Inspection on 23/08/05 for Evergreen

This inspection was carried out on 23rd August 2005.

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

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

Other inspections for this house

Evergreen 29/05/07

Evergreen 26/07/06

Evergreen 27/02/06

Evergreen 25/02/05

Evergreen 27/08/04

Evergreen 02/03/04

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

CARE HOME ADULTS 18-65 Evergreen 119 Wake Green Road Moselely Birmingham B13 9UT Lead Inspector Alison Ridge Unannounced 23 August 2005 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 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 Stationary 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. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Evergreen Address 119 Wake Green Road Moseley Birmingham B13 9UT 0121 449 1016 0121 449 1016 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) TRACS Miss Vicki Mae Morris Care Home 8 Category(ies) of Younger adults with physical disability and registration, with number learning disability. of places Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of eight (8) service users with learning and physical disabilities, aged under 65 years. 2. That the home can continue to accommodate three named service users who are over 65. 3. That TRACS Evergreen apply for variation on behalf of future service users who reach the age of 65. 4. That details regarding how the specific care and social needs of people over the age of 65 will be met must be included in the service users plan. 5. Future admissions to the home are only considered for service users over the age of 45 years. 6. To provide full care for reasons of terminal illness for one named service user. Date of last inspection 25 February 2005 Brief Description of the Service: Evergreen is a large detached property, located in Moseley Birmingham. The home is close to a range of community facilities, which include shops, parks, places of worship, a library, leisure centre and public transport links. The home is set back off the main road in a small avenue that provides security and privacy from the road. The accomodation comprises of four bedrooms,an assisted bathroom, kitchen, lounge diner, laundry and conservatory on the ground floor. On the first floor are a further four single bedrooms, another bathroom, wc, and staff office/sleep in room. TRACS have submitted plans, which the CSCI have approved to improve upon these facilities. The home has off road parking, and at the rear of the home is a large deck area, and mature gardens. This home provides care and support for eight people with a Learning Disability or Acquired brain injury. Three service users are over the age of 65, and the home aims to provide support to people over the age of 45. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this visit over the late morning and afternoon of one day. During the visit the inspector was pleased to meet all six of the people that live in the home, staff on duty and the manager. Information was collected by talking with the people that live in the home, staff, the manager, walking around the premises, and reading documents about care, staff and health and safety. What the service does well: One person the inspector spoke with informed her that the home was entirely satisfactory, and that he could not fault it. He reported that staff work hard to meet his needs and that he could have any type of food he liked to eat. The food provided is of a good quality, and includes a range of home cooked dishes. At lunch time people had a choice of food, and were able to help in the preparation of the meal. The staff help people that live in the home to get ready for meetings and reviews. Records of care showed that the care people receive and their need are reviewed regularly, and the person is involved in this process. Staff are good at building friendships with the people who live in the home. It was good to see staff and service users chatting and undertaking games, or activities together. Staff help service users stay in touch with their family and friends. This can be by visiting, or on the phone. Staff support the people who live in the home with their healthcare. They are able to see the dentist, GP and optician as they need, and for routine checks. The management team are good at responding to concerns raised by people that live in the home. A good piece of work had been undertaken regarding this a few weeks prior to the inspection. The staff at Evergreen have undertaken NVQ training. The minimum of 50 of staff qualified to NVQ level 2 by 2005 has been exceeded. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 6 What has improved since the last inspection? 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. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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 standard(s) x These standards were not assessed. EVIDENCE: The home had two service user vacancies at the time of inspection. A previous requirement regarding the Statement of Purpose and Service Users Guide was not assessed. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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 standard(s) 6,7,8,9,10 Service users mainly benefit from well-planned care. Individual needs and aspirations require better planning and delivery. Service users have opportunity to be involved in the planning of their care. EVIDENCE: Two service users plans were assessed in full, and specific parts of a further two plans were also assessed. It was evident that service users had been involved in a personal review and actions identified by them and significant others had been incorporated in to the plan. The plans assessed in full were generally very detailed, and the inspector commented that a good balance between medical/clinical needs and aspirations and interests had been reached. Some of the goals set were tracked to see how these had been actionned or achieved. It was not evident in all cases that this had been undertaken, and a requirement of the inspection is that the process by which goals are action planned, and progress towards them monitored be undertaken. During the inspection service users were offered opportunity to partake in household tasks. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 10 Records of recruitment showed that one service user had played an active role in this process. Risk assessments had all been subject to regular review. Risk assessments were comprehensive and available for the known and perceived risks. The need to ensure assessments are reviewed and amended as needs change, and not just at set intervals was identified. The information held in service users files was all securely stored. Interactions between staff and service users were friendly but professional, and mindful of confidentiality. All care notes are held in one file, and it is required that this be reviewed to further promote confidentiality. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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 standard(s) 11,12,13,14,15,17 Service users are supported to make individual lifestyle choices. A range of interesting and valued activities are available in the home and community. Service users are well supported to maintain links with family and friends. Service users benefit from a nutritious and varied diet. EVIDENCE: Service users can undertake personal development by formal learning opportunities at day placements or by attending courses. Opportunity to develop new personal skills regarding self-care, or home making are provided at Evergreen. Care plans are written in such a way that promotes development of the individual. The opportunities available for leisure were assessed for two service users. In house opportunities were available daily, and included table games, snooker, music, TV, gardening, and watching DVD’s. Community activities included visiting local markets, local and household shopping, eating out and staying in touch with friends and family. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 12 Two service users the inspector spoke with commented favourably about the range of things to do. Service users are supported to stay in touch with friends and family in person, and by phone. Observation and conversation with service users during the inspection identified positive practices in this area. The menu is planned, but changes can be made as service users wish. At lunch it was pleasing to see that the service users all had slightly different meals to reflect their preferences. The record of food eaten evidenced that fresh fruit and vegetables are available and offered. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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 standard(s) 18,19,20,21 Service users are supported to attend routine health care appointments. Specific healthcare needs were not all well planned ensuring that needs were fully and consistently met. Medication management was generally good; management of non-blister packed medicines requires improvement. Service users are supported to make plans regards illness and dying. EVIDENCE: All service users the inspector met with appeared well presented, and to have undertaken personal care. The need to better record and plan how personal care is to be offered and undertaken was identified in one of the plans sampled. One service users needs had changed since the drafting of the plan, and it was identified the plan needed updating to reflect this. Another plan sampled contained a very detailed morning and evening routine. TRACS utilises a personal care matrix. These had not been routinely maintained, and it is recommended the use of these be reviewed. The inspector observed three service users rooms. Each person had an individual supply of towels and toiletries. TRACS aims to weigh service users monthly. The weight record for one service user was assessed and it was not evident this had been offered or undertaken. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 14 Opportunities for two of the service users to undertake healthcare monitoring were assessed. Appointments with the GP, optician and dentist had been offered as required. Specific healthcare needs including epilepsy and respiratory health continue to require further development in the plan. The plan of one service user, who had experienced a change in needs, evidenced extensive liaison with the multi-disciplinary team. Monitoring of some body functions had been identified as a need. This had not been undertaken by the homes staff as required to ensure the service users wellbeing in this area. It was identified that the care plan requires updating as needs change, and not just at set intervals. Medication management was generally good. The home utilises a blister pack system. Medicines contained in this were well stored and recorded. The need to audit medicines not blister packed was identified, as medicines audited during the inspection did not tally with records of receipt and disposal. Service users wishes in the event of them becoming seriously ill or dying had been ascertained and recorded. These documents were very personalised. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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 standard(s) 22,23 Service users best interests are protected by a robust complaints procedure. EVIDENCE: The work undertaken regarding an incident that was both a complaint and possible matter of Adult Protection was tracked. It was evident the service user had been supported through the incident, and given information on the process and options available. The provider had undertaken a detailed investigation, involved the relevant agencies, and ensured that the outcome for the service user was as positive as possible. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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 standard(s) 24,25,26,27,28,30 Evergreen is domestic and homely, but the size of rooms do not well meet the needs of the service users. TRACS does intend to improve upon this situation. EVIDENCE: TRACS have submitted plans to the CSCI that detail the improvement of three very small bedrooms, development of the ground floor bathroom, development of the laundry, the addition of some ensuites, and a new staff office. The CSCI has approved these plans and considers that they will improve upon the existing facilities for the benefit of service users. TRACS should confirm that the work is to go ahead, and timescales. The décor of the home appeared tired and worn in some places. The inspector found that staff locally had mainly maintained a high standard of cleanliness but that wear on carpets, gloss paintwork and the décor in some rooms was in need of attention. Kitchen cupboard shelves were identified as needing to be included on a regular cleaning schedule. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 17 The Kitchen cupboards and worktops were identified as being very worn, and the melamine coating had excessively worn in some areas. It is required that a schedule for the replacement of the kitchen be submitted with the action plan to this report. It was positive that work had been undertaken on the front drive of the home, and in the back garden. These areas are much safer, and aesthetically pleasing. The provider has replaced the assisted bath chair in the ground floor bathroom. This is more robust, and was reported to meet service users needs well. The panel on this bath was loose and dirty. This must be secured and kept clean. The type of lock fitted to service users bedrooms has previously been discussed. Locks cannot be de-activated, and if the door closes behind a service user, a key is required to regain entry to the room. Not all service users accommodated are able to manage a key, and the effect of these locks therefore impacts on service users independence. A requirement of this inspection is that these locks be reviewed and replaced. The provider informed the inspector that they still consider the locks to be the most appropriate available. The laundry area was much better managed. It was disappointing to find that clean linen was stored in the room, despite a large sign reminding staff not to leave it there. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35,36 Staff have a positive regard for service users, and demonstrated knowledge of individual needs and preferences. Recruitment, training and supervision must improve to ensure service users needs are met by a suitably experienced, qualified and supported staff. EVIDENCE: The recruitment records of four staff were tracked. Two of the four files did not contain proof of identity. One staff file did not contain evidence of the person’s eligibility to work in the UK, or number of hours that could be worked. Two file’s contained references that identified some concerns about the candidate. Evidence of how these had been explored, and the provider satisfied about their suitability was not available. In two instances the inspector queried information given on the application form. It was not evident that this had been followed up with the candidate. TRACS involves service users in recruitment where possible, and this is positive. Training is provided each month at the team meeting. Mandatory and service user specific topics had been covered. Provision for staff that where unable to attend must be explored, to ensure they get the training/update at the required intervals. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 19 The manager informed the inspector that eight of the twelve staff have completed accredited medication training, and seven out of twelve have completed NVQ level 2 or above. Supervision of staff had been undertaken to a high standard. The content of supervisions was balanced. The frequency supervision for one of the two staff sampled should be increased to meet the six times a year minimum standard. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,41,42 The management of the home is service user focussed. Household records, and health and safety are well organised. EVIDENCE: The manager has the required qualifications to manage such a home, and the inspector has found the management of the home to be steadily improving over recent inspections. It was positive to hear that a deputy manager has been recruited. A current certificate of registration and liability insurance were on display. Records were generally in good order. The need to ensure care notes are written contemporaneously, and stored in order was identified again at this inspection. An environmental health officer inspected the home in July 2005. Work identified had been commenced or completed. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 21 Routine tests and servicing of the electrical hard wiring, gas installations, hot water (to include legionella screening) were all up to date. A contract for the safe disposal of clinical waste was available. Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 1 2 2 2 x 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 1 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Evergreen Score 2 1 2 3 Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 3 x E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 23 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 1 Regulation 4 and 5 Requirement Not assessed at this inspection. Timescale for action 2. 3 3. 6 4. 5. 6. 9 10 18 The home must provide a Statement of Purpose and Service User Guide that fully meets the requirments. 23(1)(a)( The environment must be further 2)(a) developed to meet the needs of service users accomodated and the categories of registration. 12(1)(a)( How service users goals and 2) and 15 aspirations will be worked towards and monitored must be available. 13(4)(a-c) Risk Assesments must be reviewed as needs change. 12(4)(a) Care notes must be stored individually to promote confidentiality. 12(1)(a) Records regarding the delivery of personal care must be fully completed. 12(1)(a)( 2) 12(1)(a) 13(4)(b) Guidance on how personal care is to be offered and the service users preferences must be available for each person. The Epilepsy care plan must be reviewed in light of developments in this field. Plans have been submitted. 31/10/05 12/9/05 31/10/05 Unmet from the previous inspection. 30/9/05 31/10/05 7. 18 8. 18 31/10/05 Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 24 9. 19 12(1)(ab)and 13(1)(ab) 12(1)(ab) All care needs including epilpesy, respiratory needs, and dysphasia must be included in the service users plan. 10. 19 11. 19 12(1)(ab) 12. 13. 19 20 12(1)(a) 13(4)(c ) 13(2) 14. 24 23(2)(b)( d) 15. 25 23(2)(a) Unmet from the previous inspection. 31/10/05 Weight monitoring must be Unmet undertaken consistently and from the records of such maintained. previous inspection. 30/9/05 The care plan must be kept up to Unmet date, and reviewed/ammended from the as care needs change. previous inspection. 30/9/05 Body functions must be recorded 5/9/05 and as is required for each individual. ongoing Tablets that are not blister Unmet packed must be auditted to from the ensure stock levels tally with previous medication records. inspection. 12/9/05 The premises must be auditted Plan to be and a plan or redecoration returned developed.This must include , with action flooring and décor. plan, by Plans detailing how the kitchen provider. will be updated/replaced must be developed and forwarded. The available space in three of Plans have the service users bedrooms must been be increased. submitted. Locks on service users doors must be reviewed, to ensure service users welfare and freedom of movement is maintained. The bath panel must be secured, and maintained in a clean condition. Clean and dirty laundry must be stored seperately. Unmet from the previous inspection. 31/12/05 5/9/05 Unmet from the previous inspection. 5/9/05 Unmet from the Page 25 16. 26 12(4)(a) 17. 18. 27 30 23(2)(b) 13(3) 13(3) 19. 34 17(2) Schedule Staff files must contain all documents as listed in schedule Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 4 20. 35 18(1)(a) and 18(1)(c )(1) 18(2) 4 of the care homes regulations. Training and updates must be provided to all staff at the required intervals. Supervisions must be undertaken at least six times a year which each staff member. previous inspection. 30/9/05 31/12/05 21. 22. 23. 36 30/9/05 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. Refer to Standard Good Practice Recommendations Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 Page 26 Commission for Social Care Inspection Birmingham and Solihull Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Evergreen E54 S16727 Evergreen V245983 220805 Stage 2.doc Version 1.40 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!