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Inspection on 04/03/09 for Lady Forester Residential & Day Care Centre

Also see our care home review for Lady Forester Residential & Day Care Centre for more information

This inspection was carried out on 4th March 2009.

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

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

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

What the care home does well

The home has a stable staff group who are committed to providing good care and support to people living at the home. People told us that they are able to spend their day how they wish without having any restrictions placed upon them. The home is clean and tidy and has a dedicated housekeeping team. People are consulted in their views about the home.

What has improved since the last inspection?

The assessment procedure is carried out, and people are only admitted to the home if their needs match the homes category of registration. The statement of purpose and service user guide have been reviewed. Contracts/terms and conditions of residence have been reviewed. People know how to make a complaint because the home has produced a complaints procedure, which informs people how their complaint will be dealt with. An effective quality assurance system has been developed to seek the views of people who use the service. Care staff are now receiving regular formal supervision.

What the care home could do better:

There are a number of good practice recommendations that have been made. People we spoke to said they could not think of anything the home could do better.The AQAA contains good information that is supported by evidence and informs us of changes made to the service to make improvements. The home has identified areas for improvement over the next 12 months.

CARE HOMES FOR OLDER PEOPLE Lady Forester Residential & Day Care Centre Church Street Broseley Shropshire TF12 5BQ Lead Inspector Karen Powell Key Unannounced Inspection 4th March 2009 09:30 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 Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lady Forester Residential & Day Care Centre Address Church Street Broseley Shropshire TF12 5BQ 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) 01952 884539 01952 884552 Lady Forester Residential & Day Care Centre Post vacant Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 13 The maximum number of service users to be accommodated is 13. 2. Date of last inspection 23rd September 2008 Brief Description of the Service: Lady Forester Residential and Day Care Centre is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care to a maximum of thirteen elderly people. Twelve rooms are provided for permanent service users and one bed is provided for respite purposes. The home is situated on the outskirts of Broseley, Shropshire and set in well maintained grounds. The building was formerly the Cottage Hospital. The centre is a charitable organisation and managed by a board of Trustees. The home is situated on the ground and first floor of the centre, which is accessible via a passenger lift. Two small quiet rooms are situated on the ground floor. All bedrooms are single. Day Care is provided three days a week on the ground floor and people living at the home are able to participate in activities arranged by day care staff if they wish to do so. The manager is Trish Cornes who has been in post since 18th August 2008, she has previously been registered with CSCI when she managed older peoples services prior to taking up this post. People can obtain information about this service from the home’s Statement of Purpose and Service User Guide. The reader is advised to contact the home to obtain up date information on the fees charged. Inspection reports produced by CSCI can be obtained direct from the provider or are available on our website at www.csci.org.uk Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 5 Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that people who use this service experience adequate quality outcomes. The inspection of the service was unannounced and took place on 4th March by one inspector over a period of five and a half hours. A range of evidence was used to make judgements about this service to include discussions with people using the service the manager, and staff. We also examined a number of records to include care records of people living at the home, staff training, staff recruitment and health and safety records. Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting them, discussing their care with staff, looking at care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. Prior to the key inspection an Annual Quality Assurance Assessment (AQAA) document was posted to Lady Forester residential and day care centre for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale. The manager completed this and some comments have been included within this inspection report. The purpose of the inspection was to assess all 22 Key National Minimum Standards for Care Homes for older people and any further standards necessary, including the three requirements and eleven recommendations made at the last key inspection carried out on 23rd and 24th September 2008. Information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating is provided throughout the report based on each outcome area for the people who use the service. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. Fees are currently not provided in the service user guide as required. Readers wishing to know more about this information should contact the service directly. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? What they could do better: There are a number of good practice recommendations that have been made. People we spoke to said they could not think of anything the home could do better. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 8 The AQAA contains good information that is supported by evidence and informs us of changes made to the service to make improvements. The home has identified areas for improvement over the next 12 months. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 9 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 Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 The home understands the importance of having information about their service so that people can choose a home that will meet their needs and preferences. The admission process is personalised so that people are given consideration to their individual needs, concerns and anxieties before moving into Lady Forester care home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A statement of purpose and service user guide, which is information about the home, is given to all people who move into the Lady Forester care home. This tells people what they can expect from the service. Following a recommendation at the last inspection that both documents are reviewed, the homes manager has carried this out. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 11 All people have an assessment of their needs carried out before the home offers a place to them. This is done by the manager who makes sure that the home can meet the individuals needs. It was considered that the requirement made at the last inspection, which stated people must only be admitted into the home if their needs match with the homes category of registration and following a full needs assessment undertaken by a suitably qualified or trained person has been met. We case tracked the most recent admission to the home. We saw evidence that the manager had visited them in hospital where they were being cared for before moving into the care home. A comprehensive assessment of their needs was documented. The manager gained information from a number of people including the medical staff and the individuals family. The person did not visit the care home before admission, their family viewed the home on their behalf. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Staff have the information they need and have a clear understanding of how to offer care to each person, which ensures peoples health and personal care needs are met in a way that they prefer. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at care plans for two people living at the home. The manager has revised the care plan document since the last inspection, which makes it very clear to staff how to meet peoples assessed needs. Senior care staff have received care plan training and are now completing care plans with individuals. Care plans contained information about the persons assessed needs and how staff are to deliver care and support in a way that the individual prefers. Care plans contained useful tools such as a nutritional risk assessment, however one did not contain the persons name or date the assessment was carried out and the other was left blank in the individuals file. Manual handling risk Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 13 assessments had been completed once again one contained no name or date, and was not signed by the assessor. The other manual handling risk assessment was also not signed by the assessor. Care plans did contain how a persons health care needs should be met including special dietary needs. Records of Drs visits had not always been recorded, in one case a change of treatment had been arranged. However, staff spoken to were able to tell us what treatment the Dr had prescribed. There is a clear medication policy for all staff to follow. Medication of the people we case tracked was examined. Each person has medication administration records, which contain their photograph. Records were fully completed and storage and return of medication was satisfactory following good practice guidelines. All staff that administer medication have completed safe handling of medication training. We observed people to be treated with respect during the visit with their dignity and privacy being maintained. Privacy signs are in use on bathroom doors to indicate personal care is being delivered and not to enter at that time. The staff group were patient, kind and caring throughout the day. People we case tracked confirmed this is the case at all times. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet peoples expectations. People who use the service receive a healthy, varied diet according to their assessed requirement in choice. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans we looked at included information such as peoples preferred rising and retiring times. People we case tracked told us that their daily routines are flexible and they are able to choose how they wish to spend their day. One person told us they like to have an afternoon walk, which we observed during our visit. When asked what they were going to do with the rest of the afternoon they told us they would be spending it resting in their bedroom. Again we saw that this person was able to exercise their choice. Individuals told us that their family and friends could visit at any time, records showed that visits take place at various times of the day. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 15 People living at the home can access the day centre where activities are provided, an activities plan was seen on display. People we case tracked told us they like to spend time in the day centre. There are two small lounges at the front of the home that can be accessed by people living at Lady Forester care home. A music concert to be held at the local church with a school band providing entertainment is due to be held in April. A small number of individuals are planning to attend. The home acknowledged in the completed AQAA that menus needed to be reviewed and have revised them since our last visit. The home have accessed up-to-date information from a document providing information for care homes on eating well for older people, this has assisted in revising the menus. People we case tracked told us that the choice of food is good and personal preferences are taken into account. We made general observations during lunchtime and found the activity to the relaxed. People choose where they wish to eat and this was seen in practice during the visit. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service and their representatives are able to express their concerns and have access to a complaints procedure. Procedures are in place to safeguard people from potential abuse and staff receive training ensuring people who use the service are protected from abuse and have their legal rights protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One out of the two people we case tracked knew what to do if they were unhappy with the service they receive and reported that they have no concerns or complaints about the home. The second person could not recall knowing what to do. We could see from their records that they had been issued with the complaints procedure and noted that there was a family member who visited regularly and was also made aware of the complaints procedure at the point of admission. Neither the home or CSCI have received any complaints or concerns since our last inspection, which indicates peoples continued satisfaction with the service the home provides. All people spoken to were very complimentary about the service provided by the staff at Lady Forester. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 17 The two people case tracked told us they feel safe and secure at the home. Staff are trained in adult protection and further training in adult protection is planned for April. There have been no referrals made under local safeguarding procedures since our last inspection. The manager is due to attend adult protection training for managers on 31st March 2009 following a recommendation made at the last inspection. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The environment of the home in parts is in need of redecoration and refurbishment to provide people living at the Lady Forester Centre with a homely and more comfortable place to live. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The general state of the home is reasonable, with a better standard of surroundings and décor on the ground floor to upstairs, which has some wear and tear. One bedroom has been redecorated since our last visit to the home on the upstairs floor of the home. The upstairs bathroom, corridor and some bedrooms are in need of re decorating and refurbishing. Carpets to the upstairs of the home and most bedrooms are in need of replacing due to general wear and tear. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 19 Two additional bedrooms have been registered by CSCI since our last inspection and were seen to be of a high standard. These rooms are on the ground floor of the home. One was occupied by one of the people we case tracked who told us they were very pleased with the facilities. Their room was personalised and provided a good standard of furnishings. The second person we case tracked also occupied a bedroom on the ground floor, once again decorated and furnished to a high standard. The room was personalised with the individuals own belongings. An annual programme of renewal and maintenance should be devised with timescales to measure progress. A recent environmental health officer visit was undertaken with no requirements made. Staff follow infection control procedures to minimise the risk of infection within the home. All staff complete infection control training, evidence of training certificates were seen on training files examined. The manager has obtained an infection control DVD training facility from the health protection agency but this has not yet been rolled out to staff. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The arrangement for staffing, their support and development ensures that the needs of people living at Lady Forester are met. People have confidence in the staff at the home because checks are done to make sure that they are suitable to care for them. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People we spoke to were complimentary about the staff. One person we spoke to said the staff are all very good, another person said the staff look after me well. Throughout the inspection staff were observed to be available to all of the people living at the home. They were seen to work as a team going about their duties in a professional way. The staff team have been at the home for some time and know the people living at the home very well. Staff reported they felt supported by the homes manager and that training opportunities are still good at the home. People considered that there are enough staff on duty to meet the current individual needs of people living at the home. Each staff member has a training file, we examined the file of a member of staff on duty during her Inspection she told us she had completed supervision Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 21 skills training and care planning training since the last inspection. We saw evidence of certificates on her training file. All staff with the exception of two have completed their National vocational qualification (NVQ) level 2 or above. The remaining two members of staff will be undertaking this in November 2009. This exceeds the national minimum standards of 50 . We looked at the files of one staff member employed since our last inspection to make sure that pre employment checks are undertaken so that staff are checked as being suitable to work with vulnerable adults. The file was well organised and contained all the checks required under regulation. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. People have confidence in The Lady Forester care home because it is effectively managed in the best interests of the people living and working there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager, appointed in August 2008 has settled well into her new post. People spoken to including the staff group told us that she is managing the care home well. They reported she is kind and supportive and easy to approach. Ms Cornes has worked hard to achieve compliance with the requirements and recommendations made at our last inspection visit. In the Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 23 completed AQAA she recognises areas where the home needs to improve for the benefit of people living and working there. Ms Cornes holds the relevant qualifications to manage the care home. She continues to develop her professional practice and has attended training provided by outside sources since the last inspection. She has further training booked in the near future for her and the staff group. Ms Cornes has applied to CSCI for registration to manage both the care home and the domiciliary care agency. The quality assurance system has been put into place. Surveys have been sent to all people living at home. We saw the results, which were very positive. We discussed with the manager widening the survey to include other interested stakeholders including relatives, health care professionals and staff working at the home. People who require support to manage their finances are safeguarded by the procedures in place. Records are available for finances held and two signatures are obtained for all transactions in addition to receipts. Property inventories had not been completed on either of the people we case tracked. The home should ensure that these are completed on admission, and kept upto-date if new property is brought into the home. A sample of maintenance records required for health and safety appear to be satisfactory and routine maintenance checks were reported to have been carried out. Accidents are recorded but are not audited as part of the management systems to monitor trends and any other issues that may require the manager taking action. A system should be put in place to do this. A recent visit from the fire officer and health and safety officer has been carried out. No requirements were made from their visits. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 24 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 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x 3 2 Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 OP26 Good Practice Recommendations A programme of redecoration/refurbishment and maintenance should be devised. This is to ensure that the home continues to improve the environment for people who live at Lady Forester Care home. Personal inventories should be completed to ensure the home has an up to date inventory of peoples belongings. The quality assurance system should include other interested stakeholders including relatives, staff and health care professionals. This ensures that anyone who has an interest in the care home is given an opportunity to express their views. A system should be in place to monitor accidents that occur in the home. This is to ensure that any trends in accidents are identified and any action required by the DS0000020681.V374413.R01.S.doc Version 5.2 Page 26 2 3 OP18 OP33 4 OP38 Lady Forester Residential & Day Care Centre manager is carried out. Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lady Forester Residential & Day Care Centre DS0000020681.V374413.R01.S.doc Version 5.2 Page 28 - 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!