Inspection on 22/09/05 for Garswood House

This inspection was carried out on 22nd September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Garswood House 07/09/06

Garswood House 10/01/06

Garswood House 02/12/04

Garswood House 03/06/04

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

CARE HOMES FOR OLDER PEOPLE GARSWOOD HOUSE Wentworth Road Ashton-in-Makerfield Wigan WN4 9TZ Lead Inspector Kath Smethurst Unannounced 22 September 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. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Garswood House Address Wentworth Road Ashton-in-Makerfield Wigan WN4 9TZ 01942 728333 01942 276682 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) CLS Care Services Limited Ms Anne Julie Washington CRH Care Home only 40 Category(ies) of DE(E) Dementia over 65 - 1 registration, with number OP Old Age - 40 of places PD(E) Physical Disability over 65 - 8 GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include:up to 40 service users in the category of OP (Older People) up to 8 service users in the category of PD(E) Physical Disability over 65 2. The service should employ a suitably qualified and experienced manager who is registered by the CSCI. 3. One named service user (MC) may be admitted in the category of DE(E). 4. The Homes Statement of Purpose must be altered to set out how the service and facilities offered by the Home will meet the needs of the one individual service user with Dementia by 31/3/05. 5. The Homes Manager and senior carers must be adequately trained to meet the specific needs of the two individual service users with Dementia by 31/3/05. 6. The Homes carers must be adequately trained to meet the specific needs of the one individual service user with Dementia by 31/3/05. Date of last inspection Brief Description of the Service: Garswood House is a single storey building with well maintained garden areas, situated in the middle of a housing estate, approximately a mile from AshtonIn-makerfield town centre. It is close to shops and other local facilities and is well served by public transport. The Home is spacious with several lounges. All bedrooms are single and some have an ensuite toilet facility. There are ample communal toilets and bathrooms situated throughout the home. Garswood House provides personal care and support for forty people over the age of sixty five years eight of whom may have a physical disability. The home is owned and managed by CLS Care Services Limited who have 40 plus homes around Cheshire and the Wigan area. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9.30 am. It took place over five hours during the morning and afternoon. The inspector looked around some but not all of the home. Records were looked at and the inspector ate the meal served to residents at lunchtime. To get more information about the home the inspector spoke to five residents, seven staff and the acting manager. What the service does well: What has improved since the last inspection? Good progress has been made by the manager to make sure that the things, which needed improving from the last inspection, have been done. The home is well presented nevertheless improvements to the décor continue, ensuring residents live in a welcoming, pleasant and homely environment. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 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 GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 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) 3 and 4 The admission procedure is good and systems are in place to ensure proper assessments are completed prior to people moving in. The manager and staff demonstrated a high level of commitment to ensuring the needs of residents were being met. EVIDENCE: Inspection of the records of four residents showed an assessment of care needs had been completed and where applicable social work assessments had been taken note off. The assessment document was detailed and included information relating to physical needs and personal preferences. All assessment documents had been signed and agreed by residents or their representatives. A good assessment system is in place. The manager or senior staff visit each person either at home or in hospital whether they are paying for themselves or being paid for by the local authority. The acting manager was very clear that if following an assessment it was felt the home could not meet needs then an individual would not be admitted. If possible the home will arrange for prospective residents to visit prior to admission so they can meet the staff and other residents. Two residents spoken to confirmed they had visited before GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 9 deciding to come to live at the home. For those residents admitted on an emergency basis all necessary details are obtained as soon after admission as possible. All residents spoken to felt their needs were being met. During the inspection staff were seen to be attentive to the needs of residents and knew what care was needed. The manager had identified where staff required training and had arranged training sessions for staff in different aspects of care such as moving and handling, first aid, medication and National Vocational Qualifications. Where it was identified that residents had specialist health needs, health care professionals were involved. For example general practitioners, district nurses and consultant geriatricians. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 10 In the main care plans were detailed, up to date and reflected the care needed, but some records had not been completed, which meant important information had not been documented. Personal support is offered in such a way as to promote residents privacy. EVIDENCE: Four care plans were examined. All contained comprehensive information relating to residents personal, social and health care needs. Daily entries in care notes were completed in all the plans examined and gave a good indication of the care provided and residents well being. The plans were easy to read, had been regularly reviewed and set out clear guidance for staff to take when providing care. There was written evidence that the plans had been signed and agreed by either the residents or their representatives. All the residents spoken to all said they were satisfied with the care provided. The acting manager is in the process of reviewing and updating care plans taking a person centred approach. The care plans examined contained some very good information in respect to residents past lives, needs, likes/dislikes and chosen lifestyle. For example one read “ I like to make my own choice of what time I go to bed”, a second “I like to stay in my room and watch TV but I GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 11 enjoy a chat at lunchtime and like a smoke on the link”, a third “ I often have the radio on throughout the night”. While records of residents weights are maintained some omissions in recording were noted in three of the care plans examined. For example in one plan staff were instructed to weigh weekly but records indicated this particular resident had not been weighed for three weeks. It is important to regularly weigh residents to ensure their nutritional needs are being met and as such needs to be addressed. This was discussed with the acting manager who offered assurances this would be addressed. Comprehensive risk assessments were in place in all files examined. They covered areas such as nutrition, pressure areas, moving and handling, bedrails and falls. All had been reviewed and updated on a regular basis. Anecdotal evidence from residents indicated that staff respected their privacy and dignity. During the inspection staff were seen to treat residents with respect and consideration, were attentive to individual needs and discreet when providing assistance. Written evidence in care plans showed that resident’s needs in respect to dignity were considered important. For example personal appearance. In one plan staff were instructed, “ I like my nails manicured and painted, not bright colours but nice pinks”. A resident spoken to confirmed she had a key to her bedroom door and that staff always “knocked” before they came in. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15. Meals are good and the needs of residents are well catered for with a balanced and varied selection of food provided. EVIDENCE: Activities in the home were not covered during this inspection, but in discussions with residents, some said they would like Sky TV installed as they enjoyed watching sport. This is an area management should give some consideration to. Menus were examined and were found to be well balanced and nutritious. Menus are compiled centrally for all CLS establishments. Discussion with the staff indicated menus were adapted to suit resident’s preferences. A choice is offered at every meal. Breakfast is served on a flexible basis from 8.30am to 10.30 am residents were observed having their breakfast at various times during the morning. One resident spoken to confirmed she was able to have her breakfast when she wished. The main meal is served at teatime with a lighter meal served at lunchtime. Drinks and snacks are offered throughout the day. Meals are eaten in the main dining room but if they wish residents may eat their meals in their rooms. The dining area was clean and efforts had been GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 13 made to give an air of domesticity. Dining tables were tastefully set so ensuring a congenial atmosphere. Menus are also displayed. The inspector sampled the food served at lunchtime. Lunch on the day of inspection consisted of soup and sandwiches. A good selection of sandwich fillings was available. The meal was well presented, in sufficient quantities and tasted good. Staff were sensitive and discreet when providing assistance, no one was rushed and second helpings were offered. A number of residents living in the home were spoken to and everyone who commented said the food was good. All expressed satisfaction with the quantity and quality of the meals provided. Residents also confirmed that if the meal was not to their liking an alternative was always made available. One resident described the food as being “ good”. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. The home has a satisfactory complaints system with evidence that residents feel their views are listened to and acted upon. EVIDENCE: A detailed complaints procedure is in place. Details of how to complain are contained in the “Service User Guide” which each resident has a copy of. A system is in place for recording complaints. The homes complaints book was examined and showed seven complaints had been logged since the last inspection. The complaints related to care practice, missing items of clothes, provision of drinks and late meals. There was written evidence these complaints had been thoroughly investigated including details of the steps taken to rectify the issues and a copy of the report sent to the complainant. All the concerns raised had been resolved to the complainant’s satisfaction. No formal complaints have been received by the CSCI over the past year. Anecdotal evidence from residents indicated they felt able to approach staff with any concerns and these would be taken seriously. None of the residents spoken to had made a complaint but all indicated they were aware of how to do so if the need arose. In addition to the formal complaints system the home holds regular residents meetings where residents can air their views. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 15 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 and 26. The standard of the environment within this home is good providing residents with an attractive, homely and clean place to live. EVIDENCE: Garswood House is well maintained internally and externally. Nevertheless improvements to the fabric of the building continue. For example, since the last inspection the dining room and some corridors have been redecorated. In the main standards are good but it was noted that the parquet flooring in the dining room is stained/ worn and as such requires attention. It would be a shame to remove or cover this original feature so sanding and staining might prove to be the best option. The Home is spacious with several lounges, a dining area, activity and hairdressing rooms. These areas are furnished with good quality items. Ornaments, pictures and flowers enhance the homeliness of these areas. The garden areas are tidy, well maintained, safe, secure and accessible for residents. Residents spoken to made no adverse comments about environmental standards in the home. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 16 With the exception of a slight malodour in the corridor near Ascot lounge all other areas of the home had good odour control. On the day of this unannounced inspection the home was clean throughout. Residents commented positively about the cleanliness of the home. Policies and procedures were in place with regard to infection control. Staff were provided with protective aprons and disposable gloves. Liquid soap and paper towels were provided near to hand washing facilities. Staff were observed to be maintaining good hygienic practices. All laundry is undertaken on site and residents spoken to had no complaints about the standard of laundry service provided. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 17 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 and 30. Staff morale is high resulting in a committed and enthusiastic workforce, this ensures a consistent standard of care for people living in the home, but staffing levels need to be reviewed to ensure care needs are not compromised. A comprehensive on-going training programme is in place, but induction training needs to be improved to ensure new staff are equipped with the skills and knowledge they need to meet residents care needs. EVIDENCE: Residents spoken to said staff looked after them well. One resident described the care as being “ very kind and caring”. Many of the staff have worked at the home for a considerable time and staff turnover is relatively low low. It was clear from the comments of staff that they liked working at the home and felt they worked well as a team. On the day of inspection sufficient staff were on duty to meet residents care needs. During the visit staff were observed to respond speedily to requests for assistance made by residents. Examination of staff rotas showed that when staff were on leave or off sick absences were covered. The Manager works on a supernumery basis. Domestic and catering staff support care staff seven days a week. In addition an activity organiser and handyman work on a part time basis. There are four staff working on each day shift, one of these is a Care Team Leader who is counted in staffing but who carries out admin and management and is responsible for the shift when the manager is not on duty. These duties GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 18 could at times take care team leaders away from providing direct care to residents. This situation could compromise resident’s care if dependency levels increase. Currently the night shift has one care team leader and one carer on duty, to assist residents to bed and support them throughout the night. Given the layout of the building and dependency levels of residents this may not be sufficient. It was evident from staff comments that additional care staff would be beneficial. Staff said they would like to spend more quality time with residents socialising and providing emotional support. Staff felt this was an important aspect of their work, which could be improved with additional staff. In previous inspections concerns were raised as to whether staffing levels at night are sufficient to meet service users needs. In response the manager undertook a review of staffing levels. The review indicated that staffing levels were adequate. Nevertheless this situation needs to be kept under review to ensure ratios are sufficient to meet residents care needs. It is important to regularly review staffing levels given that the needs of older people can increase suddenly as a result of an accident, illness or as part of the ageing process. The training records of four staff were examined. The record of a recently appointed member of staff showed she had undertaken one-day induction training. However there was no documentary evidence of this member of staff having completed further training although blank induction packs that meet the National Training Organisation (NTO) specifications were seen. The manger must ensure that all new staff undertake induction training, which meets NTO specification within 6 weeks of appointment to their posts, and foundation training within 6 months of appointment. The acting manager offered assurances this would be addressed. A comprehensive staff development programme is in place and records of training are maintained. All grades of staff have a training profile, which identifies training needs. Ongoing training is available and there is ample evidence that these opportunities are taken up. Recent courses undertaken include moving and handling, first aid, medication, dementia care and National Vocational Qualifications (NVQ). The manger advised that by Christmas it is expected that 50 of staff will be in receipt of NVQ level two. This needs to be monitored to ensure progress in meeting the required target is maintained. It was also pleasing to note that training opportunities are made available to catering and domestic staff. Staff who commented confirmed that training was encouraged and widely available. One member of staff described the training as being “ good”. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 19 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) 33 and 35. The home regularly reviews aspects of its performance through a good programme of self-review and consultations, which include seeking the views of residents, staff and relatives. A satisfactory accounting system was in place, which protected resident’s interests. EVIDENCE: Effective internal and external quality assurance systems are in place such as staff and residents meetings and visitor/residents surveys. A sample of the most recent completed surveys was examined. The feedback from both residents and visitors was very positive. There was evidence that comments in surveys had been acted upon. For example a resident spoken to said she had wrote in the most recent survey that the chairs on the link area needed cleaning and this had been done. Some visitors commented that items of their relatives clothing had been lost in the laundry. As a result a review of the laundry had been undertaken and a new system of returning residents clothes had been introduced. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 20 CLS representatives visit the home on a monthly basis to audit records and speak to residents and staff. A written report is then produced of the findings, which is then forwarded to the CSCI. The home has a system for recording the complaints of those who don’t wish to complain formally. Residents are informed of CSCI inspections and inspection reports are available for visitors and residents to read. The Contracts Section of Wigan Social Services Department, in conjunction with a company called RDB Limited, has undertaken a voluntary star rating of homes in Wigan. As part of the rating process an annual audit of quality is undertaken. This includes consultation with service users and staff. Garswood House has been awarded 5 stars, which is the highest rating. The home has a satisfactory accounting system in place. Staff could determine exactly how much money the home was holding for each resident. The Home looks after small amounts of resident’s personal allowances. Detailed records are held of all transactions. All monies held for safekeeping are kept individually. A record is kept of monies credited and debited and receipts were obtained for financial transactions. Secure facilities are provided for the safe keeping of money. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 21 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 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 29 x 30 2 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 3 x 3 x x x GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 22 No 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 7 Regulation 15 Requirement Care plans must reflect full details of service users assessed needs and actions necessary to meet identified needs including a record of residents weight. As part of the planned maintenance the flooring in the dining room must be attended to. To ensure staffing levels are sufficient a review of ratios must be undertaken. Details to be forwarded to the CSCI. 50 of staff must be in reciept of NVQ level 2. All staff must undertake induction training which meets the National Training Organisation specifications. Timescale for action 31 October 2005. 2. 19 16 & 23 1 March 2006. 31 October 2005. 1 January 2006. 31 October 2005. 3. 27 18 4. 5. 28 30 18 18 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 12 Good Practice Recommendations Consideration should be given to providing Sky TV for residents. F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 23 GARSWOOD HOUSE 2. 27 Consideration should be given to providing an additional member of staff at night. GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 GARSWOOD HOUSE F56 F06 S5734 Garswood V238745 210705 Stage 4.doc Version 1.40 Page 25 - 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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