Inspection on 21/02/06 for Eastfield Residential Home

This inspection was carried out on 21st February 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Eastfield Residential Home 04/07/07

Eastfield Residential Home 05/07/06

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Sign Health

Springwood

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

CARE HOME ADULTS 18-65 Eastfield Residential Home Eastfield Residential Home Wawne Road Hull East Yorkshire HU7 5YS Lead Inspector Angela Sizer Unannounced Inspection 21st February 2006 09:00 Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 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 Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eastfield Residential Home Address Eastfield Residential Home Wawne Road Hull East Yorkshire HU7 5YS 01482 838333 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) Eastfield Residential Home Limited Ms Jane Fenton Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (17), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (17) Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12/10/04 Brief Description of the Service: Eastfield House lies to the north of the City of Hull, near to Wawne village. The home is positioned in its own grounds just off the main road on a main bus route leading to the nearby Bransholme shopping centre and into Hull city centre approximately 8 miles away. It is a family run home and the registered provider is also the registered manager. The home is registered to care for 17 service users with a mental disorder, of whom a number are aged 65 years or over. Currently building work is being undertaken and once completed this will add a further 6 bedrooms this will also reduce the number of double rooms to three, a small communal lounge, bathroom/shower room and a drinks making area for the residents. On the ground floor there are two lounges and a dining room, an office, kitchen, laundry, toilet and bathroom facilities and the majority of bedrooms. On the first floor there is one bedroom for shared occupancy. This bedroom has an ensuite facility. Access to the first floor is by means of a staircase. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 7 hours and preparation work took a further 2 hours. The majority of the residents and two staff members were spoken to throughout the course of the day to find out what it was like for people who live here. The registered manager/registered provider was present throughout the inspection and was told how the inspection had gone at the end of the day. Three of the residents and three staff files were looked at and also other paperwork relating to the running of the home. A tour of the building was undertaken. The outstanding requirements and recommendations were discussed and the manager gave an update, most of which have now been met. What the service does well: What has improved since the last inspection? Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 6 The quality assurance system has been developed and the home now asks the views of a variety of people and they are asked to complete surveys about the home, staff and care offered. The results are collated and feedback is given to the residents, also with regard to any action being needed. The environment is undergoing some improvement and the extension that is currently being built is expected to be finished in March 06, this will increase the occupancy level to 20 and a further six single bedrooms will be added, the current number of double rooms will be reduced from five to three. 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. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Residents have a needs assessment undertaken prior to moving into the home. This process means that a resident and their representatives can be sure the home will meet their needs. EVIDENCE: An assessment of care needs is carried out on all residents before admission to the service. This is completed either in the resident’s own home or hospital and by the Local Authority Care Management team, from this information a more detailed care plan is produced and the home’s care staff work towards achieving the goals identified. Evidence of the assessments were in written form and found within the residents files, residents also confirmed that they had seen the document and had signed giving their permission for this assessment to be undertaken. Some comments from residents were; “I remember someone coming to see me and asking me what I thought I needed”, “I had to answer questions about myself to make sure that Eastfield would be right for me”. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 & 10 The residents are well cared for, but this would be enhanced by care plans and risk assessments being more specific and greater consistency being achieved. Choice is sometimes restricted and residents do not make decisions about their lives. Residents are aware of information held about them and that their confidences are kept. EVIDENCE: Each resident has a care plan in place that has been developed from the assessment of need, initially there is a care plan drawn up by the Care Management team and then following admission the home further develops a working care plan unfortunately this does not contain much information and requires further expansion to include specific needs, what action is required and by whom and how regular the intervention would need to be. Other more specialised intervention (dementia) is not described in depth in particular for those residents who require a lot of input. The case files are not well organised and it is difficult to locate information. When speaking to residents it was clear that on the whole the home delivers a good quality of care, but does not always ensure that residents are consulted. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 10 Some comments included, “I would like to have a bath every night or when I choose to”, “I would like to have a bath when I decide to”. Other residents expressed their views and stated that they were quite happy to have a bath when it was their turn on the rota. Other issues discussed were not having a key to their bedroom door or being able to make drinks for themselves. Several residents commented; “I would like more drinks and be able to make them myself”, “We have set drink times and I get thirsty in between this”. The home does not offer choice to all residents and must consult with them on an individual basis to ascertain what their preferences are in relation to bathing, having a key to their bedroom or making drinks for themselves. Residents were aware of what information was held about them and that the case files were kept in a locked office. Some stated, “I have seen the staff writing notes and asked if I could look and they let me read it”, “Yes I know that records are kept about me”. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 & 17 Residents are supported to take part in appropriate activities, education, community events, leisure activities. Residents are able to develop and maintain relationships. Daily routines do not always promote independence and choice for the residents. Residents are offered a healthy and wholesome diet. EVIDENCE: From speaking with the majority of the residents it was clear that they feel supported in maintaining their interests and hobbies. One resident said, “I go out every day sometimes 2 or 3 times, I like to keep myself busy”, another resident spoke about finding out what was going on in the community “I like to know what is going on and I go to different groups”. One resident attends a local church on a regular basis, others go to groups held in local community centres. All of the residents spoke highly of the manager and staff and said that they were well cared for. Residents confirmed that they are encouraged to maintain links with their family, friends or partners and that visitors are welcomed at any reasonable time. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 12 Several residents stated that they felt that sometimes their choice and independence was not fully supported especially in relation to bathing, making a drink for themselves rather than at set times and staff not knocking prior to entering their rooms. Other residents did confirm that they were happy in the home, “I like it here”, “the staff look after us”, “visitors can come and see me when they want to. The home offers a varied and nutritious menu. Residents spoke positively about the food stating that there was a good choice and the meals were plentiful. Lunch was observed during the visit and consisted of soup and sandwiches, followed by a selection of cakes. The main meal of the day is in the evening and is always a cooked meal, on the day of the inspection it was going to be gammon or liver and sausages. The home employs two cooks on a part-time basis, but care staff do help out with breakfast and other meals where necessary. Some comments made by residents included; “the food is always nice, I have never had any problems”, “if I don’t like something I just tell Jane and she sorts it out”. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Not all of the residents’ personal and healthcare needs are met. The medication procedure needs more attention in order that service users are protected by the policy and practice. EVIDENCE: On the whole the personal support is delivered in a caring and sensitive manner, residents spoke about “some staff do not knock before coming in” and also “there is a bath rota and you are told when you can have one”. Residents confirmed that the majority of staff always speak to them in an appropriate way and by the name they prefer. Paperwork looked at in relation to residents did confirm that there is a bathing rota in place that is restrictive. Residents were individual in style and it was clear that they had chosen their own clothes, some confirmed that they go to the shops themselves to purchase clothing and other items. From looking at the care plans and daily notes it wasn’t clear about what health care checks are undertaken, some records were out of date and others were not completed. During the visit the residents confirmed that if they required any medical attention then this would be sought, also that they have regular appointments with the CPN or Psychiatrist. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 14 The home has a medication policy and procedure in place and during the last inspection a requirement was made with regard to the records being completed accurately, unfortunately this remained the same during this visit. Some of the MAR charts did not correlate to the actual medication stock. The home has a returns procedure and there is a controlled drug register and procedure for administering and storing controlled drugs. Staff have received training through the Pharmacist, it is envisaged that all staff will eventually undertake the accredited medication training offered by the Local Authority. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has a complaints procedure that meets the resident’s needs who feel their views are listened to. A vulnerable adults procedure is in place, most of the staff are supervised and trained in order to protect the residents from abuse. EVIDENCE: The home has a complaints procedure in place and from speaking to the residents it was clear that they knew about it and how to access it. One resident said, “I tell the staff or manager if I am not happy with something, it usually gets sorted fairly quickly”, “I have made complaints in the past and they have been dealt with”. The complaints book was inspected and it was evident that complaints had been recorded and any action required was detailed. A vulnerable adults procedure was held in the home and during interviews with staff some staff were aware of what abuse was and what course of action they would need to take, unfortunately one staff member interviewed did not understand what the procedure was for nor had she received any training. From perusal of staff training records it wasn’t clear who had received training in relation to the protection of vulnerable adults. All staff receive regular and consistent supervision, staff commented; “supervision is offered on a regular basis, but I can have it more often if I need it”, “I have meetings with the manager about every 2 months”. All staff are checked via the Criminal Records Bureau including a POVA 1st check and references sought prior to employment commencing. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The home’s premises are on the whole suitable for its stated purpose and are accessible, safe and well maintained. The home is clean, tidy and domestic in style. EVIDENCE: A tour of the building was undertaken and the environment was observed to be homely and comfortable. Several of the resident’s bedrooms were looked at and were decorated in a domestic style and having comfortable surroundings and personal belongings on display. Some of the residents were present in their rooms and confirmed that they can return to their bedroom whenever they choose to. The home was heated to a comfortable temperature and there was adequate ventilation. Furnishings were of a good standard both in the communal areas and in the bedrooms. There was no offensive odour in the building. The home was clean and hygienic and there were no malodours present during the inspection. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 The home has a staff team who vary in knowledge and experience, some are more experienced and competent than others. Staff have clear roles and responsibilities, less than 50 have achieved NVQ level 2 or 3. Supervision is offered ensuring that the service and support offered is safe. The home operates a robust recruitment procedure that ensures the residents are protected. EVIDENCE: The home employs 12 care staff and currently 3 of them have achieved NVQ level 2 or 4, a further 6 are working towards the award. The registered manager explained that they aim to complete this training within the next 6 months. During interviews held with staff it was apparent that some are more experienced and knowledgeable than others. One staff member is employed as a domestic/carer and had little experience, but were undertaking a care role without fully understanding the needs of the residents and had no knowledge in relation to the protection of vulnerable adults or other mandatory training that is required within six months of employment. One member of staff had been in post for 5 months and had only undertaken fire safety training. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 18 Written documentation is kept with regard to supervision stated that all staff receive regular and consistent supervision and from speaking to three staff members it was confirmed that this was the case. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Overall the home is a well run, there is clear leadership and direction. The home has developed a good quality assurance system and residents are involved in this process ensuring that their views are listened to and acted upon. The health and safety of the residents is promoted, the home carries out safe working practices in relation to the environment. The protection of the resident’s is not always ensured as training in key areas is not always undertaken. EVIDENCE: The home’s registered provider is also the registered manager and has been in post for several years. She has a good understanding of the needs of the client group and has attended various training courses to keep up to date with current good practice. There is clear leadership and direction offered to staff and some comments from staff included, “Jane is always available if she is needed”, “support from the assistant manager and manager is very good, I can go to them whenever I have a problem”. During the inspection the manager was observed giving direction and advice to staff and this was carried Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 20 out in an appropriate way. She has commenced the NVQ level 4 in Care and the Registered Manager’s Award and stated that she is about half way through the training. The home’s quality assurance system has been further developed and surveys are now completed by residents, family/carers, staff and other professionals to gain their views and put right any shortfalls in the service. Once the information is collected a report is produced and feedback given at the residents’ meetings as to any action needed. A copy of the annual report is to be forwarded to the CSCI. Regular staff and residents’ meetings are held ensuring that the views of staff and residents’ are taken notice of and recorded. All staff undertake a basic induction, but this does not meet the Skills for Care specification. Some mandatory training has been undertaken, but not by all staff and therefore the health and safety of the residents may be put at risk by having less experienced care staff looking after them. Fire training had been undertaken in January 06 and all of the fire records, testing of the alarm, drills and equipment were recorded and up to date. All of the home’s maintenance certificates were in order and up to date. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 1 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 1 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 1 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 X 3 X 3 X X 2 X Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15,17 Requirement Timescale for action 21/05/06 2 YA7 3 YA9 4 YA16 5 6 YA18 YA19 Care plans to be developed and include detail of need, any specialist or therapeutic intervention, action required, by whom and when. 12,17 Residents must be enabled to make everyday decisions about their lives, including when to take a bath, make a drink or have a key to their bedroom. 12,13,17 Risk assessments require development to ensure clear guidance is given to staff about how to reduce or manage the risk. 12,13, 16,18 Residents choice and independence must be promoted, unless a risk assessment identifies otherwise. (As detailed in standard 7). Staff must ensure that privacy and dignity is maintained and knock prior to entering a resident’s bedroom. 12,17 See Standard 7 12,13,16,17,18 Residents must be offered minimum health checks (vision, hearing, DS0000064775.V263732.R01.S.doc 21/05/06 21/05/06 21/05/06 21/05/06 21/05/06 Eastfield Residential Home Version 5.1 Page 23 7 YA20 8 YA23 9 10 YA32 YA35 11 YA37 12 YA42 medication,dental) and evidence maintained. 12,13,16,17,18 Medication records must be accurate and medication stock must match what is recorded. 12,13,16,17,18 Staff must be aware of the protection of vulnerable adults procedure and undertake training within 6 months of employment with records kept. 12,13,18 50 of staff must achieve NVQ level 2. 12,13,16,17,18 All staff must undertake all of the mandatory training within the first six months of employment, this includes; moving and handling, first aid, health and safety, food hygiene, infection control and protection of vulnerable adults. Also specialist training in relation to mental health issues must be undertaken. 9,17,18 The registered manager must complete the NVQ level 4 in Care and Registered Manager’s Award. 12,13,17,18 The induction and foundation training must meet the Skills for Care specification and be completed within six months of employment. 21/05/06 21/05/06 21/08/06 21/06/06 21/08/06 21/08/06 Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 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 YA6 YA34 Good Practice Recommendations Residents’ files would benefit from being re-organised into specific sections. All prospective employees must sign a declaration stating that they are mentally and physically fit for the purpose of their job. Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Eastfield Residential Home DS0000064775.V263732.R01.S.doc Version 5.1 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. 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