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Inspection on 09/11/05 for Forest Place Nursing Home

Also see our care home review for Forest Place Nursing Home for more information

This inspection was carried out on 9th November 2005.

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

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

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

Forest Place NH provides an open, friendly and homely environment with good standards of nursing and personal care. Residents` health needs are met appropriately and well monitored and prompt referrals are made to relevant health professionals where required. Staff are employed in sufficient numbers and skill mix to care for the needs of residents and are well supervised by the manager. Residents spoken with said they felt at home and that staff were helpful, friendly and kind.

What has improved since the last inspection?

Good progress has been made in addressing previous requirements. Including making provision for a lockable storage area in each room; increased use of appropriate risk assessments; regular, `useful` supervision for all staff; and checking of recruitment references. There has been a noticeable improvement in care planning for the permanent residents with an increase in resident and family input into the plans.

What the care home could do better:

Although there has been an improvement in care plans generally more work needs to be put into the detail and regular reviewing of change. Respite care planning needs to be improved and plans need rewriting/reviewing at each admission.A course in dementia activities should be considered for the current coordinator to enable her to fully utilise the facilities available to her. There were three health & safety issues found at this inspection that were discussed with the manager at the time. The floor in the laundry needed replacing; the staff must ensure that all COSHH products are safely lock up at all times; and window restrictors throughout the home need to be reviewed. Resident monies must be handled consistently and safely to avoid accounting or actual loses.

CARE HOMES FOR OLDER PEOPLE Forest Place Nursing Home Roebuck Lane Buckhurst Hill Essex IG9 5QN Lead Inspector Lysette Butler Unannounced Inspection Wednesday 9th November 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 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. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Forest Place Nursing Home Address Roebuck Lane Buckhurst Hill Essex IG0 5 QN 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) 0208 505 2063 0208 559 0193 Martlane Limited Mrs Kanagathevi Obeyesekere Care Home 72 Category(ies) of Dementia - over 65 yerars of age (30), Learning registration, with number disability (1), Physical disability over 65 years of of places age (41) Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 One named person, under the age of 65 years, who requires care by reason of a learning disability 2 Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 41 persons) 3 Persons of either sex, aged 65 years and over, who require nursing care by reason of dementia (not to exceed 30 persons) 4 The total number of service users accommodated must not exceed 72 persons Date of last inspection 9 March 2005 Brief Description of the Service: Forest Place is a two-storey building with attractive grounds to the side and rear. There is a large extension to the rear of the home. Forest Place provides nursing care to older persons with physical illness/disability, older persons with dementia and for one person with a learning disability. All rooms were a good size and are of various shapes/layout’s. The home is divided into three distinct units, Kingfisher, Maple and Beech. Kingfisher is the dementia unit. The home is located within 1 mile of the local shopping centre, railway and underground stations. There is a bus route that goes past the home and Buckhurst Hill is close to main roads and motorways. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took eight and half hours on one day in November 2005. Twenty-four of the thirty-eight National Minimum Standards were inspected during this visit. It was found that many of the standards had been met or partially met. The overall care and well being of the residents was good; staff and residents were welcoming and happy to speak to the inspector. At the time of this inspection major building work was being carried out to create eighteen new beds at the home. During this visit the inspector spoke to five residents; two relatives/ visitors; eighteen staff members including the administrator; four housekeeping staff; two of the laundry staff; the cook; one of the activities coordinators; four Registered Nurses and five care assistants. The inspector also spent time with the registered manager; the housekeeping manager and the proprietor. Residents and their relatives expressed satisfaction with the care they received and with the quality of the food offered. What the service does well: What has improved since the last inspection? What they could do better: Although there has been an improvement in care plans generally more work needs to be put into the detail and regular reviewing of change. Respite care planning needs to be improved and plans need rewriting/reviewing at each admission. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 6 A course in dementia activities should be considered for the current coordinator to enable her to fully utilise the facilities available to her. There were three health & safety issues found at this inspection that were discussed with the manager at the time. The floor in the laundry needed replacing; the staff must ensure that all COSHH products are safely lock up at all times; and window restrictors throughout the home need to be reviewed. Resident monies must be handled consistently and safely to avoid accounting or actual loses. 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. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 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 standard(s) 6 This section of the standards was not evaluated during this visit. EVIDENCE: At the time of this inspection the statement of purpose was being completely reviewed as part of the registration process of the new beds and will be supplied with the variation pack. This home does not accept emergency admissions or offer intermediate care. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8 & 10 All indicators examined during this inspection suggested that the service users health and personal care needs were well catered for. EVIDENCE: Seven resident care plans were reviewed during this inspection. The general quality and content of the plans has improved since the last inspection. Both units laid out their care plans in slightly different ways. However the detail needs to be more specific. For example one plan stated ‘Dress pressure area as necessary’; there was no specific dressing regime. The detail was slightly better on one unit (Beech) than on the other one. More thorough risk assessments were included in the files reviewed and there was evidence that some had been reviewed on a regular basis. The staff were experimenting with resident, or their representative, signature sheets so that they only have to sign once rather than on every sheet. However the first sheets used did not allow for reviews to be signed for by the residents or their representatives. The manager stated that this would be rectified in the next version of the sheet. The detail of the residents’ wishes when their health is deteriorating and upon their death was not completed on the majority of the plans reviewed. One of the care plans reviewed was for a resident on respite in the home. This resident regularly attended the home for short respite breaks. The care plan used was totally inadequate and had been originally completed in 2003. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 10 At the time of this inspection the proprietor was in the process of negotiating a contract to have a consultant for the elderly undertake a regular clinic in the home. This was to cure the problem of inconsistent GP advice about the residents. This would be a support mechanism for all residents. During this inspection I was able to speak with the regular CPN for the home. She felt the home was very supportive of her role, communicated well and had a good understanding of the needs of all the residents. She stated that the staff were good at referring residents for assessment from the frail elderly unit if they felt that there had been a deterioration in their mental health. The staff and manager consulted with her regarding the changing health needs of the residents and were good at noticing changes in the residents’ behaviour. One registered nurse was responsible for issues of tissue viability throughout the home. A chiropodist regularly attends the home and treats any residents who need/want chiropody care. Residents spoken to all stated that the staff were approachable, helpful and they respected service user privacy in all aspects of care. Staff were observed during this inspection to treat the residents with dignity whilst maintaining their privacy. When residents were hoisted in the lounge, mobile screens were seen to be used to protect the resident’s dignity. All residents were dressed in well laundered, age appropriate clothing. The preferred name of the resident, their wishes concerning personal mail and telephone procedures are documented within the care plans. Some residents had their own telephones in their rooms and paid the bills separately. There was also a payphone on the ground floor for the use of the residents. The hairdresser attended the home three times a week and there were ongoing negotiations to increase this once the number of residents increased. There are no shared rooms in this home. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12 & 15 Social activities and the dietary arrangements in the home facilitates good mental and physical health of the residents. EVIDENCE: During this visit I spoke to the activities coordinator for the dementia unit who works thirty-five hours each week. She was very enthusiastic and was trying to expand the range of activities offered to the residents. She held group activities and one to one activities dependant on the needs of the individual residents. She is in contact with other coordinators within the group. However she has not yet undertaken a dementia activities course and this was discussed with the manager at the end of this inspection. The coordinators kept progress notes and evaluations of the activities undertaken separately from the individual resident care plans. There were weekly activities timetables on show throughout the home. The chef stated that he was much ‘happier’ with the present ordering and agreement for food and drink arrangements in the home. The chef has complete control over all ordering and there is no need to shop on a daily basis to ‘top up’ the supplies. Stock levels were good at the time of this inspection and the last Environmental Health Officer inspection had be two months before this inspection. Menu planning was good and demonstrated that a balanced diet was offered to all residents. Fresh fruit and vegetables were now served everyday. The kitchen was going to be changed as part of the refurbishment and increased bed numbers, but the plans did not create any extra space. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 12 However the chef felt that the changes were enough to allow him to offer an adequate menu to the increased number of residents. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 Minor complaint handling demonstrated a commitment to improving the environment for the residents. EVIDENCE: There had been no further formal complaints to either the home or the commission since the last inspection. I was therefore not able to check the quality of the documentation generated as stated in the last inspection report. However a complaint investigation that had been received previous to the last inspection was still ongoing at the time of this inspection. The complaints log demonstrated that minor complaints were dealt with promptly and efficiently. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 20, 21, 22, 23, 24, 25 & 26 The environment for the residents is generally good, but will be further improved when the current building work has been completed. EVIDENCE: At the time of this inspection there was extensive building work being carried out to create eighteen new beds at the home. The residents spoken to did not feel that it has caused too much disruption, although the noise sometimes disturbed them. When speaking to the housekeeping manager she stated that the disruption had so far been minimal. However the housekeeping staff were generally concerned about the extra workload that may be caused once the construction staff started to work inside and linked the new rooms to the rest of the home, which included putting a new lift in. On discussing this with the proprietor he confirmed that the construction workers were aware of the need to consult with the staff during this period of remodelling. All new rooms have en-suite toilet and showers. On going maintenance/repairs in the home were being carried out as part of the building work. All work appeared to be of a high standard. The dementia unit was in need of redecoration and this is to be carried out once the new beds are opened, so that residents can be moved within the home to allow for Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 15 the work to be carried out as quickly as possible. Whilst the building work was being carried out a significant part of the grounds were not accessible to the residents but all areas that were accessible had been assessed for safety. Once the work is finished the grounds will again be accessible to all residents. All rooms have been fitted with either a lockable drawer or a small lockable cabinet since the last inspection. The home was general clean and tidy. There were no malodours anywhere at the time of this inspection. The laundry area was cramped and hot at the time of this inspection. As part of the building/refurbishment work the laundry is to be remodelled and the changes were described to me, along with a description of the new equipment that is to be purchased. Discussion ensued with the staff regarding the problem of soiled/infected laundry, how it was currently handled and future plans. However the handling of soiled laundry was within local infection guidelines, the main problem is the shrinkage of clothing when washed at high temperatures. Solutions for this problem were discussed but no clear solution was reached. One area of the floor in the laundry had loose/raised floor covering that constituted a trip risk. The proprietor arranged for this to be fixed by maintenance staff urgently. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 &30 Staffing levels and training are appropriate to maintain the safety of the residents. EVIDENCE: Staffing numbers were maintained at agreed levels throughout the home. New prospective staffing numbers are to be supplied with the registration application. There will also be a need for a deputy manager to be employed when the bed numbers increase. The staff spoken to all enjoy working at the home and felt supported by the manager. Agency staff are not used at this home and all shifts are covered by the permanent staff. Staff turnover is generally very low. 95 of all care staff at Forest Place have National Vocational Qualifications at level 2 or above. Six of the staff employed as care assistants were foreign trained nurses, who were at various stages of an adaptation course, to enable them to register in this country. A number of the permanent registered nurses in the home were adaptation nurses originally and chose to stay on at the home when their courses was finished. Recruitment procedures were fair and thorough. Three staff files were reviewed during this inspection. Staff do not start work until the home has received two references and their Criminal Records Bureau declaration has been returned. References are always sent to the referee and ‘spot’ checks on their authenticity are made by phoning the referee. Statutory staff training was up-to-date and participants do not receive their certificates until they have completed and returned evaluation questionnaires that are designed to test their comprehension of the subject taught. Certificates are kept on individual personnel files. All attendance lists are signed by the participants and kept on file. At the time of this inspection there Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 17 had been a recent dementia updating course for all grades of staff in the home. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35, 36, 37 & 38 Management and administration procedures within the home generally protect the residents and ensure efficient running of the business. EVIDENCE: There had been no change in the management of this home since the last inspection, but recruitment of a deputy manager was being undertaken, planned to commence working at the home before registration of the new beds. Five residents accounts and monies were checked; three were correct. However the two incorrect ones were audited and corrected before the end of this inspection. Both errors were written accounting errors that were shown to the inspector for checking before leaving the home. The staff handling residents’ monies must be careful not to get distracted to ensure that they maintain accurate records. The inspector asked that the home check all residents’ monies and supply the commission with a statement that all were correct and up to date. None of the residents were handling their own financial Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 19 affairs at the time of this inspection. The home or its employees were not appointees for any of the residents. Supervision was being carried out on a more regular basis and the care staff spoken to on this occasion understood the basis of the supervision system. One care assistant spoken to said, “Supervision is very helpful.” Another found the regular meetings beneficial to discuss they’re workload and “challenges in caring for the elderly”. Supervision sessions were documented on new easy to follow charts, kept in the individual staff development files. Appraisals were up to date on the personnel files checked during this visit. Policies & procedures were generally good and documentation was kept securely throughout the home in line with the Data Protection Act 1998. All servicing contracts and certificates checked at the time of this inspection were up to date. The home was in the process of applying for the ISO 9000 certification so was getting all their documentation collated and up to date. During the tour of the home three of the sluices were left unlocked and all contained cleaning materials that should have been locked up under COSHH regulations. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x 2 3 3 2 Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 21 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 OP7 Regulation 15, Schedule 3(1b) 15(2b-c), Schedule 3(1b) 17(2), Schedule 4(11) Requirement The care plans of respite residents must be of the same detail as the care plans of premanent residents. The care plans of regular respite residents must be reviewed and changed as necessary, on each admission to the home. The registered manager must ensure that all complaint documentation is detailed and that the complainant is informed in writing of all outcomes of the investigation. (However this standard was not inspected at this visit.) The registered manager must ensure that all areas of the home are free from risk for staff as well as residents. (This is in relation to the repair of the flooring in the laundry area.) A yearly action plan must be written each year to ensure the ongoing development of the home for the improvement of the service users. (However this standard was not inspected at this visit.) {Timescale of 28/2/05 not met.} A yearly quality assurance Timescale for action Immediate 2. OP7 Immediate 3. OP16 Immediate 4. OP26 & OP38 23(2b) Immediate 5. OP33 24(1a-b) Immediate 6. OP33 24(2-3) Immediate Page 22 Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 7. OP35 17(2), Schedule 4(9a) 12(1a) 8. OP38 evaluation should be supplied to the local office of the Commission for Social Care Inspection. (However this standard was not inspected at this visit.) {Timescale of 28/2/05 not met.} The manager must ensure that the residents personal money accounts are kept up to date and correctly. The manager must ensure that all substances covered by the COSHH regulations are properly stored in locked areas. Immediate, on-going Immediate 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. Refer to Standard OP7 OP12 OP35 Good Practice Recommendations The detail in the care plan actions should be further improved, to enable the staff to know what specific care was needed for each individual resident. The registered manager should consider obtaining a course on a dementia course for the demnentia coordinator in the home. The manager should supply the local office of the commission with a written statement that all residents personal monies have been checked, are correct and up to date. Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Forest Place Nursing Home I56-I05 S15391 Forst Place V248282 091105 Stage 4.doc Version 1.40 Page 24 - 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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