroom doors and speaking to residents with respect. It was obvious that there were good relations between the staff on duty and the resident group. One resident said ‘us ladies are very lucky to be here’. Visitors at the time confirmed staff were respectful and very well liked by residents. Records of a confidential nature were kept in a lockable facility. Collingwood DS0000003320.V254321.R02.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): 12-15 Residents’ have autonomy over their lives and lead a fulfilling lifestyle. Relatives and friends maintain contact and are consulted where appropriate over decisions made in care provision. Residents’ receive a wholesome well balanced diet where the 4 weekly menus are affected by resident choice and likes and dislikes. EVIDENCE: Relatives and visitors were available to give their views on service provision. One said ‘we are so glad that mum is here’. Residents informed the inspector that French language classes were held in the Home. One said ‘I really enjoy them, she’s a good teacher’. It was noted that the hairdresser visits regularly, and residents were observed to be smart in appearance. There is also a monthly communion service held in the Home that residents can chose to attend. There were photographs on display of social activities that had taken place involving residents. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 13 Residents said that they were able to exercise choice in what time they went to bed, and what time they got up. They also said ‘we are able to choose our meals’. Another resident told the inspector that there were residents meetings available where opinions and views could be heard. The manager confirmed this and said the owner always chairs these meetings so that she can keep abreast of resident concerns etc. It was noted that there was a suggestion box in place and only the owner had a key. The manager said anyone could put in a comment or suggestion anonymously. This is good practice. The inspector sat with some residents during lunchtime and observed a wellpresented meal. Residents said ‘the food is always good’ another said ‘if we don’t like something there is another choice available’. The inspector went into the kitchen and noted it was clean and well maintained. Recent improvements have been carried out and all surfaces are now stainless steel. Care folders contain information relating to food likes and dislikes although the manager said these are not adequate enough and will be reviewed. Collingwood DS0000003320.V254321.R02.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 Residents are confident that their concerns will be taken seriously and improvements in the recording systems will ensure the appropriate action is taken within specified timescales. Residents can feel confident that their legal rights are protected and that they are protected from abuse. EVIDENCE: Residents were asked if they were familiar with the complaints procedure. One resident said ‘of course I will go to the manager but I have no complaints at all’. Another resident said she did have a complaint that she addressed with the manager but felt nothing was done. The inspector examined the complaints book and could find no relevant entry. The manager was asked about the complaint and said she was in fact acting upon it but was unable to discuss confidential information with the complainant. The inspector saw that adequate action had been taken. It is a requirement that all complaints are adequately recorded. It is recommended that all complaints and concerns be recorded in a book containing the date, the nature of the complaint, the action to be taken and who is responsible, the outcome and any follow up required. The manager must follow the complaints procedure and ensure the complainant is informed of the outcome of the complaint. The complaints procedure was examined and it contained the contact details of the CSCI. Relatives spoken to said ‘staff are approachable and any concerns are dealt with’. Another said ‘this seems like a good place’. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 15 The manager explained that she does not hold any significant finances for residents on the premises and she does not act as appointee. An example was given where a resident was advised to seek a solicitor to support her with her financial concerns. This is good practice. Relatives generally hold personal allowances and top up resident accounts when needed. The manager was able to evidence to the inspector through training records that Protection from abuse training was sought for some staff members. The inspector recommended Bristol Social Services training and provided contact details. It is suggested that protection training be added to the statutory training list and updated on an annual basis to keep abuse awareness in the forefront. The DOH ‘No Secrets’ document was in place and the manager said protection issues were discussed at team meetings. Staff spoken with were aware of the whistle blowing policy. Records show staff will be given information regarding the General Social Care Council (GSCC) codes of conduct at the next staff meeting. Collingwood DS0000003320.V254321.R02.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): 19-26 Residents are satisfied they live in a well-maintained, clean and comfortable environment. There is adequate equipment provided to maximise independence both in communal and personal rooms. EVIDENCE: The inspector took the opportunity to tour the environment. It was noted that the home was clean and tidy throughout. Residents bedrooms were individualised all containing a sink with separate toilet en-suite. The bedrooms and the communal rooms were individually and naturally ventilated with windows, that also provide plenty of natural light into the room. All rooms were centrally heated and radiators in residents’ bedrooms were thermostatically controlled. Radiators have not as yet been fitted with protective guards although the manager said installation would be prioritized. There are call alarms with an accessible alarm facility in every bedroom. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 17 Residents have access to all parts of the home and there is a regularly serviced passenger lift. There are grab rails positioned along the corridors and there are manual handling lifting aids in bathrooms and toilets. Grab rails and seat aids are also available in the toilets. The home is well maintained and improvements have recently been made to the kitchen. Residents were particularly fond of the well-kept and attractive garden. One said ‘my friend and I both had visitors this morning and we sat watching the squirrels, it was lovely’. Another resident said, ‘I go out into the garden with some of the others in the summer and we read books and have tea’. It was noted that there was adequate garden furniture provided. Shared rooms were comfortable and homely looking and residents said ‘this is a lovely house’. Collingwood DS0000003320.V254321.R02.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): 27-30 Residents are put at risk if supported by staff members who have not had the necessary checks carried out in respect of them. Residents are put at risk if supported by staff not deemed competent in basic first aid, manual handling and food hygiene practices. EVIDENCE: Staffing records were examined and it was noted that residents are not protected by the home’s recruitment policies. Existing staff did not have adequate Criminal Record Bureau checks carried out in respect of them and none had received a ‘POVA first’ check. An immediate requirement was left at the home to ensure the manager began the process of collating personal identification documents to enable a CRB check to place. The manager was reminded that if this requirement is not met enforcement action might be taken. Staffing records must contain all information as stated in schedule 2 of the Care Homes Regulations 2001 and the manager is advised to refer to this Schedule when compiling information needed for the staffing records. Training records were examined and it was noted that not all staff were up to date with manual handling training, food hygiene training or first aid. This must be addressed. One staff member who started in March 2005 had no formal training recorded and no record of induction training taking place. This is unacceptable and action must be taken to address this. It is further recommended that ‘quick Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 19 view’ training sheets be put in place to record all statutory training undertaken and when refreshers are due. This can also include induction training. It was noted that there are adequate staff on duty and the manager remains supernumerary. Residents gave positive comments about the staff that included ‘they are all lovely, we are well looked after’. The inspector observed staff and residents interacting in a positive friendly way. Collingwood DS0000003320.V254321.R02.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): 31,36,38 Residents’ benefit from an approachable manager who has the necessary qualifications needed to improve care practice and who is able to meet the requirements and recommendations set at inspection. Staff are not adequately formally supervised. Residents’ arte not currently assured of their safety in the event of a fire. EVIDENCE: Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 21 The manager is a long-standing member of the staff team who has a positive attitude towards the management of this home. She has NVQ level 4 in care, is a qualified NVQ assessor and has achieved the registered managers award. The manager confirmed that supervision sessions do not take place within appropriate timescales. Records were not available at this time to be examined. The manager said they were at home being updated. It is a requirement that formal supervision is carried out for all staff at least 6 times per year. Supervision must cover all aspects of practice, training needs and the philosophy of care for the home. The fire logbook was examined and all equipment checks were found to be in order. There were no doors propped open at the time of this inspection. It was noted that fire training and fire drills are not carried out within timescales as specified by the Avon Fire Brigade. The manager was reminded of the need to ensure 6 monthly training and drills for day staff and 3 monthly for night staff. Staff names should be added to the fire log when training is completed as the term ‘all staff’ is not informative and staff may miss essential health and safety training. The fire risk assessment was examined but was found to contain information gathered from the internet on how to carry out a risk assessment rather than a ‘home specific’ risk assessment itself. Collingwood DS0000003320.V254321.R02.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 3 3 3 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X 2 X 2 Collingwood DS0000003320.V254321.R02.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 OP7 Regulation 15(1)(2)( b) Requirement Timescale for action 31/12/05 2 OP16 22(3)(4) 3 OP29 Schedule 2 The care plans must set out in detail the action which needs to be taken by care staff to ensure all aspects of health, personal and social care needs are met. The care plans must be adequately reviewed on a regular basis and contain adequate details relating to the prevention of falls and other information as detailed in Schedule 3 of the Care Homes Regulations 2001. The home must ensure all 01/12/05 complaints are fully recorded and acted upon following the complaints procedure. REQUIREMENT MADE AT LAST INSPECTION. Begin the process of gaining CRB 07/11/05 clearance and ‘POVA first’ checks for all current staff. 4 OP30 Ensure all new staff do not work at the home before a CRB and ‘POVA first’ check is carried out in respect of them. 18(1)(a)(c All staff must receive induction ) training within the first 6 weeks DS0000003320.V254321.R02.S.doc 01/12/05 Collingwood Version 5.0 Page 24 5 OP30 18(1)(c) 6 OP36 18(2) 7 OP38 23(4) 8 OP9 13(2) of employment including safe working practices and principles of care. All staff must receive foundation training within the first 6 months of employment designed to ensure staff members meet the assessed needs of residents. Staff must ensure they carry out the necessary statutory training and update within specified timescales i.e. Food Hygiene, first aid, COSHH, Manual Handling. Send a training action plan to the CSCI by 21/11/05. Formal supervision is to be carried out for all staff at least 6 times per year. REQUIREMENT MADE AT LAST INSPECTION. A fire risk assessment must be put in place detailing the care of residents, escape routes, fire detection equipment, staff training, specific problems with resident mobility etc. Training and drills must be carried out within the timescales specified by the Avon Fire Brigade. Medication administration practice must be reviewed. Medication administration sheets must not be signed unless medication is given. Medication given must be signed for. 21/11/05 01/12/05 21/11/05 05/11/05 Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 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. 1 2 3 4 Refer to Standard OP2 OP9 OP16 OP30 Good Practice Recommendations Residents to sign contracts to evidence terms and conditions have been agreed. Use ‘quick view sheets’ to record all healthcare visits for ease of reference. The complaints book to contain the date the complaint was recieved, the nature of the complaint, the action taken and by whom, the outcome, any follow up required. Quick view’ training sheets to be put in place to record all statutory training undertaken and when refreshers are due. This can also include induction and foundation training. Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Collingwood DS0000003320.V254321.R02.S.doc Version 5.0 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. 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!