Inspection on 04/04/07 for Grange Hill House

This inspection was carried out on 4th April 2007.

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

Grange Hill House 09/02/06

Grange Hill House 30/08/05

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

CARE HOMES FOR OLDER PEOPLE Grange Hill House Grange Hill House 516 Bromsgrove Road Hunnington Halesowen B62 0JJ Lead Inspector Yvonne South Unannounced Inspection 4th April 2007 09:00 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 Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 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. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grange Hill House Address Grange Hill House 516 Bromsgrove Road Hunnington Halesowen B62 0JJ 0121 550 1312 0121 550 6536 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) Carlton Care Homes Ltd T/A Grange Hill House Mrs Joanne Wheeler Care Home 36 Category(ies) of Dementia - over 65 years of age (36), Old age, registration, with number not falling within any other category (36), of places Physical disability over 65 years of age (36) Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 09/02/06 Brief Description of the Service: Grange Hill House provides personal care and accommodation for up to thirtysix older people who may have a physical disability and/or a mental health need associated with older age. The main purpose of the service is to provide a high standard of accommodation and personal care in a homely, friendly atmosphere. Within this number there is a smaller unit in the home providing care for four residents who are more independent. They may also use the communal space in the main house. The main house and extension provide twenty-nine beds, three of which are double rooms. All the rooms have ensuite toilet facilities. There is a choice of sitting/lounge space for all residents to use, and communal bathrooms with lifting equipment, and communal toilets. Access to the first floor is gained by the use of stair lifts. Handrails are provided throughout the home. The residents have access to a large level garden and the home is surrounded by countryside while have easy access to towns and the motorways. The register providers are Carlton Care Homes Ltd and the registered manager is Mrs Joanne Wheeler. The email address for the home is grange@carltoncaregroup.co.uk In the pre inspection questionnaire submitted to the Commission for Social Care Inspection (CSCI) by the manager on 27.03.07, the manager stated that the range of fees extended from £1440 to £1520 per month. Additional charges were made for Hairdressing; £5.50, Chiropody: £9.00 and Newspapers/magazines: individual prices. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that incorporated information received by the Commission for Social Care Inspection since the previous inspection, which took place on 09.02.06, and the information obtained during fieldwork on 04.04.07. The fieldwork took place over eight and three quarter hours, during which the inspector spoke to five residents and four staff. Documents were assessed and a partial tour of the premises was also undertaken. Assistance was given by the registered manager and the deputy manager. Prior to the fieldwork the home was asked by the CSCI to complete and return a pre-inspection questionnaire and to distribute questionnaires to the residents and health care professionals seeking their opinions of the service. To date eight responses have been received from residents and one from health care professionals. In addition the inspector has spoken to a relative on the phone regarding their opinion of the quality of the service provided. The focus of this inspection was on the key National Minimum Standards and recommendations that arose out of the previous inspection. What the service does well: The home is situated in a lovely area, close to all amenities. It is well maintained, decorated and furnished, light and comfortable. Equipment is fitted and provided to help those people who have difficulty moving. The staff provide a warm friend welcome for all visitors and the residents say that they provide very good care. One resident said, ’’Everything is very good for me.’ Another person said, ‘Gifts at Xmas, Easter eggs and birthday presents. Quite marvellous.’ There is a good recruitment process and training provision so that the right people are employed and trained to provide the individual care each person needs. A wide range of activities, entertainment and events are arranged in-house and in the community in which residents can participate if they wish. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 6 The residents say the food is excellent and they are provided with a good balanced menu and choice. 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. The summary of this inspection report can be made available in other formats on request. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 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 Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (An intermediate service was not offered by this home therefore standard six was not relevant.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have the information they need to aid their choice of home and their needs are assessed by a qualified person to ensure the home can provide the care needed before a place is offered. EVIDENCE: It was observed that copies of the statement of purpose, service users’ guide and most recent inspection report were available to everyone in the reception area of the home. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 9 In the questionnaire responses completed and returned by the residents everyone agreed that they had received the information they needed to help them decide if the home was the right place for them. Relatives had usually visited the home first and informed the prospective resident of their findings and opinions. For example one resident said: ‘Family came and viewed home. They said it was wonderful so I came’ Assessments were made of the care records for three residents. It was observed that the manager had visited everyone and assessed what care they needed before they were offered a place in the home. The assessment documents were in a tick box format and extra information had been included where necessary. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive the personal and health care they need. However there is insufficient detailed information and guidance available for staff in care plans for them to consult regarding current needs and care. Medication is well managed but there are issues concerning storage and equipment that may have a detrimental impact on health and safety. Residents are treated with courtesy and respect and their privacy and dignity is safeguarded. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 11 EVIDENCE: The care documents demonstrated that initial care plans had been drawn up based on the pre-admission assessments. Information had not always been added to this document but regular reviews/evaluations had been undertaken in which changes had been noted. This had resulted in out of date and uninformative assessments and care plans, and there was a risk that current information and guidance for staff could be concealed within the review/evaluation documentation and consequently overlooked by staff consulting the care plans. Risk assessments had been undertaken and were well monitored. It was recommended that although the district nurse visited and attended to any residents that had wounds requiring dressings, there should still be a care plan to guide staff in the care they needed to provide for the resident relating to this area of care. Some forms had not been completed and some lacked full dates and signatures. There was good evidence that resident and/or their supporter had been involved in the care planning process. A relative confirmed that she had been consulted. The records clearly demonstrated that doctors, district nurses, chiropodists and dentists were consulted and the residents confirmed that they had access to the doctor each week and were pleased with the service. ‘Residents said that they were pleased with the medical care and support they received and staff were usually available when needed. One resident responded in the questionnaire that: ‘I understand I have to wait at times, as staff are busy.’ Medication management was assessed. It was observed that storage was maintained in an acceptable medication trolley secured to the wall in the dining room, a large lockable solid wood cupboard secured to the dining room wall and a lockable fridge. Although the storage was clean there were many nonmedication items stored. Medication storage should be solely for medication. Medication keys are now kept on the person responsible. There was no acceptable storage for controlled drugs. The controlled drug registered was a hard backed A4 book. It was acknowledged that no resident in the home has been prescribed a controlled drug for some years. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 12 However it was recommended that approved storage and a register should be obtained as soon as possible as there is usually little warning of when they might be needed. There was a concern regarding the management of warfarin. The system in use was considered to be ‘secondary dispensing’ and poor practice. The home undertook to change the process. The records were generally well maintained. Administration was recorded and a record had been made of most drugs when checked into the home. An assessment of a resident’s understanding and ability to self medicate was seen and there was some discussion as to how more detail would provide more clarity. It was recommended that whenever stock was given to a resident to self medicate a record should be maintained to enable an audit trail and monitoring to take place. All hand written entries and amendments should have the signatures of two trained staff to ensure accuracy. It was observed that residents were treated with courtesy and kindness. Residents who spoke to the inspector described them as: kind, wonderful, excellent, could not be better and caring. A questionnaire response contained the comment: ‘Grange Hill is a very caring home and I’m quite happy’. Another comment was: ‘I’m as happy as possible not being in my own home’. The doors to all bedrooms were fitted with approved locks so that residents could secure their privacy and property should they wish, without the risk of entrapment. Communal bathrooms and toilets were also fitted with acceptable locks with an emergency access facility. There were no such locks on the ensuite facilities, which is recommended as good practice. Staff were observed to knock on all bedroom doors and wait for a response before entering. Personal mail was delivered to the addressee unopened and if necessary and agreed by the resident mail could be held for or forwarded to the resident’s supporter. A consent document was signed and available on some files concerning this. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice about their life style and activities. They have access to a wide selection of in-house and community activities in which they can participate if they choose. People of different faiths receive the support they need. Good quality nutritional food is provided so that resident are able to select and enjoy what appeals to them. EVIDENCE: The pre-inspection questionnaire submitted by the manager indicated that the home employed an activities co-ordinator to work twelve hours each week. The home had its own transport and residents were supported to visit the churches of their choice, the library and local pubs. In addition there was an outing each week. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 14 A copy of the monthly programme of activities was provided for each resident and this indicated that a range of activities took place in-house and in the community. Several entertainers visited the home providing music, singing, exercise and craft work. Residents belonged to several different branches of the Christian faith and visits were received from representatives of the Church of England, The Roman Catholic faith, the Salvation Army and the Methodist Church. Residents who spoke to the inspector indicated that they had particular favourites among the entertainers and joined in where they wished. Some residents preferred to stay in their own rooms and entertain themselves with reading, television, music and visitor. Comments made in the questionnaire responses included: ‘I always enjoy all the activities. The staff inform me daily of what goes on.’ ‘I don’t always attend the activities.’ ‘I enjoy the exercise classes.’ Visitors were welcome at any time. It was observed that they were greeted in a friendly fashion and were made to feel welcome. The documentation demonstrated that they were kept informed of their relatives’ welfare as appropriate and residents were supported to maintain links with family and friends. The food was described by residents as ‘excellent’, ‘varied’, and ‘well balanced’. One person said that it was comparable to a ‘top class hotel’. The questionnaire responses indicated that five of the eight respondents always liked the meals. The other three people said that they usually did. Comments made were: ‘I’m able to choose what I want to eat.’ ‘Exceptional, and plentiful’. Sample menus demonstrated an attractive and balanced choice was offered and a sample scone was superb. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have the information they need to raise their concerns and are confident of an appropriate response. Staff are well recruited and have the training they need to respond to complaints and suspicions of abuse so that residents are protected. EVIDENCE: The statement of purpose and service users’ guide both contained copies of the homes’ complaints procedure. Residents each had a copy of the service users’ guide in their bedroom. Residents told the inspector that they felt able to raise their concerns with staff, the manager and during the residents’ meetings. In addition the questionnaire responses indicated that all respondents knew who to speak to if they were unhappy and knew how to make a complaint. They commented: ‘I’ve read the Service Users’ Guide in my room.’ ‘I’d speak to the manager.’ Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 16 At the time the pre-inspection questionnaire was completed neither the home nor the CSCI had received any concerns, complaints or allegations regarding the service. Since then the home had received one complaint concerning the provision of hot water to a resident’s bedroom. Efforts were already in hand to address this and now that a new boiler has been installed the matter has been resolved. Acceptable records and communications were maintained. Three staff were interviewed by the inspector and their records were assessed. The records supported the staff’s accounts of the recruitment process they had undergone. References had been taken up and checks had been undertaken by the Criminal Records Bureau. They were all aware of the correct action to take should they be in receipt of a complaint and they had all received training in recognition and response to suspected abuse of vulnerable people. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, attractive well maintained home that suits their needs and wishes. Infection control is well managed to protect the people in the home. EVIDENCE: The home is positioned at the end of a drive and is surrounded by a large wellmaintained garden, and countryside. A partial tour of the building was undertaken. It was well maintained, decorated and furnished. Staff were employed to swiftly address any maintenance concerns and specialists were consulted when necessary. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 18 Two bedrooms were seen and they were light, spacious and personalised with property belonging to the occupant. The large lounge was attractively furnished with the armchairs arranged in social groups, a large screen television provided by the home’s league of friends and a piano that was used by the entertainers and some residents. The dining room was well furnished. Attractive views could be obtained from all windows in the home. Currently there was building work in progress that impacted on an area to one side of the entrance to the home. Two new single bedrooms with ensuite facilities were being constructed. These rooms open off the communal lounge through two doors and this is of some concern as there may be an impact on privacy and infection control. When completed it is the registered providers’ intention to apply to the CSCI for a variation of their registration in respect of an increase in the number of people the service can be offered to. There were two laundries that were appropriately equipped. The one that was seen was clean and acceptable. Liquid soap, disposable towels and personal protective equipment was appropriately placed around the home and seen to be used. Staff and their records confirmed that they had received training in the control of infection. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Sufficient staff are well recruited and trained so that the residents receive a high standard of care. EVIDENCE: An example of the staff rota indicated that current staffing levels met residents’ current needs. This view was supported by staff and residents who spoke to the inspector. The pre-inspection questionnaire indicated that only one member of staff had left the employment of the home in the past year. The residents commented on this and said that they really appreciated the stable work force. The manager said that there were no staff vacancies at the time of the fieldwork. The pre-inspection questionnaire stated that there were twenty care staff employed, 85 of whom had National Vocational Qualifications (NVQ). The records and staff indicted that an acceptable recruitment process was used. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 20 In addition to NVQ training the pre-inspection questionnaire recorded that training updates were provided in a range of subjects to ensure all staff continued to develop their knowledge and skills for the benefit if the residents and themselves. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents benefit from a well managed home that gives good attention to health and safety. EVIDENCE: The home is well managed by a competent, experienced and qualified manager. There is a friendly open ethos that residents, relatives and staff appreciate. Comments made included; fine, no issues, very good, easy to come to. The G.P. who completed and returned the questionnaire stated that it was a ‘Very well run home’. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 22 A strong and effective quality assurance system was in use that demonstrated the structures and systems were regularly audited and action plans were drawn up to address identified weaknesses and develop the service further. Personal money was held in safekeeping for some residents and managed by the home. Security and records were acceptable. Receipts for expenditure were retained and when money was deposited the record was signed by the donor and the receiving member of staff. It was recommended that receipts should also be given to the donor to protect all concerned. Staff confirmed that they received regular supervision and their records confirmed this. They said that they found the sessions useful. Two health and safety manuals containing risk assessments for the home were available. Records and the pre-inspection questionnaire demonstrated that equipment and systems were appropriately serviced and maintained. It was observed that the Fire Risk Assessment for the home had been drawn up in December 2003 and had been reviewed annually since then. Records confirmed that safety checks of the systems and equipment were undertaken in accordance with the guidance given by the Hereford and Worcester Fire Authority. However staff training was only being undertaken twice a year. The Fire Authority guidance is that this is done every three months. It does not require intensive training sessions each time but a regular raising of awareness, and revision of knowledge and the procedure. The staff who were interviewed were aware of the action they should take if the fire alarm sounded. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 23 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 3 X 2 Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 24 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 Standard OP7 Regulation 15 The residents’ care plans must set out in detail the action that needs to be taken by care staff and updated to reflect changes, to ensure all aspects of the health, personal and social care needs of the residents are met. 2 OP9 13 Medication must be managed in accordance with the procedures for the receipt, storage, handling and administration of medication. 05/04/07 Requirement Timescale for action 01/06/07 Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 25 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 OP9 Good Practice Recommendations A controlled drugs cupboard and register should be obtained. 2 OP38 Staff should receive revision of fire safety training every three months in accordance with the guidance given by the Hereford and Worcester Fire Authority. Grange Hill House DS0000059470.V332640.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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