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Inspection on 31/10/07 for Great Wyrley Community Support Unit

Also see our care home review for Great Wyrley Community Support Unit for more information

This inspection was carried out on 31st October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A small unit providing a good service for 8 people requiring ongoing respite care periods throughout the year (carer relief) and a supportive service to 8people discharged from hospital but requiring further support, assessment and care prior to returning home. The environment is bright, homely and providing accommodation on one level with good access to the large, private garden area. The service caters for a wide range of age and need. People from aged 18 years upwards are accommodated with needs including learning disabilities, physical disabilities, dementia care and mental health needs. There is a constantly changing range of needs, the home attempts to plan ongoing respite periods to balance the overall dependency levels of the group wherever possible. The flexibility of the service allows personal lifestyles and needs to be accommodated as the priority for the service. Staffing supports those diverse needs.

What has improved since the last inspection?

The tarmac approach areas to the home have been repaired providing level safe access to the bulding.

What the care home could do better:

Staff training in dementia care and mental health needs would further improve the service to residents with those needs.

CARE HOMES FOR OLDER PEOPLE Great Wyrley Community Support Unit 156 Walsall Road Great Wyrley Near Walsall WS6 6NQ Lead Inspector Peter Dawson Draft – Key Unannounced Inspection 08:45 31ST October 2007 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 Great Wyrley Community Support Unit DS0000028926.V342232.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. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Great Wyrley Community Support Unit Address 156 Walsall Road Great Wyrley Near Walsall WS6 6NQ 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) 01922 419054 01922 415763 Staffordshire County Council, Social Care and Health Directorate Jane Louise Lawton Care Home 16 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (8), Learning disability (8), Mental disorder, of places excluding learning disability or dementia (2), Mental Disorder, excluding learning disability or dementia - over 65 years of age (8), Old age, not falling within any other category (16), Physical disability (8), Physical disability over 65 years of age (16) Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Eight beds to be used for respite care Eight beds to be used for reablement care. Two Dementia (DE) minimum age 50 years on admission. Eight Learning Disability (LD - Minimum age 21 years on admission. Eight Physical Disability (PD) - Minimum age 18 years on admission. Two Mental Disorder (MD) - for named existing service users only who receive the service currently. 14th November 2006 Date of last inspection Brief Description of the Service: Great Wyrley community support unit is a purpose built facility that can accommodate sixteen short stay service users. All accommodation is provided on the ground floor and comprises of sixteen single en/suite bedrooms. Eight of the beds are used for respite care and the remaining eight are used for enablement. There is one assisted bathroom and a fully assisted shower room, both with toilets. There are four separate lounge and dining areas. The eight respite beds provide short stay residential care services to adults and the short stays are usually of one to two weeks duration.The eight re-ablement beds provide short stay residential care for service users, which is a stepping-stone between hospital discharge and returning to their own home. The typical length of stay has been between six to eight weeks and both physiotherapy and occupational therapy are strong components of the care being delivered. Care is provided in the respite unit by community support workers and by reablement assistants in the re-ablement unit. Health service professionals are accessed when required and local GPs and a pharmacist service the home. A physiotherapist and an occupational therapist are directly employed for the reablement beds. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over one day from 8.45 am – 2.30 pm by one inspector. The National Minimum Standards for Older People were used as the reference for the inspection . An Annual Quality Assurance Assessment was completed by the service and returned to CSCI prior to the inspection. There was an inspection of the environment including a sample of bedrooms. Records relating to the inspection process were available and inspected, including care plans, risk assessments, medication records, accident records, maintenance records etc. All residents were seen and most spoken to during the inspection. There were 7 people receiving the Re-ablement service and 6 the Respite Care Service. Two written questionnaires were returned by current service users prior to the inspection. Comments received were very positive, it was clear that people using the service regularly see the unit as a lifeline for their continued care in the community. Comments included “When my daughter goes for a weeks respite care, I know that the care will be excellent and knowing this I can relax for the week and enjoy my break, I am 81 years old and need the break” and “The facilities could not be improved the care is excellent”. People in the Reablement unit were equally complimentary speaking of the support and encouragement they were given to enable them to return home. As with all other Local Authority Homes at this time the future of this service is in question and this creates considerable anxiety amongst residents and staff, although the standards of current care are not affected by this factor. What the service does well: A small unit providing a good service for 8 people requiring ongoing respite care periods throughout the year (carer relief) and a supportive service to 8 Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 6 people discharged from hospital but requiring further support, assessment and care prior to returning home. The environment is bright, homely and providing accommodation on one level with good access to the large, private garden area. The service caters for a wide range of age and need. People from aged 18 years upwards are accommodated with needs including learning disabilities, physical disabilities, dementia care and mental health needs. There is a constantly changing range of needs, the home attempts to plan ongoing respite periods to balance the overall dependency levels of the group wherever possible. The flexibility of the service allows personal lifestyles and needs to be accommodated as the priority for the service. Staffing supports those diverse needs. 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. Great Wyrley Community Support Unit DS0000028926.V342232.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 Great Wyrley Community Support Unit DS0000028926.V342232.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): Quality in this outcome area is good. Information about the home is readily available to prospective and current residents. All have contracts. Needs assessments are carried out prior to admission, with pre-admission visits by prospective residents and relatives arranged wherever possible. Confirmation in writing is provided confirming that needs can be met following assessment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a statement of purpose and service users guide provided giving comprehensive information about the care and services provided by the home. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 9 The information allows an objective choice to be made by prospective residents about the suitability of the home. All residents are provided with contracts by the Local Authority who sponsor both respite and re-ablement care in the home. Needs assessments are carried out prior to admission. The pre-admission assessment document was seen and had been completed in instances seen, prior to admission by the homes staff. Admissions are sometimes made on an emergency basis but assessments carried out wherever possible prior to the admission. A resident admitted on an emergency basis on the day prior to this inspection had been assessed on the day and some information provided by the Care Management team, although the information was limited, attempts had been made to carry out and record an assessment. There were still some unanswered questions but the home were dealing appropriately with the situation and needs of the person who insisted upon remaining in his bedroom and uncooperative in some aspects of personal care. The home had and were continuing to do their best in a difficult situation. It was clear that decisions about admission to the Re-ablement beds were not always fully discussed with the homes staff, sometimes beds allocated for Social Services expediency. Great Wyrley Community Support Unit DS0000028926.V342232.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): Quality in this outcome area is good. Care plans outlined clearly the health, personal and social care needs of residents and reviewed regularly. Attention to health care needs ensure they were fully met. Self medication is promoted where possible following risk assessments. There was evidence that residents were treated with respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of care plans were seen and reflected the pre admission assessment by the home and also the Care Management Assessment. A resident admitted as an emergency from hospital following de-hydration had a care plan in place to address hydration issues. There was a fluid intake chart recording daily Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 11 inputs. These had not always been quantified, for example “a cup of tea” but most had quantified inputs such as 100mls juice, there had not been daily totals but inputs had been considerably increased and maintained and vast improvement made in this crucial area. Care plans contained adequate details about pre-existing medical conditions and the actions required to sustain good health care. A range of external health professions were involved in areas of healthcare need e.g. Learning Disability Nurse, CPN, Consultant Psychiatrist, regular GP visits etc. Residents on the re-ablement unit have the services in house, of Physiotherapist, Occupational Therapist, Therapeutic Assistant and Social work to aid their progress and early discharge home. Moving & Handling and other risk assessments were in place to support the information contained in care plans. There were regular reviews of all plans/risk assessments. The home provides a community resource facility for respite and re-ablement needs and as such provides a range of care for people with physical disabilities, dementia care, mental health needs and learning disabilities across an age range from 18 years upwards. Often there are quite diverse needs needing to be met at a particular time across a wide spectrum of need. A resident who had been admitted to the re-ablement unit had a learning disability and high physical care dependency needs, often needing total care and constant hoisting. The home were providing a high standard of care for this person, although re-ablement was certainly not an option. The medication system was inspected. All residents are short-stay and bring medication in to the home which has to be carefully checked and monitored. Where possible self-medication continues following risk assessment and all rooms have lockable facilities to house the required medication. MAR sheets and other documentation of medication had been completed accurately and satisfactorily, with returns to the pharmacy countersigned to provide an audit of the system. Only Senior staff administer medication and all have completed courses in the Safe Handling of Medicines. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents confirmed their expectations and preferences were met. Visitors are encouraged and an intergral part of daily care. Residents were happy with the choices available and highly satisfied with the food provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents were seen and the majority spoken with. All said that they were treated well by staff and enjoyed their stay at the Support Unit. The majority have pre-booked weeks over the year and look forward to their stay. One resident who is wheelchair-bound has been to London to protest/lobby at the House of Commons and High Court about the possible threatened closure of the unit. She is able to articulate the very positive advantages to her and other people of providing ongoing carer relief. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 13 One person had recorded in written feedback to the home that she had “ not wanted to come for respite care, but have enjoyed the stay and now do not want to go home”. The particularly diverse social and recreational needs of this mixed resident group are known and where possible their needs are met. The re-ablement group were involved in a dough-baking session during the morning, clearly enjoying the practical and social aspects which promoted conversation and stimulation. One person said she had “never done this before, but I have enjoyed it” The home clearly meets the chosen lifestyles of residents and matches their expectations. Residents meetings are held 6 weekly, but feedback relates specifically to the resident group at the time (which is constantly changing). All residents spoken with expressed high satisfaction with food. The main meal of the day was seen, was well presented and clearly enjoyed by all residents who confirmed choices were always available to them at all mealtimes. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The complaints procedure is in place and known to all. It is available to residents and visitors to the home. Staff have received training in the Protection of Vulnerable Adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Local Authority complaints procedure in place and available to all. The procedure is concise and clear. There have been no complaints to the home or CSCI since the last inspection. There is also a suggestion box available in the reception area for anonymous complaint or suggestions to improve the service. Residents spoken to on the day confirmed they were aware of the complaints procedure and knew how to make a complaint. Staff talk about the complaints procedure in residents meetings also There is an Adult Protection procedure in place (Safeguarding) and known to all staff. Additionally there has been staff training Vulnerable Adults issues since the last inspection. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 15 Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The environment is safe and adequately maintained. There is good and safe access to the excellent outdoor facilities of the garden area. There are suitable and sufficient bathing/toilet facilities for the resident group. There is good wheelchair access throughout with handrails/assisted facilities where needed. Standards of hygiene throughout the home are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 17 The environment is spacious, bright and homely. All accommodation is on one level. There are extensive grounds providing privacy with good seating. The garden is south-facing and much used during the summer months, this adds to the attractiveness of the building and facilities. The environment has been well maintained over the years. Due to the present doubts about the future viablityof this and other Local Authority homes nonessential work is on hold. There are 3 assisted bathing facilities, one presently out of use for that reason. There is an assisted bathroom and a walk-in shower room, both with toilets and adequate for the current resident group. Some areas do require some redecoration, currently on hold also, but are satisfactory and do not detract from the overall good appearance of the environment. A requirement of the last report to make safe the tarmac area on the approach to the building has been addressed and is quite safe and improved. A sample of bedrooms seen were of good size, well equipped and some personalised as needed by this transient resident group. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. The numbers and skill mix of staff are adequate. NVQ training exceeds the required minimum. Recruitment procedures are robust and satisfactory. Training in areas of mental health and dementia care are needed for staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although run as one unit the home naturally divides into two halves to provide 8 beds for respite care and 8 for re-ablement. Staffing on the day of the inspection was sastisfactory. The two units are staffed separately – the number of staff on duty were: Respite unit – 1 Care Shift Leader and 2 Carers. Re-ablement unit – 2 Senior Support Workers and 2 Carers – a total of 7 staff. Additionally a cook was on duty. There are no laundry staff or dometic hours for the respite unit – these duties carried out by care staff. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 19 Although there is presently no staff recruitment due to the present consulation period about home closures, there were adequate numbers of staff in the home. There have been no changes in the staff since the last inspection. A sample of staff files were seen and confirmed the Local Authority’s robust system of staff recruitment with appropriate references/checks etc. There is considerable anxiety expressed by residents spoken with and also from written feedback concerning the possible closure of this unit. There is an open, healthy discussion about these issues and staff handling the situation very well. There were positive, relaxed and friendly exchanges observed between residents and staff. Staff commitment to resident care is clearly high and this was confirmed in discussions with all residents spoken with. The staff training matrix indicated ongoing training for all levels of staff. Virtually all staff are NVQ trained. One area of concern was that there has been no formal training for staff in dementia care or mental health awareness. This is particularly surprising as the home has approved category to admit people with Dementia or Mental Illness. – A resident had been admitted days prior to this inspection suffering from a psychotic illness. This was being handled well by staff and being overseen by the Community Psychiatric Nurse. It was stated that the Manager was due to attend a course in November on Mental Health Awareness. This training and dementia care training should be extended to all staff. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. The home is well-run and managed with good management support from the Local Authority. Residents indicated that their interests were known to staff and acted upon. Record keeping, policies, procedures and risk assessments protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 21 The Registered Manager was off-duty at the time of this unannounced inspection. The Manager has the required experience and qualification (RMA) to run the home. There are clear lines of responsibility defined by the Local Authority employers. There was a relaxed, homely atmosphere and good engagement between residents and staff. The Manager is line-managed by an external Service Manager who visits unannounced on a monthly basis and leaves a report in the home (Regulation 26 – seen). There are residents meetings approximately 6 weekly (minutes seen) allowing opportunity for feedback about the service. Additional quality assurance is monitored by regular audits and questionnaires to residents. The result were seen and positive and included such statement as “Would recommend this home to anyone, it could not be bettered”. Records seen were clear, concise and to a good professional standard. The health, safety and welfare of service users and staff are promoted with comprehensive policies, procedures and risk assessments relating to the environment and individual risk assessments for residents relating to daily living activities. Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 3 3 Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 23 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 OP30 Regulation 18()(1)(c) (i) Requirement Provide staff training appropriate to the work they perform (Dementia care and mental health awareness). Timescale for action 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Birmingham Local Office 1st Floor Ladywood House 45-56 Stephenson Street Birmingham B2 4UZ 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. Extracts may not be used or reproduced without the express permission of CSCI Great Wyrley Community Support Unit DS0000028926.V342232.R01.S.doc Version 5.2 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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