Inspection on 15/11/05 for Grennell Lodge

This inspection was carried out on 15th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grennell Lodge 11/11/07

Grennell Lodge 15/01/07

Grennell Lodge 31/08/05

Grennell Lodge 02/03/05

Grennell Lodge 08/12/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Grennell Lodge 69 All Saints Road Sutton Surrey SM1 3DJ Lead Inspector Michael Williams Unannounced Inspection 15th November 2005 11:30 Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 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 Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 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 and Care Homes for Adults 18 – 65*. 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. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grennell Lodge Address 69 All Saints Road Sutton Surrey SM1 3DJ 020 8644 7567 020 8644 2921 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) Care Unlimited Miss Teresita Calama-an Care Home 32 Category(ies) of Dementia - over 65 years of age (7), Mental registration, with number disorder, excluding learning disability or of places dementia (25) Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow eight specified service users in the category of Mental Disorder, excluding learning disability or dementia over 65 years of age (MD(E)) to be accommodated. A variation has been granted to allow two specified service users in the Learning Disability category to be accommodated. 31st August 2005 2. Date of last inspection Brief Description of the Service: Grennell Lodge is located in the suburbs of Sutton. It is close to local amenities such as shops, newsagents, hairdressers, pubs and post office. There is a local bus service from outside the home, which will take passengers into the centre of Sutton. The home consists of a three-story building, plus a small mezzanine floor and a basement that is used for storage. Bedrooms are situated on all floors (except the basement). A passenger lift serves the basement and the ground, first and second floors, but not the mezzanine floor. There are a number of communal areas, including a smoking lounge, conservatory and a large sitting/dining room. There is garden to the rear of the house, in which there is a second conservatory and an occupational therapy room. The home provides care for 32 residents, 25 in the younger adult mental health category, and 7 in the older person dementia category. There is a mix of single and double bedrooms. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the fourth unannounced for this year and was conducted at midday onwards. Whilst many of the services users contributed their (positive) opinions about the service, none wished to be interviewed at length about the quality of care provided. Several of the management team were in attendance including one of the proprietors and the manager Mrs Calama-an, known more informally by everyone in the home as “Terri”. This is a well established care home that has been providing care for people with a variety of mental health problems for many years. Two main themes emerged in the previous three inspections this year; the first was about the home’s shift towards a younger client group, which will require an increased emphasis on rehabilitation work in the home, and secondly safety matters such as the excessive use of a deadlocking mechanism on most doors. The management team have agreed these are matters they will be addressing in the coming year and work is in progress. This inspection was used to monitor previous requirements and those key standards not fully met earlier in the year. What the service does well: What has improved since the last inspection? What they could do better: The management team is firmly resolved to address and complete all requirements and in particular to enhance the home’s work in offering a more pro-active approach to rehabilitating the younger service users in order to help them improve their self-help and social skills. The home’s rehabilitation annexe will assist in this work. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Service users are being assessed prior to admission so as to assure prospective service users that all their health and social care needs can be met when admitted. Contracts are now given to all service users to ensure they know about the terms and conditions of their stay but the home’s own contract is being revised. EVIDENCE: Not inspected on this occasion but key standards were met as the judgement indicates. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Care Plans are in place for each service user to ensure their health and personal care needs are being met. Staff assist and encourage service users to make choices and to lead as fulfilled lives as they wish or their mental frailty allows. Service users have had individual risk assessments carried out thus enabling them to participate in activities in the home and in the community with appropriate support. EVIDENCE: Not inspected on this occasion but key standards were met as the judgement indicates. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 16 17 The home is developing its rehabilitation opportunities for the personal development of service users. When providing personal care staff are ensuring service users’ privacy and dignity is being maintained at all times so that service users feel their right to be treated with respect is upheld. Service users Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 11 are receiving a wholesome, appealing and well balanced diet in a congenial setting in accordance with their recorded requirements and preferences EVIDENCE: As reported in previous inspection, this home has a most useful resource in the form of an annexe with an open plan kitchen/dining area, toilet and small conservatory. However, it needs to be kept locked for safety reasons and is only used when staff are available to supervise service users. The management team has agreed that in the coming year they will work towards offering a more assertive programme to help service users develop their personal skills. At present service users are free to engage in appropriate activities as they may wish, this enable them to lead a lifestyle that suites them. So, for example, on the day of inspection many service users remained in the home and watched television. Some sought the peace and quite in one of the small conservatories set aside for smoking and just few chose to go out into the community. The home has an activity coordinator and a weekly routine of inhouse activities is available and is typical for this type of home, music, tabletop games, gentle exercise, religious observance and so forth. This is aimed at meeting the social, cultural and religious needs of service users but the recommendation to enhance the work in helping service users personal development is restated. A choice of two main meal is now offered and this meets a recommendation to widen the choice offered for the main meal of the day. Special diets/meals are provided for vegetarians and others with health care needs such as those with diabetes. The wide range of service users is most apparent at meal times; most remain in the large open plan lounge/dining area. The more dependent and frail service users remain in the lounge and are assisted to eat whilst the younger residents use the dining area. As an existing home there is limited choice of dining facilities to offer service users a different location to eat if they do not wish to eat in this large communal setting. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The home has in place procedures for ensuring the safe management of medicines. This includes, where appropriate, support and risk management for service users who wish to be responsible for their own medication so that they may do so safely. EVIDENCE: A sample of medication charts were checked on this occasion to monitor progress in meeting the requirement to provide a method for auditing all medication including medicines not delivered in a dosette pack. The charts now include a note of the number of tablets and this is commended but in checking medicines it was clear some medicines had not been correctly signed for at the time they were administered. Whilst the updated monitoring system helped to identify this error a requirement is now made to make use of this improved system to monitor nurses’ practice is administering medication to ensure it is in compliance with safe practice. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards in this section, about complaints and protection, are 22 and 23 for Younger Adults (and 16, 18 and 35 for Older People) and not as highlighted above. Arrangements are in place for service users and their representatives to either complain or compliment the service. Effective procedures are in place to deal with complaints in a timely and professional manner. Policies and procedures are in place to ensure the protect service users from abuse. EVIDENCE: Not inspected on this occasion but these key standards were met as the judgement indicates. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The layout of the home and the manner in which it is being maintained means that this is a safe, comfortable and suitable environment that provides for the privacy and comfort of service users. EVIDENCE: Standard 27 only was re-evaluated to confirm that progress is being to ensure greater privacy. Net curtains are in place in bedroom doors but these will be replaced with curtains giving greater privacy. Suitable doors are also being fitted to toilets and bathrooms and to bedrooms but this work is not yet complete. The requirement about privacy is restated because the work has not yet been completed. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 The management team gave an assurance that the number of staff on duty and their skill mix are appropriate to the assessed needs of the current service users in this home - this ensures that their needs are being met. EVIDENCE: Minimum staffing levels for this home are under review by the CSCI. As an existing care home staffing levels in Grennell Lodge are to be no less that proscribed by the previous registering (Health) authority. On the day of inspection it was noted that, for 29 service users, there were 2 qualified Nurses and 1 senior carer and 3 care staff. In addition to this there was the manager and her personal assistant; there were also several ancillary staff on duty including 2 cleaners, a cook, a housekeeper and the maintenance person. The management team has requested a review of staffing levels and intend submitting to the CSCI a revised staff roster. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41 42 The home is ensuring that in so far as it is reasonably practical the health, safety and welfare of service users and staff is being promoted and protected but a number of matters of safety do need to be addressed, these are listed below. EVIDENCE: Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 17 This is a well managed care home and the kind, caring ethos of this home was apparent throughout the inspection. It is clear the best interests of the service users are central to the running of this home and their views are seen as paramount. Policies and procedures are efficiently organised and record keeping sound thus ensuring the administration in this home will safeguard service users’ interests. A sample of records were checked to confirm good administration in the home including Complaints, Accidents, Medication, Food and Menus, Director Visits, Incident reports, portable electrical appliances (PAT) and so forth. Although record keeping is proficient in this home one record still needs to be further improved. There was evidence that nurses were not always signing the medication chart when medications is administered (or not taken when offered); the medication record must be signed either to show that medication was given or that it was refused or not required. Unsuitable door locks, particularly bedroom doors, have been removed but suitable replacements are not installed in all locations and so the requirement is restated. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 2 28 X 29 X 30 x STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT 37 X 38 X 39 X 40 X 41 2 42 2 43 X Standard No 6 7 8 9 10 LIFESTYLES 11 12 13 14 15 16 17 Score X X X X X 3 X X X X 3 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA41YA20 Regulation 13(2) Timescale for action Medication: The medication chart 30/12/05 must be signed each time medication is adminstered or other action is taken. Health & Safety: deadlcoks must 28/02/06 not be used in any locations that would impede exit including bedroom doors and doors leading to exits; suitable alternatives must be installed and it noted that this work is in progress. This is outstanding but a revised timescale is given to allow completion of the work. Privacy: the home must conduct 28/02/06 the home in a manner that respects the privacy and dignity of service including the provision of suitable curtain and suitable door locks to all toilets, bathrooms and shower-rooms. This is outstanding but a revised timescale is given to allow completion of the work. Requirement 2 YA42 13(4)a 3 YA27YA16 12(4)a Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 20 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 YA33 Good Practice Recommendations Staffing: The home must ensure that at all times there are staff in such numbers and suitably qualified and experienced to meet the needs of services users and in particular there must be adequate arrangements to replace staff who are absent - without relying upon staff working excessivley long shifts. Personal Development: It is recommended that staff increase the opportunities for service users to maintain and develop social, emotional, communication and independent living skills. 2 YA11 Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. Grennell Lodge DS0000019093.V266106.R01.S.doc Version 5.0 Page 22 - 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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