Inspection on 07/02/06 for Gorselands

This inspection was carried out on 7th February 2006.

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

The inspector 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

Gorselands 03/07/08

Gorselands 31/07/07

Gorselands 01/08/06

Gorselands 31/10/05

Gorselands 27/01/05

Gorselands 15/04/04

Gorselands 28/10/03

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

CARE HOMES FOR OLDER PEOPLE Gorselands 25 Sandringham Road Hunstanton Norfolk PE36 5DP Lead Inspector Mr Christopher Handley Unannounced Inspection 7th February 2006 09:30 am 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 Gorselands DS0000037280.V281735.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. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gorselands Address 25 Sandringham Road Hunstanton Norfolk PE36 5DP 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) 01485 532580 cieves@ntlworld.com Cieves Limited Position Vacant Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2005 Brief Description of the Service: Gorselands is a large detached residential home which has 21 beds, and is situated in Hunstanton, which provides care for elderly ladies. The accommodation is on the ground and first floors with a shaft lift to access the first floor. There are 17 single rooms and two double rooms. Eight of the bedrooms have en suite toilets. There are assisted bathrooms and toilets. The communal areas consist of a large lounge and dining room, both of which have good natural light and overlook the garden. There is a large paved car parking area at the front of the home. The gardens, which are well maintained, have a range of ornamental flowers and a fountain. The garden at the rear of the home is suitable for wheel chair users. The home is adjacent to the facilities and seafront of Hunstanton. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which was part of the annual inspection programme. Six residents, one visitor, and three members of staff were interviewed. The Inspection commenced at 9.30am, and was completed at 2 pm. Mrs Civa the Proprietor was present during the inspection and Mrs Morris, Senior Carer, was involved with some elements of the Inspection A wide range of documentation was examined as part of the inspection. The Inspector toured of the home accompanied by the Proprietor. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 6 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 Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 7 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): 4 & 5. The home can meet the needs of prospective residents. Prospective residents and their relatives have the opportunity to visit the home, to see if it meets their needs. EVIDENCE: The Proprietor said that she is able to demonstrate the home’s capacity to meet the needs of prospective residents and this is based mainly on three factors, which she considers prior to offering a placement. Firstly, the detailed pre-admission assessment of the physical, mental, and social needs of the prospective resident. Secondly, her knowledge of the layout of the home and equipment available, the residents ability, and their degree of mobility to move around the home. Thirdly, the staff skills and her knowledge of local community support. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 8 Prospective residents and relatives are welcomed to visit the home prior to admission, the Proprietor said. She feels strongly that “the home must be for them”. Residents interviewed by the Inspector confirmed this view, having seen other homes prior to admission they told the Inspector that “they felt that this was the home for me”. Prospective residents and relatives are taken on a tour of the home, and a question and answer session follows. Printed information is provided. The Statement of Purpose and Service Users Guide provide a wide range of information about the home. Refreshments are provided. Based on what the Proprietor and residents said, it does appear that every effort is made to provide the prospective residents with a full picture of the home, prior to them moving in. Gorselands DS0000037280.V281735.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. All residents have a care plan but service users do not appear to be involved in the process. They need to be made more individual, and the management of the documentation needs to be improved so it is accessible to service users. The medicine system needs to be made safer. Residents’ rights are respected and their privacy is upheld. At the time of their death, residents, and their families, are treated with dignity, sensitivity, and respect. EVIDENCE: All residents have a care plan, six were read by the Inspector. The plans have the elements of assessment, plan, implementation, and review. Other documentation include a Pressure Sore, Falls and Moving and Handling Assessment. There is a Geographical Hazard of the home. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 10 The Proprietor needs to undertake a major review of the present system used. At present there are six sets of notes kept in one ring binder folder and each folder is marked Confidential. Such arrangements make the effective management of the documents very difficult. In the inspection dated 31/10/05 a recommendation was made that the home returns to its previous practice in which each resident had an individual folder. The Inspector was disappointed to see that this has not happened and now makes this a requirement. By doing this it emphasises the individuality of each residents records, and they would be easier to manage and maintain and would make it easy to comply with requests by residents to access information held on them. Some of the documents in the files are now out of date and need to be removed but kept. At present the care plans are kept in a locked cupboard and the Inspector recommends that a new metal cupboard be purchased specifically for the storage of these documents. In the files read there was no evidence of the residents or relatives being involved in reviews of care and it is recommended that they must be. The medicine system was inspected by the Inspector with the assistance of Mrs Morris, the Senior Care Assistant, who provided the information required. The first thing that was noticed was that the medicine trolley was not locked to the wall. In the inspection dated 31/10/05 it was recommended that it should be kept locked to the wall. This is now required, because of the potential dangers involved. The Inspector also saw a blue medicine return bag in the corridor awaiting return which contained medicines. This is not safe practice. The Senior Care Assistant removed them and put them in an adjacent cupboard, which was locked. The Inspector makes it a requirement that when medicines arrive in the home or await removal they are kept in locked cupboard, until they can be dealt with. The medicine trolley was found to be neat and tidy, there were no loose, or unaccounted for medicines. The home uses a Monitored Dosage System and there are well kept records for this. There were no Controlled Drugs in the home on the day of the inspection; the Senior Carer said, and added that the District Nurse brings them to the home and dispenses them. There are no residents who self medicate, Mrs Morris informed the Inspector. All staff who administer medicines have had training for this. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 11 The home has a detailed medicine procedure, which was briefly read by the Inspector. The administration of medicines was seen, and they were neatly initialled. From time to time residents go home for a short spell and take their medicine with them. The Senior Carer explained the process for this. The medicines are put into proper containers, and the medicine record is marked D, for Social Leave. On return to the home, the resident/relative is asked how they managed the medicines, and they are commended for this good practice. Medicines are reviewed by the prescribing G.P. and this is recorded in the residents notes, the Inspector was informed. The home has a good working relationship with the dispensing pharmacy. If staff had any concerns about the effects of medicines on residents they would contact the prescribing doctor. The residents’ privacy and dignity are upheld at all times the Proprietor said. The residents spoken to positively confirmed this. When personal care is being provided or consultations or/examination are being undertaken this would be carried out in the privacy of the resident’s room. There is a public phone on the ground floor, two residents have phones in their rooms, and at times residents use the home’s mobile phone, the Proprietor said. Residents wear their own clothes at all times, the Proprietor said. Residents are addressed by their preferred name and the Inspector heard evidence of during the process of the inspection. Screens are provided in double rooms. The Proprietor said that care and comfort are provided to the dying resident. Pain relief would be arranged and provided if needed. The families are very much involved in this process. The resident’s wishes concerning terminal care are carried out. Representatives of religious bodies are called ,if the resident wishes. Relatives can stay over if they wish and they are quietly supported during these times, with refreshments, and company etc. The home has a policy on this matter. The Proprietor said that the role of the home is to support people at such times, but not to take over. Junior staff who may not have experienced death are supported by more senior staff, the Proprietor said. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 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 the following standard(s): 12, 13 & 15. The lifestyle of residents matches their expectation and preferences. Good contact is maintained between the residents and their family and friends. The home provides a good catering services. EVIDENCE: The daily routines of the home are as flexible as can be arranged. Residents told the Inspector that they choose what they want to do, “ I can lie in if I want to”, “ I can go to bed when I choose”, “I can go up to my room if I want”. A number of residents go out with their relatives, and the Inspector spoke to one such relative who told him that she was “Just taking mother into town”. Representatives of local churches and organisations call to the home on a regular basis. Relationships and friendships do form from time to time, the Proprietor said. The Inspector was provide with a copy of the Activities Calendar for February, and this showed, Friendly Faces, Union church choir, Exercise Sessions with Jenny, “Nick the entertainer”, “Musical Movement” and Holy Communion by Father John.” Some of the residents interviewed confirmed that these activities took place and they were enjoyed. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 13 A number of residents attend the local Day Centre. Visitors may visit at any time, and this was observed during the inspection, but are requested not to visit during meal times, the Proprietor said. Residents may receive visitors in the privacy of their rooms; some choose to see them in the lounge. Residents are able choose whom they see, and don’t see, the Proprietor said. The Inspector was shown the menus, they appeared nutritious, varied, and interesting. At present there are no residents who require a special diet but if they were required they would be recorded the Proprietor said. The residents interviewed spoke very highly of the meals provided and said that they were “very nice”, there is a “good variety” and that they are always “nice and warm”. If needed the Proprietor would seek advice from the Dietician based at the Queen Elizabeth Hospital. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 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 the following standard(s): 16, 17 & 18. The home has an effective complaints procedure. Residents’ legal rights are protected. Service users are not protected from abuse as the owner of the home has not received up to date training. EVIDENCE: The complaints procedure, is contained in the Service Users guide, which was seen by the Inspector. There have not been any complaints since the last inspection, the Proprietor said. Residents interviewed were aware that the home has a complaints procedure, and they knew how to make a complaint if it were needed. In the inspection dated 31/10/05 the Proprietor said that she intended to place a complaints procedure in the porch of the main entrance and the Inspector supported this idea. As yet how ever this has not happened and the Inspector now makes this a recommendation, as the move would positively enable residents/ relative to read the document discreetly. The Proprietor added that she intends to provide a box for complaints to be placed in. The Proprietor said that the resident’s legal rights are protected. If needed advocacy would be facilitated with the assistance of a Social Worker. There are a number of residents who use their postal votes, the Proprietor said. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 15 The home has a policy for dealing with Adult Abuse. There have not been any such incidents since the last inspection, the Proprietor said. All staff has been provided with training in this matter. In the inspection dated 31/10/05 it was recommended the Proprietor undertake training in Adult Abuse Prevention, as yet this has not happened. She acts as the manager for this service, so it is essential that she undertakes this training. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 16 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, 22, 25 & 26. Residents live in a safe, well maintained environment. Residents have access to safe and comfortable communal facilities. Residents live in a safe comfortable environment. The home is clean, pleasant and hygienic. EVIDENCE: The location and layout of the home is suitable for its stated purpose. The Inspector was shown the home’s programme of routine maintenance, and the Proprietors are commended for this, as this management tool will assist them in maintaining the environment of the home to a high standard. The Proprietor said that the home has a dedicated budget for the upkeep of the home. New carpeting has been laid in the dining room, hallway, lounge, staircase and part of the first floor corridor. The Proprietors are commended for this. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 17 The Inspector toured the home accompanied by the Proprietor. The communal rooms have good natural, and artificial light and are in a good state of decoration. There is a large comfortable lounge and a traditional dining room, which the Proprietor said would have parts of it redecorated in the near future. Both rooms are traditional in design and are decorated to a high standard, and have been re-carpeted, and both overlook the gardens. The grounds are kept neat and tidy and have garden furniture with sitting out space. During the tour the Inspector noticed that the names of residents were not on doors. In the inspection dated 31/10/05 it was recommended that residents have name plates on the doors of their rooms. This has not yet taken place and the Inspector repeats the recommendation The Proprietor told the Inspector that an assessment of the home had been undertaken by a qualified Occupational Therapist shortly before they had purchased the home and the advice given concerned lifting equipment, which has been purchased. Since then grab rails, hoist, wheel chairs, and other equipment have been purchased and were seen by the Inspector during the process of the inspection. The premises were neat clean and tidy during the morning of the inspection. Residents told the Inspector that the home was always clean and tidy. There is a laundry at the end of the ground floor corridor which has good natural light. There are hand-washing facilities, the floor is impermeable, and there are tiles on the walls. The home has procedures for the control of infection and the safe handling and disposal of clinical waste, dealing with spillages and provision of protective clothing. There are domestic type washing machines and dryers in place. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 18 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): 28 & 30 There is an NVQ training programme in place. Not all staff are trained to do their jobs. EVIDENCE: The Proprietor said that there were 6 members of staff who had completed or were about to complete NVQ level 2 or 3. There are 13 Care Assistants in the home and on this basis there are 38 of staff who have an NVQ. Plans exist for 5 more staff to achieve NVQ level 2 which will equate to 84 of staff who have NVQ. This means that the home is on target to achieve the required standard of training but has not achieved it yet. The Proprietor outlined the training provided which includes Fire Prevention, First Aid training, Adult Abuse, Medication Training, Infection Control. The Inspector recommends that the Proprietor draw up a programme of training which will further improve the skills of staff and the quality of care provided. This programme should include training in Moving and Handling, Prevention of Pressure Sores, Nutritional Needs of the elderly. Training in care for the elderly at a more advanced level, should be provided and this should be aimed at the senior staff. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 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 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, 34, 37 & 38. The home does not have a Manager at present. The home is financial sound. Residents’ rights are safeguarded. Health and Safety is promoted, but the home does not have all the documentation required. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 20 EVIDENCE: The home does not have a Registered Manager at present, but the Proprietor is busy recruiting one, and is keen to ensure that she gets the right person for the post. The Proprietor is aware that the person needs to undergo a “Fit person Interview”, and stated that she would keep the Inspector informed on this matter. It is required that the home should have a registered Manager. The Proprietor, Mrs Civa, was in charge of the home at the time of the inspection. There are suitable accounting and financial procedures in place and the home is currently financial viable, and the Inspector was shown documentary evidence which stated this. Records required by regulations are maintained. Residents can have access to their records but none have expressed a wish to read them the Proprietor said. Records are kept up to date and are kept secure. The Proprietor ensures, as far as is possible, that the health and safety of residents is protected. The Inspector and Proprietor went through Standard 38 in detail. The home has the documentation as set out in Standard 38.2 and 38.3 but not the remainder. Mrs Civa is aware that the home is required to have all the documentation which is set out in Standard 38, and has undertaken to obtain it all. The Inspector advised that once the information had been obtained that it should be kept in a folder where it could be accessible for all staff. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X X X 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 2 3 X X 3 X X x 3 STAFFING Standard No Score 27 X 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X X 3 X X 3 2 Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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. 2. 3. Standard OP7 OP9 OP9 Regulation Part 111 15 Schedule 3 (i) Schedule 3 (i) Requirement It is required that all care plans are kept in individual record files. The medicine trolley is kept locked to the wall when not in use. It is required that medicines which have just arrived and those which await being taken back, are kept in a locked cupboard until they can be dealt with. It is required that the Proprietor and Manager undertake training in the prevention of Adult Abuse. It is required that the NVQ training continues. It is required that the home should have a registered manager. It is required that the home has all the documentation set out in Standard 38. Timescale for action 01/04/06 28/02/06 28/02/06 4. 5. 6. 7. OP18 OP28 OP31 OP38 18 1(c) 18. (a) 8 (1) 38 01/05/06 12/12/06 01/05/06 01/07/06 Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 23 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. 4. 5. 6. Refer to Standard OP7 OP7 OP7 OP16 OP19 OP30 Good Practice Recommendations It is recommended that the older papers in the care plan files be removed and stored safely. It is recommended that a new filling cabinet be purchased for the care plans. It is recommended that residents and relatives sign the care plans to indicate their involvement with reviews of care. It is recommended that a copy of the complaints procedure be placed in the porch. It is recommended that residents have name plates on the doors of their rooms. It is recommended that the Proprietor draw up a training and development programme which will included Moving and Handling, Prevention of Pressure Sores, Nutritional Needs of the Elderly, and care for the elderly at an advanced level for senior staff. Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Gorselands DS0000037280.V281735.R01.S.doc Version 5.1 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. 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