Inspection on 21/02/06 for Homestead Care Home (Brownhills) Ltd

This inspection was carried out on 21st February 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Homestead Care Home (Brownhills)... 24/01/08

Homestead Care Home (Brownhills)... 25/08/05

Homestead Care Home (Brownhills)... 11/01/05

Homestead Care Home (Brownhills)... 06/09/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homestead Care Home The Homestead Care Home 208 Ogley Road Brownhills Walsall West Midlands WS8 6AN Lead Inspector Lesley Webb Unannounced Inspection 21st February 2006 07:50 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 Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Homestead Care Home Address The Homestead Care Home 208 Ogley Road Brownhills Walsall West Midlands WS8 6AN 01543 360120 01543 452144 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) Homestead Care Home (Brownhills) Limited Mrs Mandy Christina Kunkel Care Home 30 Category(ies) of Dementia (30) registration, with number of places Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 30 Service Users from 55 years of age with the category of Dementia (DE). 30 service users from 55 years of age with the category of Mental Disorder (MD) One service user to reside at the home under the age of 55. This will remain until such time that the current service users placement is terminated. 25 August 2005. Date of last inspection Brief Description of the Service: The Homestead is a private and purpose built residential care home providing specialised care for elderly people suffering from past and present mental illness. The home provides all aspects of care on a twenty-four hour basis. It is situated in the Brownhills area of Walsall and within easy reach of bus routes into Walsall. There are two separate lounge areas, one being used for residents who are frailer and more dependent and a day room that the home uses as a hair salon, and for holding reviews and private meetings. Bedrooms are located on both the ground and first floor, with bathing and toilet facilities located throughout the home. All residents are offered single room accommodation, some of which have en-suite facilities. There is a well-kept garden for residents use at the rear of the premises and parking facilities to the side of the home. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived unannounced at 7.50am and stayed until 5pm. Time was spent informally talking to residents, observing care practices, formally interviewing staff and looking at records before giving feedback to the registered manager. As this is the second inspection to take place in twelve months both this report and the one published in August 2005 should be read when looking at how the home is achieving national minimum standards. By the end of the visit the inspector found sufficient evidence to demonstrate that in general the home offers a good service and would like to thank everyone for the co-operation and assistance shown. What the service does well: Staff have very good knowledge of medication practices and how these offer protection to residents with dementia. The inspector observed the morning medication being administered, this took over one and a half hours due to staff witnessing residents take their medication before moving on to the next person. As one member of staff explained, “we have to assess their level of understanding, capability and contributing factors such as their health. This identifies the level of risk and supervision people require.” Staff also demonstrated very good understanding of resident’s rights and adult protection and their role as advocates. Examples given by staff regarding these subjects include, “residents have the same human rights as anyone else despite them having dementia, its our job to safeguard them and promote their rights” and “we have to make sure residents are safe, we must report any concerns whether its changes in behaviour or a physical change we have a duty to report and follow procedures”. The home also has good quality assurance and monitoring systems for the management of resident’s finances both of which offer further protection to those living at the home. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The main areas that the home must improve are the monitoring of food temperatures when meals are served to residents, devising an action plan for its intentions to provide a separate smoking room for residents and monitoring the temperature in the dining room of a morning. These must be addressed before other areas to ensure the health, welfare and safety of residents living at the home. In addition the home must introduce policies and procedures for covert medication practices and homely remedies, ensure the cleaning of the kitchen is carried out to a satisfactorily level, ensure at least one reference is from the most recent employer when recruiting new staff and arrange for intermediate food hygiene training for all cooks employed at the home. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 7 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. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 8 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 Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards assessed at previous inspection. EVIDENCE: Although not assessed at this visit it was noted by the inspector that a previous requirement to expand the homes pre-admission assessment is now met. Upon inspection of the document it was found to cover all aspects of standard 3.3 of the national minimum standards. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9. Generally care planning provides staff with the information they need to satisfactorily meet resident’s needs. Recent improvements to mobility and nutritional screening processes ensure resident’s health needs are assessed and monitored in full. Generally medication at this home is well managed, promoting good health. EVIDENCE: Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 11 Although standard 7 and 8 were not assessed in full at this visit it was noted that requirements identified in the previous inspection relating to the use of wheelchairs are now part met. The home has completed its own assessments and wrote to General Practitioners requesting referrals for professional assessments and reduced the number of communal wheelchairs in use. Once residents have been assessed by a qualified person and subsequent action taken the requirements will be met in full. In addition to this its was pleasing to find that all residents now have nutritional assessments completed as part of the homes admissions process along with referrals to General Practitioners if required, however further work is required to evidence the outcome of referrals as nothing was recorded on files sampled. The inspector sat in the dining room at breakfast time and observed the morning medication being dispensed. All practices observed relating to the administration and recording of mediation were found to be correct. A member of staff was observed dispensing each resident’s medication, observing them when taking it and then recording on the medication administration records that they had witnessed this action before starting the process with the next resident. In addition to this all other records relating to the receipt, administration and disposal of medicines were found to be in order including the recording and storage of controlled drugs. All staff that administers medication have completed accredited medication training. The home has written policies and procedures for many aspects of the management of medication apart from covert practices and homely remedies. The inspector instructed that these must be implemented to further enhance the systems already in place at the home. All staff that were interviewed demonstrated knowledge and understanding of medication, including selfadministration assessments, as one member of staff explained, “due to mental health problems on admission we assess capabilities, levels of understanding and contributing factors such as health. This will determine the level of risk if someone chooses to self medicate and what support we need to provide such as restricted assess and lockable facilities”. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meet residents tastes and choices. Further work must be undertaken to protect residents from harm in relation to the temperatures of food products. EVIDENCE: Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 13 The inspector sat in the dining room at breakfast time indirectly observing care practices and meals taken. The inspector was pleased to observe staff offering choices of cereals and hot breakfasts to residents in a discreet and sensitive manor. For example one resident was unable to comprehend what choices were being offered verbally so the member of staff brought both dishes to show the resident in order that their choice could be obtained. The atmosphere in the dining room was found to be relaxed and cheerful. The inspector did however raise concerns regarding the temperature of one food item being served (tinned tomatoes 63 degrees) after witnessing a frail resident in discomfort when attempting to eat. The inspector instructed that the home must assess the level of risk to residents of excessive food temperatures and their frailty, seek professional advice and take any necessary actions to reduce the risk of injury. Records seen by the inspector demonstrate that residents are offered a choice of hot and cold meals every day, with special diets catered for that includes soft meals. Due to the residents who live at the home having varying forms of dementia their choice of meal is determined at each sitting. This produces waste for the home but meets the needs of residents in a more appropriate manor. Menus seen by the inspector demonstrated that a variety of food is offered to service users that are nutritionally balanced. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 and 18. Staff understanding of residents’ rights and of adult protection issues provide a safe environment that protects residents’ from abuse. EVIDENCE: Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 15 The manager informed the inspector that all residents are encouraged to exercise their legal rights and are all registered to participate in the political process, using postal voting. Advocacy services are arranged through Age Concern where service users lack capacity and information regarding advocacy services is also included in the homes brochure. Staff that were interviewed confirmed their understanding of residents rights, for example one person stated, “despite having dementia they have the same rights as anyone else but we have to put extra safeguards in place to protect them such as the financial and complaints procedures”. All staff that were interviewed also demonstrated knowledge and understanding of their role in protecting residents from abuse. Examples of this include, “this is one of the most important roles we have, we must understand changes in behaviour and report any suspicions regardless of who it is” and “if we suspect anything we must follow procedures and report concerns, if concerns involve a senior we must still report but to the manager, owner or CSCI, its our duty”. The home has policies and procedures that cover all aspects of abuse, with the home following Walsall’s Multi Agency Adult Protection procedures. Since the last inspection there has been one complaint that generated an adult protection investigation. The proprietor, manager and staff at the home worked constructively with all agencies concerned to resolve this matter, resulting in the home altering its recording practices and implementing documentation in order that effective monitoring can take place. Also since the last inspection 26 of the 27 staff at the home have undertaken adult protection training (addressing a requirement identified in the previous inspection) and the manager has provided in-house training relating to physical aggression. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19. Generally the standard of the environment within this home is good, providing residents with an attractive and homely place to live. Further improvements will enhance standards within the home. EVIDENCE: Generally the home is maintained and furnished to a good standard. Since the last inspection the home has sought advice from an infection control advisor in relation to the sanitising of commodes (a requirement identified in the previous inspection) resulting in the home purchasing a mechanical sluicing disinfector and the refurbishment of the laundry has been completed. When sitting in the dining room at breakfast time the temperature was considerably lower than in other areas of the building, with some residents commenting to the inspector that, “its cold” and “its only like this in the mornings”. When talking to staff about this situation they confirmed that this was normal and felt it related to the dining room being located in the older part of the building. Staff did inform Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 17 the inspector that as they day went on the temperature in the dining room increased. The inspector also instructed that an action plan must be drawn up identifying how the home intends to provide a smoking room that does not impact on non-smoking residents. The current practice at the home is for residents who wish to smoke to sit in one of the hallways. This current practice does not restrict smoke from travelling to other parts of the building and residents. The only other area found to be requiring attention is the kitchen. Cleaning practices within this facility do not appear to be at the same high standards as other areas within the home. For example the inspector found a build up of dirt around the hand wash basin, no paper towels available, the waste bin and surrounding area badly stained and what appeared to be a build up of dried milk residue on the cupboard runners underneath the hot water urn. Cleaning records were found to be in place but no schedule of timescales detailing how often facilities in the kitchen must be cleaned. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. Recent improvements in staffing levels have increased the quality of care provided at this home, enhancing resident’s lives. Generally the procedures for the recruitment of staff are robust and provide safeguards and protection to people living in the home. In the main the arrangements for the training of staff are good, with staff demonstrating clear understanding of their roles and responsibilities. EVIDENCE: Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 19 Although standard 27 (staffing) was not assessed in full at this visit it was noted by the inspector that previous requirements to increase staffing levels at peak times and to ensure additional staff are available seven days a week to help prepare and serve meals is now met. Throughout the visit the inspector observed how the increase in staff hours is benefiting residents. For example people were observed participating in more activities than previously seen at other inspections and residents were seen to have one to one sessions with staff. Both residents and staff confirmed that the additional hours have improved the quality of service provided. All staff files sampled by the inspector contained the appropriate records required by regulation including medical declarations, CRB disclosures and statements of terms and conditions. All staff are employed in accordance with the code of conduct and practice set by the General Social Care Council, with all staff given copies at the onset of employment. When examining staff references the inspector found that not all staff supplied references from their most recent employer. The inspector instructed the home to instigate this for all new prospective employees as a further safeguard to people living at the home. The home has a recruitment policy that requires expanding to include the procedures it follows when recruiting. Since the last inspection all staff have undertaken dementia training provided by the Alscimours Society (partly addressing a previous requirement). Many staff informed the inspector that this one-day course was very informative and gave them a greater understanding of the needs of the people they care for. The manager informed the inspector that further dementia training is going to be provided later in the year to enhance the knowledge so far gained by staff. In addition to this all staff have also undertaken continence training, with certificates viewed by the inspector. When looking at staff training the inspector instructed that any cooks employed by the home must undertake intermediate food hygiene training due to the additional responsibilities associated with their role such as monitoring food temperature, sampling, stock rotation and nutrition. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35. The home has an excellent quality assurance system, which ensures the views of residents and other interested parties are listened to and acted upon. The homes practices in relation to the management of resident’s finances are good, reducing them from risk of harm or abuse. EVIDENCE: Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 21 The manager and her team should be commended for the quality assurance system in place at the home. The system involves obtaining the views of residents , an annual development plan, views of familes or advocates and an annual audit by Chamber Certification Assessment Services Limited. The inspector congratulated everyone for their efforts in this area, especially after interviewing staff all of whom were able to explain quality assurance and why this is important. As one member of staff explained, “this ensures we provide the best quality service in all areas” and another, “it gives residents a better home, high standards of care and a better quality of life”. The majority of families have the responsibility to manage resident’s financial affairs. There are appropriate policies and procedures in place to safeguard residents such as the non- acceptance of staff of gifts and gratuities. A spot check of three residents personal finances kept in safe keeping by the home was undertaken and found to be satisfactory. Financial assessments are completed for all residents that identify what assistance if any they require to look after their finances with lockable facilities provided in all rooms if residents choose to manage their own money. The manager also maintains a register of valuables held by the home that the inspector recommends be expanded to include total safe contents in order that additional monitoring can take place. It was also noted that previous requirements relating to standard 37 have now been met. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 2 2 X X X X X X X STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 4 X 3 X X X Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 23 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 OP7 Regulation 15 Requirement Service users who use wheelchairs must be assessed by a qualified person as requiring this facility and records maintained in the plan of care – Part met. Requirement originally made August 2005. The practice of using communal wheelchairs must cease, with risk assessments implemented until such time as individual assessments for service users have been completed – Part met. Requirement originally made August 2005. The home must maintain records of actions taken when referrals to general practitioners have been made in relation to nutritional assessments. The home must devise and implement policies and procedures for covert medication administration practices and homely remedies. The home must assess the level of risk in relation to food temperatures and individual residents frailty, seek DS0000057030.V284104.R01.S.doc Timescale for action 30/04/06 2 OP7 15 30/04/06 3 OP8 12(1) 31/03/06 4 OP9 13(2) 31/03/06 5 OP15 13(4) 28/02/06 Homestead Care Home Version 5.1 Page 24 6 OP18 10(1) 7 OP19 16(1) 8 OP19 16(1) professional advice and take any necessary actions to reduce the risk of injury. All staff must undertake Physical Aggression training, with certificates maintained on file – Part met. Requirement originally made August 2005. The temperatures in the dining room must be monitored in the morning, with records maintained. Temperatures must be maintained in line with Workplace (Health, Safety and Welfare) Regulations 1992. An action plan must be supplied to CSCI (Halesowen area office) detailing: The proposed action the home intends to take to provide a separate smoking room for residents. Confirmation that the smoking room will have suitable extractor/ventilation systems. Details of how people with dementia will be monitored and safeguarded whilst using the smoking room. Details of when this facility will be operational. 30/04/06 28/02/06 31/03/06 9 OP19 16(1) 10 OP29 19 All areas of the kitchen must be cleaned on a regular basis, with written procedures including a schedule of timescales implemented. The home must obtain 2 references for all new employees, one of which must be from their most recent employer. The home must expand its 28/02/06 28/02/06 Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 25 11 OP30 18(1) 12 OP30 18(1) recruitment policy to include the procedures it follows when recruiting and selecting new staff. All staff must undertake comprehensive dementia training, with certificates maintained on file – Part met. Requirement originally made August 2005. Any cooks employed by the home must undertake intermediate food hygiene training. 30/04/06 31/08/06 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 OP35 Good Practice Recommendations It is recommended that the register of valuables be expanded to include a record of total safe contents. Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Homestead Care Home DS0000057030.V284104.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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