Inspection on 04/05/06 for Kingswood Court

This inspection was carried out on 4th May 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kingswood Court 04/02/08

Kingswood Court 10/09/07

Kingswood Court 23/05/07

Kingswood Court 10/11/05

Kingswood Court 31/05/05

Kingswood Court 24/02/05

Kingswood Court 14/12/04

Kingswood Court 21/06/04

Kingswood Court 24/05/04

Kingswood Court 15/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingswood Court Soundwell Road Kingswood South Glos BS15 1PN Lead Inspector Melanie Edwards Key Unannounced Inspection 4th May 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kingswood Court DS0000020249.V292924.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. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kingswood Court Address Soundwell Road Kingswood South Glos BS15 1PN 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) 0117 9603722 0117 9603744 Grandcross Limited(wholly owned subsidiary of Four Seasons Health Care Ltd) Mr Aubrey Sibiya Care Home 66 Category(ies) of Old age, not falling within any other category registration, with number (66) of places Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. May accommodate up to 66 persons aged 50 years and over who are receiving nursing care. Of the total 66 persons, up to 3 persons (who must be 65 years or over) may be accommodated and provided with personal care only. Manager must be a RN on parts 1 or 12 of the NMC register Staffing notice dated 22/6/1998 applies. May accommodate one person under the age of 50, who has physical disability. This condition relates to a named person and will lapse if the person leaves the home. 10th November 2005 Date of last inspection Brief Description of the Service: Kingswood Court is a purpose built home, operated by Grand cross Ltd, which is affiliated to Four Seasons Health Care. The home is registered to provide nursing care for 66 people over the age of 50. It has ample car parking space at the rear and a small garden in front separating it from the main road. There is access to local shops, amenities and bus routes. Accommodation is provided over three floors; each floor has its own lounge and dining area. There is level access throughout the home and a lift to each floor. Toilets and bathroom facilities are adequate for the number of residents and have adaptations to meet their assessed needs. All rooms are equipped with call alarm systems. Visitors may visit at any time. An activities organiser is employed and organises a varied programme of activities throughout the week. The fees charged for staying at the Home for nursing care are from £600 to £650 per week. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Fifteen residents and a number of visitors were consulted to find out their views. There were fifty-nine residents in the Home on the day of the inspection. The registered manager, one registered nurse, a number of care assistants and the cook were also consulted about their roles and responsibilities, training needs, and how they assist and support residents. Staff were observed assisting residents with their needs. A selection of records relating to the day-to-day running and management of the Home were inspected. A range of resident’s care records and care plans were also reviewed. The majority of the environment was seen with the only areas not viewed being a small number of resident’s bedrooms. The Home was found to be operating within the required conditions of registration set down by the Commission for Social Care Inspection. The conditions of registration detail the type of care and the needs of residents as well as the numbers of residents who may stay at the Home. These judgments have been made using available evidence including a visit to the service What the service does well: What has improved since the last inspection? The health and safety of residents’ and staff is now better maintained as the old kitchen fridge has been replaced with a new one. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 6 Residents’ care plans are now written clearly and demonstrate how needs are met. Assessment records include information about the type of skin pressure relieving equipment residents are provided with. Bed rails risk assessments are now being signed and dated, which protects residents, by demonstrating when the need for bedside rails has been assessed, and when it must be reviewed. 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. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 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 Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. Generally residents’ assessed needs are being met. EVIDENCE: To find out how residents needs are being assessed five assessment records were inspected. There was information recorded about residents’ range of assessed needs. There were moving and handling assessments completed for each resident to assist staff in safe working practices. There was also an assessment for each resident around their vulnerability to pressure sores, risk from falls, and their nutritional needs. The completion of such assessments helps demonstrate residents’ range of needs have been identified and addressed. Residents’ plans of care that were looked at, related to the assessment information taken at the time of the person’s admission (see standard 7 of the report). However one resident has an assessed need identified relating to communication and speech difficulties. It would be of benefit to the resident if the Home were to seek the advice of a speech therapist, to further assist in meeting the resident’s needs in this area. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 9 The assessments had been regularly reviewed and updated helping to demonstrate staff monitor and keep under review residents changing needs. One resident’s room was observed to have a footpad alarm system in operation by the door. There was written evidence demonstrating that the GP was directly involved in the decision for using this system. However there also needs to be an assessment carried out by the Home to support and demonstrate the reasons for using such a system. There are no residents currently living at the Home solely for intermediate care. Kingswood Court DS0000020249.V292924.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): 7,8,9,10 Quality in this outcome area is good as residents care plans demonstrate how physical and psychological needs are met, and the practices and procedures for handling; storage and administration of medication are safe. Also residents feel they are treated with respect and their privacy is maintained. EVIDENCE: Five care plans were inspected to find out how residents are supported to meet their needs. The care plans seen were reasonably informative and detailed how to meet the health care needs of the residents. Care plans included clear guidance for staff to follow to support residents with physical, psychological, social and communication needs. Care plans had been reviewed and updated regularly by registered nurses, demonstrating residents’ health needs are monitored and reviewed. Included with care plans were assessments for each resident of their nutritional needs and skin pressure vulnerability. Registered nurses are reviewing assessments on a monthly basis. This helps to demonstrate staff monitor residents’ assessed needs. There was also information written in residents care records, which recorded any specialist needs the resident had, including if they saw a Doctor, and how Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 11 those needs are met. The records showed the GP sees residents on a regular basis to attend to their health care needs. In discussion with care assistants on duty, they were able to explain in detail how they were helping residents with their needs and conveyed that they had a good understanding of the residents they were caring for at the time. There were risk assessments for residents who require bedside rails. The assessments had been signed and dated, to verify who carried out the assessment and when they did it. Residents spoke very positively about the staff and how friendly in manner they generally are. The majority of residents who were asked expressed positive views of the care they receive and how they feel their needs are met. Examples of comments made by residents included, `the staff are excellent, all of the girls are excellent,’ `the staff are very helpful even the cleaner is helpful’, `it’s very good we have a buzzer they come in five minutes,’ and, `I think they treat us all with respect’ ’. Staff were seen assisting residents in a respectful manner. Staff were also observed knocking on doors before entering the rooms, and communicating with residents in a polite and friendly manner. One resident said they felt there were occasions when they had to wait too long for their call bell to be answered, when they need assistance. However the resident also said they had spoken to Mr Sibiya about this and they said Mr Sibiya listens to their concerns and addresses them. The systems for administration, storage and disposal of residents medication, were checked to find out if the Home is operating a safe system for handling residents medication. A sample of residents’ medication administration charts were checked in detail. There was a photograph of each resident kept with his or her administration chart for ease of identification purposes. The registered nurses had signed for medication given, or recorded the reason for any omissions. Medication that needed to be stored in a fridge was being stored as required. The medication stock was stored in a cupboard in the clinic. Stock was well organised, and it was evident that the Home has a satisfactory system for ordering and receiving medication. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Overall quality in this outcome area is adequate, as residents are provided with a range of social and therapeutic activities, and are supported to receive their visits from family and friends. However quality residents’ meals are not being served to them in a way that is fair and best meets all residents’ needs. EVIDENCE: Residents’ benefit from the employment of a full time activities coordinator who works five days a week engaging residents in a range of social and therapeutic activities. A group of residents were engaged in a gardening group during the afternoon, and were sitting outside in the courtyard planting sunflowers with the help of the activities organiser. This was good practice, and the activities organiser must be commended for ensuring residents could sit outside on a hot sunny day. Although staff were clearly busy carrying out their duties, they were observed spending time when they could talking with residents and engaging in social conversation. This is clearly beneficial for all residents and its importance for residents should not be underestimated. A copy of the timetable of social activities is circulated to residents throughout the Home. A range of social activities as well as trips out into the local community are provided. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 13 The Home also has a mobile shop and the shop is taken around the Home to residents. As well as purchasing items from the mobile shop, residents can use the time for ‘one to one’ conversation at the same time. A hairdresser service is provided during the week and this is an opportunity for residents to be able to have their hair attended to at the Home if they so wish. The lunchtime meal was observed being served on one floor of the Home. The meal choices consisted of either savoury mince in gravy, or pasties, and boiled potatoes, carrots, and leeks. The inspector sampled the meal and thought it was satisfactorily cooked. However several residents commented that they found the leeks to be undercooked. Staff were working hard serving food to residents in their rooms, and to residents sitting at dining room tables. However the service was task led rather then based on meeting residents’ needs equally. Residents were being served their main course and their puddings before some residents, who need extra help, and were sitting at dining room tables, had been served their main course. This practice must not continue. Meals must be served based on everyone being treated the same regardless of how much help they need. The residents’ menu was reviewed to see what range of meals choices residents are offered. The Home operates a four-week flexible menu. The menu was looked at in detail, and there was a range of varied and traditional meals available. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Overall quality in this outcome area is good. Mr Sibiya ensures complaints are responded to promptly and thoroughly. There are also systems in place to help protect residents from abuse EVIDENCE: The Home’s complaints procedure is prominently displayed on each floor of the Home. The contact details for the Commission for Social Care Inspection were included as well as the names of senior members of the company. The complaints book record that the Home maintains was checked to monitor how many complaints are being made. There had been two recorded complaints since the last inspection relating to care practices. Mr Sibiya had dealt with both complaints promptly and thoroughly. There has been a low incidence of complaints recorded in the Home, generally over the last 12 months. In discussion with a number of care staff they conveyed they understood their duty to report to senior members of staff any incidents of abuse they may be informed of, or witness. Mr Sibiya also runs regular training sessions on the topic of the `protection of vulnerable adults from abuse’. This should help ensure staff understand the responsibility they have to protect residents from abuse. There is copy of the Home’s policies and procedures, which is kept accessible to staff at the nurse’s station. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 15 There is information included in a `protection of vulnerable adults from abuse policy about the reporting of suspected abuse in the Home. Kingswood Court DS0000020249.V292924.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): 19,26 Quality in this outcome area is adequate. Residents live in a home that is purpose built, and adapted to meet their needs. However one bedroom is not satisfactorily maintained, and the garden is currently not in the best condition for residents use. EVIDENCE: The Home is located close to private houses, and a short distance from local shops and nearby bus stops, making the Home part of the local community. The building is wheelchair accessible; and there is a passenger lift for access to the first and second floor. The Home is a purpose built care home, designed around the needs for which it is intended. There are adaptations in place throughout the Home to assist residents as well as visitors who are disabled. There are three spacious communal living areas for residents to use throughout the Home. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 17 The furnishing is domestic in style, which helps to make the large spaces in the Home more homely in appearance. There are assisted baths installed in selected bathrooms of the Home. There are accessible toilet facilities located within very close proximity of lounge and dining areas. All bedrooms also have a toilet and sink facility. There are sluice washer disinfector facilities on each floor. These are separate from residents’ toilet and bathing facilities to minimise any risk from cross infection to residents. The building internally and externally looked as if it was mostly a satisfactory maintained. However the garden grass needs to be cut as it has grown considerably meaning it is currently not suitable for residents to benefit from. Also one bedroom requires further cleaning, as there is a strong odour that requires attention so that the room is satisfactorily clean and hygienic. Kingswood Court DS0000020249.V292924.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): 27,29,30 Quality in this outcome area is good. Well-trained competent staff care for residents. Residents are also protected by the Homes recruitment procedures. EVIDENCE: A sample of three staff recruitment records were inspected to find out if required ‘safety checks’ are being carried out when employees are recruited. The required Criminal Records Bureau offences checks and accompanying `protection of vulnerable adults from abuse first checks are being carried out for all new staff. These checks help ensure that staff are suitable and `fit’ to work with vulnerable people, and helps protect vulnerable residents from potential risk of harm. There are also two professional references obtained for all newly recruited staff. This helps demonstrate the suitably of all new employees to work in the Home. Staff also spoke positively about the range of training and development opportunities that they are able to attend. There was also a range of training notices and information on display at the nursing station about forthcoming study days. This should further benefit residents, if staff are well motivated and undertake regular training and updating. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36,38 Overall quality in this area is adequate. While residents benefit from the leadership and management approach and a manager who tries to run the Home in their best interests, there are no effective ways for residents to express their views about the overall quality of food. Also the health and safety of residents and staff is being protected. However there is a failing to ensure all staff are appropriately supervised in their work. EVIDENCE: Staff supervision records were not looked at on this inspection, however care staff reported that registered nurses provide them with regular support and guidance in their work and practice. However during the inspection one newly recruited care assistant was observed trying to lift one resident from their wheelchair, without seeking support, and in a way that was potentially unsafe for the resident and the member of staff. The inspector intervened and told the care assistant they must seek assistance from another member of staff. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 20 The majority of residents who were consulted said that Mr Sibiya makes his presence known in the Home every day he is on duty, and he regularly `walks the floor’. This helps demonstrates Mr Sibiya is keen to keep in daily touch with residents and staff. A number of residents and visitors also said that Mr Sibiya is very approachable and always listens to concerns and problems and `sorts them out’. In discussion with staff on duty they were asked what their roles and responsibilities were, and how they assist and support residents to meet their needs. In discussion the staff evidently have a good understanding and awareness of residents range of needs as well as what their roles and responsibilities are. The monthly monitoring visits of the Home that must be carried out by a representative of Fours Seasons Care Limited are being undertaken as is required by law. There were detailed and informative records of these visits. The records demonstrated that the designated individual responsible for the visits spends time consulting with residents and observing staff carrying out their duties. In conversation with the inspector several residents said that they had found the leeks served at lunch to be undercooked and tough. When staff were asked how such feedback from residents about food is made known to the kitchen staff said they did not like to `upset’ kitchen staff. This needs addressing. Residents’ views and feedback about the quality of food should be sought and acted upon, as part of the ongoing quality monitoring of the Home. There is a health and safety policy for staff to follow to try and help ensure the safety of residents is maintained. The fire logbook record was checked and showed the required fire tests and checks were being carried out and were kept up to date, helping to maintain the safety of everyone inside the building. A full time maintenance worker is employed, and they were on duty on the day of the inspection carrying out routine repairs. This helps demonstrate the health and safety of residents’ staff and visitors is being maintained. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X X X X 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 2 X 3 Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP15 Regulation 16.2(i) Requirement Timescale for action 18/05/06 2. OP3 Schedule 3.3(q) 3. 4 OP36 OP26 18. (2) 16.2(k) Meals must be served so that residents are treated with equality regardless of how much help they need. The identified resident who has a 01/06/06 foot pad alarm system must have a full assessment in place that demonstrates the reasons for the use of the alarm. All newly recruited staff must be 05/05/06 appropriately supervised. The identified room must be 11/05/06 cleaned so that the room is clean and hygienic and odour free. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3 Refer to Standard OP3 OP19 OP33 Good Practice Recommendations Seek the advice of a speech therapist to asst the needs of the resident identified at the inspection. The garden grass should be cut. Residents’ views and feedback about the quality of food DS0000020249.V292924.R01.S.doc Version 5.1 Page 23 Kingswood Court should be sought and acted upon. Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Kingswood Court DS0000020249.V292924.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!