Inspection on 04/01/06 for Foxgrove Residential Home

This inspection was carried out on 4th January 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 but made no statutory requirements on the home.

Other inspections for this house

Foxgrove Residential Home 15/11/06

Foxgrove Residential Home 26/10/05

Foxgrove Residential Home 09/03/05

Foxgrove Residential Home 13/09/04

Foxgrove Residential Home 27/10/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Foxgrove Residential Home High Road East Felixstowe Suffolk IP11 9PU Lead Inspector Mary Jeffries Unannounced Inspection 4th January 2006 13:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Foxgrove Residential Home DS0000024392.V275697.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 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. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Foxgrove Residential Home Address High Road East Felixstowe Suffolk IP11 9PU 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) 01394 274037 01394 274037 Pri-Med Group Ltd. Mrs Jennifer Ann Coulson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th October 2005 Brief Description of the Service: Foxgrove is a large Victorian house that has been extended and provides accommodation for up to twenty-four older people. It is situated in a residential area of Felixstowe, not far from some shops and other local amenities. There are sixteen single rooms and four double rooms although only one of the double rooms is now shared. On the day of inspection there were twenty service users and a new admission for respite care arrived during the morning. The accommodation is over two floors that are linked by a passenger lift. There is a large lounge facing the gardens with level access to the outside and a separate dining room on the ground floor. All the rooms have at least a toilet and wash basin with some having a full ensuite facility. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during an afternoon in January 2006. The Inspector was accompanied by a regulation manager, who was conducting a quality assurance exercise in respect of the Inspector. The inspection took four hours, including feedback. The Registered Manager helped facilitate the Inspection, as did the companies Operations Director who attended. There were 22 service users in residence at the time of the inspection, non were in hospital. Seven service users were spoken with individually, and four service users were tracked. Two of these service users were in the lounge, the others were spoken with in their individual rooms. Two relatives were visiting one service user and they were given the opportunity to speak with an inspector. They chose not to take this up and said that they had no problems. The two carers on duty and the cook also participated in the inspection. What the service does well: What has improved since the last inspection? What they could do better: Laundry procedures must be reviewed and the practice be in line with the policy. Unnecessary risks in the environment must be assessed and minimised. Records of medication that is ‘as required’ (PRN) and gives an option of dose i.e. one or two tablets, should have the amount recorded that is given to allow an audit trail. All staff should receive Protection of Vulnerable Adults training. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 6 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. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,6 Prospective service users can expect to have the required information available upon which to make an informed choice about where they want to live. EVIDENCE: The Statement of Purpose was inspected and seen to contain the required information. The home does not provide intermediate treatment. Standards 2,3,4,5,were inspected at the previous unannounced inspection and were found to be met. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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 the following standard(s): 7,9,10,11 Service users can expect to be treated with respect and for their right to privacy to be upheld. EVIDENCE: Four care plans examined were generally good, with some element of each having been reviewed on a monthly basis. One manual handling assessment seen on file did not reflect current care practices, see standard 27. The carers spoken to advised that one service user, who the Registered Manager had noted had was a high level of needs, required a hoist for all transfers. No reference to two carers being required for any element of care was made on the plan, although two carers were seen attending the service user. One of the care plans inspected noted “final wishes not yet discussed” 18/1/05. This had not been subsequently added to in any way. The manager advised that bed-sides were in use with one service user. This service user was spoken to and advised that they had asked for bed-sides them self, because they had fallen out of bed previously. A risk assessment for Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 10 bed-sides was seen to be on file, it was signed by the manager and the service user. The medication administration records (MAR sheets) for the previous 6 days were inspected. An errors chart was maintained and signed when rectified. A record of received medications was maintained and signed by two people. Specimen signatures were on file. MARs sheets were accompanied by a room number, the service users’ date of birth, and General Practitioner, and showed if the service user was selfmedicating, and a photograph of the service user. There was no photograph on two of them, no G.P entered on two and no date of birth on one. A requirement was made at the previous inspection that the MAR sheets must record the number of tablets administered when a prescription allows a range of doses. This was seen to have been implemented, but not consistently. For one service user who was prescribed Senna, the quantity given was not recorded, where the medication details stated 1or2, although the dose box stated 2. For another service user prescribed senna, none had been administered but the dose stated one or two at night. One gap was identified in the signature boxes. A service user spoken with said that “they bring the tablets in when they are due and they stand there till you take them….. that’s fine, so you can’t forget them.” One of the service users spoken to advised that staff had established with them what name they preferred to be called by. Two carers arrived at the service users room whilst the inspector was speaking with the service user. The staff knocked at the door, and awaited a response before entering. The carers were friendly and personable on arrival. Another service user described the carers as very pleasant. This service user required assistance with the bath seat, and advised that staff left them to stay in the bath for as long as they liked, and that they called for the staff when they needed assistance to get out. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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 the following standard(s): 14 Service users who do require minimal personal care can expect to have considerable choice and control over their lifestyle. The home needs to ensure that there is some flexibility and consultation around the time service users requiring assistance to wash and dress rise. EVIDENCE: Standards 12,13,and 15 were inspected at the previous unannounced inspection and were found to be met. One service user spoken with praised the carers approach, saying, “I couldn’t wish for anything better, the girls are cheerful and attentive if necessary.” Another service user said “ I can go at my own pace,” and “I can do what I like.” This service user said that they had their meals in their own room, because they preferred to do so, and explained that they choose their meals from a list each day. Another service user also advised that they had their meal in their room. Staff said that they encourage service users to come down to the dining room to eat, but that it is their choice. There were newspapers in the hall of the home, and service user’s preferences were recorded. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 12 One service user spoken with said that they got up out of bed when they liked, the Inspectors were advised that another who requires assistance to rise is attended to at 6.30 am every morning. There was no entry on the care plan indicating that this time had been determined to meet the service user’s needs, and care staff advised that the times to get those service users up who need assistance was not recorded or indicated on any of the care plans. The service user who rises at 6.30 was said not to mind this by their partner, and that they did not “really mind” it. They went on to explain that the carers had a lot to get up before breakfast. Carers said that they assisted service users get up between 6 am and 8 am, and that no one had complained about this. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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 the following standard(s): 16,18 People who use this service can expect to feel able to raise concerns and for these to be responded to. They cannot be assured that all staff will have had Protection of Vulnerable Adults (POVA) training. EVIDENCE: One service user confirmed that they would speak to management of they had anything to complain about. Another said that they would, but had not had anything to complain about. They advised that they had made suggestions, and that these had been acted upon. One service user said that if they had anything to sort out they would speak to the senior carer first. At the previous inspection it was established that although staff had an understanding of dealing with abuse, that a housekeeper had not had Protection of Vulnerable Adults training, although it is within the training programme for ancillary staff. A requirement was made all staff who have not yet had any must receive updated POVA training. The Registered Manger advised that Protection of Vulnerable Adults training had not yet been arranged for managers. They also advised that no additional training had been provided since the last inspection, and that they were awaiting a scheduled “road show” of training that the company puts on. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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 the following standard(s): 19,23,25,26 Service users can expect to live in an attractive and comfortable environment, however, some of the risks that they are exposed to have not been minimised. EVIDENCE: Standards 20, 22,and 24 were inspected and found to be met at the previous inspection. The home was comfortably furnished and maintained to a high standard of cleanliness. Individual rooms seen were personalised and contained the appropriate furniture. A service user spoken with advised that they had brought in some small pieces of furniture and pictures. One of the service users spoken with said that they were very pleased with their room. There were fresh flowers in the lounge and hall. The home was nice and warm, and a wall-mounted thermometer read 25 degrees Celsius. The decor was generally good and of good quality, however carpets were seen to be badly worn in two areas. Wear in the lounge was in an area that was underfoot for Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 15 service users’ sitting in the corner of the lounge. At the inspection in September 2004, the home had advised that this was scheduled for replacement, and again at the inspection in March 2005. The carpet was threadbare on a vertical riser at the foot of the main staircase, but this did not provide a hazard. One service user spoken with said, “ It doesn’t worry me that, it’s a good quality carpet and it’s just that bit.” Radiators throughout the home had not been covered. The Registered manager advised that the home did not have risk assessments in respect of radiators. A service user spoken to commented that they thought that the home was very good in respect of hygiene and confirmed that they observed the carers wearing protective aprons when the did personal care. Another service user said that they had protective gloves in their bathroom, which the carers used when they assisted with the management of their illeostomy. Bathrooms seen had the appropriate liquid hand wash and paper towels, however one shower room seen had a towel in it, and a stack of clean towels on a shelf. Carers spoken to advised that the washing machine did not have a sluice cycle. The machine was seen and this was confirmed. The carers advised that they washed sheets in a dissolvable bag, on their own, at a very high temperature. They were asked how they deal with the soiled sheets of a service user. The service user in question had MRSA, however, their sheets should be dealt with in the same way as other laundry. The carers confirmed that the service user was sometimes incontinent of urine, and occasionally of faeces. They advised that residual waste only was present on the sheets when they were washed, and showed a bucket that the sheets were soaked in. The Registered Manager advised that the home’s infection control policy did not provide for laundry to be soaked in a bucket. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 There was no evidence to suggest that the home was not adequately staffed on the day of the inspection. EVIDENCE: Standards 29 and 30 were found to be met at the previous inspection. The Registered manager advised that the home was using a system to monitor service user’s dependency levels, and that one service user in the home had a high level of dependency. The tool was seen and was very comprehensive. The most recent one available was dated 4th November 2005, and the Registered Manager advised that they were just about to update this. Two carers were seen attending to one of the service users, and advised that the service user needed two carers for the personal care they were providing. A requirement for two carers for some tasks was not identified on the care plan that was inspected. The manual handling assessment dated May 2005 had not been updated to this effect, although it had been updated with an entry in December 2005, marked mobility assistance, “transfer (them) using wheelchair hoist”. The carers advised that the service user was currently assisted to transfer at all times. Whilst these two carers were with the one service user, this only left the Registered Manager to respond to any other service users’ needs. No call bells were heard during this time however. One service user spoken with was concerned that the carers seemed very busy and “seem to Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 17 have their lunch on the run.” Care staff spoken with said they had two twenty minute breaks. The manager advised that they were in ongoing discussion with the District Nurses who attended this service user, as they were of the opinion that they required hospital care. There were two carers, one a senior, on duty in addition to the Registered Manager. The cook was present until 3pm. The cook advised that they did as much as they could to prepare suppers before going off duty. Both carers were involved in preparing afternoon tea at 3.30 pm. The carers advised that they go off duty at 5pm, and that the two staff providing evening cover did the teatime medication round and get supper ready. Two service users individually confirmed that when they had had to use their call bells they had received very swift responses. They also said that they used their call bells very infrequently, and few bells were heard during the time the Inspectors were present. The Registered Manager confirmed that all staff had training folders, and that a notice board gave more detail. Training files were requested for the two staff on duty. The manager advised that none of the annual “road-show” of training events had occurred since the last inspection. This is provided by the company and includes moving and handling, fire awareness, POVA and health and safety training are updated each year. Both of the carers on duty were recorded to have had moving and handling training within the last six months. An NVQ 2 certificate was displayed for one of the cares on duty, a level 3 assessors certificate, which is not a care qualification in itself was displayed for the other. One of them also had a certificate displayed which evidenced they had undertaken Boots Foundation training in medication administration in 2004. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Service users can expect to live in a run that is managed by an appropriately qualified and experienced manager, in the best interest of the service users. EVIDENCE: The Registered Manager advised that they had completed a level 4 Diploma in Management Diploma Course, run by the Chartered Management Institute. The certificate was displayed in the home. Notes of a Service user Meeting held in September 2005 were seen. Only a small number of service users had attended, but a good range of issues were discussed, including laundry and lighting. Records of the three previous service user meetings were also on file, and these had taken place at approximately six monthly intervals. A service user spoken with said that they had found the meetings very useful. The manager advised that a Quality Assurance exercise Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 19 involving all stakeholders had been carried out last autumn, and a copy of the results of this were forwarded following the inspection. Some small amounts of service user’s monies were looked after. Records showed that transactions were witnesses and had two signatures against them. Amounts stated were not checked against amounts held on this occasion. The home’s certificate of registration was displayed and correct. An assisted bath hoist was seen to have been recently serviced. A record of bath temperatures was maintained on a weekly basis and showed temperatures between 42 and 43 degrees Celsius. The handyman who conducted these checks advised that they also did a weekly check of the emergency lighting in the home. Staff advised that one service user was allowed to smoke in their own room, The manager confirmed that it had been very recently decided that this was acceptable for this service user, and that a risk assessment in respect of this had not yet been undertaken. A risk assessment in respect of this was received by the CSCI within three days. The home’s fire risk assessment had not been updated to address this risk. Regular fire instructions and fire drills were logged up until the end of December 2005. Fire extinguishers were seen to have been serviced, and recorded as being. Fire training had been provided in May 2005. One service users room which was at the end of a corridor had a Dorguard closing devise holding it open, a device which is not linked to the fire alarm system, but which is activated by the sound of the fire alarm. Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X 3 X 2 2 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13(4)(c) Requirement A manual handling assessment for a service user who is not weight bearing must be reviewed. The MAR sheets must record the number of tablets administered when a prescription allows a range of doses, and if none are given this must be recorded with an explanation. All staff who have not yet had any must receive updated POVA training. The carpet in the lounge must be replaced or repaired to a good standard. All uncovered radiators that are not low surface temperature radiators must be risk assessed. Towels must not be left in communal bathrooms, so that the risk of cross infection is minimised. The home must ensure that laundry practices fully accord with good infection control procedures. DS0000024392.V275697.R01.S.doc Timescale for action 28/02/06 2. OP9 13(2) 26/10/05 3. OP18 13(6) 30/06/05 4. 5. OP19 OP25 13(4)(a) 13(4)(a) 31/03/06 28/02/06 6. OP26 13(4)(a) 28/02/06 7. OP26 13(4)(c) 28/02/06 Foxgrove Residential Home Version 5.1 Page 22 8. OP38 23(4)(c) The home’s fire risk assessment updated to address the risk of a service user who is allowed to smoke in their own bedroom. 11/01/06 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 OP9 OP14 Good Practice Recommendations Service users final wished should be elicited and entered on care plans. Records accompanying MARs sheets should be complete. Service users who require assistance to get up should be consulted with about the time when this is to occur, with a view to accommodating preferences, and this should be recorded as part of their care plan. The home should consult with their laundry and, if required, take specialist advice from infection control specialist, to establish as satisfactory way of dealing with foul laundry. Care plans should identify where two carers are required for personal care of moving and handling. The local fire officer’s advice should be sought regarding the use of a Dorguard self-closing device for a door at the end of a corridor. 4. OP26 5. 6. OP27 OP38 Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Foxgrove Residential Home DS0000024392.V275697.R01.S.doc Version 5.1 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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