Inspection on 19/08/08 for Lawfords House

This inspection was carried out on 19th August 2008.

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 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

Lawfords House 22/08/07

Lawfords House 15/02/07

Lawfords House 19/06/06

Lawfords House 14/03/06

Lawfords House 05/10/05

Lawfords House 20/01/05

Lawfords House 02/08/04

Lawfords House 28/03/04

Lawfords House 05/02/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOMES FOR OLDER PEOPLE Lawfords House Walford Road Ross-on-Wye Herefordshire HR9 5PQ Lead Inspector Sarah Blake Key Unannounced Inspection 19th August 2008 09:45 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 Lawfords House DS0000024721.V370349.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. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lawfords House Address Walford Road Ross-on-Wye Herefordshire HR9 5PQ 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) 01989 566811 01989 566811 lawfordcarehome@yahoo.co.uk Miss Mary Eileen Wilson Mr Peter Donald Vine Mrs Jill Madley Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home may accommodate 3 named service users who have needs that fall outside the scope of the registration category OP. This is conditional on regular review by the Registered Persons to ensure the Home is able to meet all needs without detriment to other service users. 22nd August 2007 Date of last inspection Brief Description of the Service: Miss M Wilson and Mr P Vine (the service providers) and Mrs J Madley (the manager) are registered in respect of Lawfords House to provide accommodation and care for 15 older people whose main care needs are due to the physical ageing process. They may not accommodate people whose main needs are due to the effects of dementia illnesses or mental health problems. The accommodation is provided in a medium sized period house about a mile from Ross on Wye town centre. The town is within walking distance for people living there who have good mobility or use mobility aids such as motorised scooters. However, as in most of Ross, the route is not level. The house is a converted building and is in need of refurbishment and upgrading. One of the bedrooms has been set aside for use as an office. This means that no more than 14 residents can be accommodated at present. Ross-on-Wye is a market town and most of the people who move to Lawfords House are local people who have lived in the area for many years or have moved there to be nearer to relatives. The current range of fees for Lawfords House is from £375 to £395. Additional charges are made for transport, hairdressing, chiropody, magazines and newspapers. A copy of this inspection report can be viewed at the home. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate outcomes. We spent a day at the home, talking to the people who use the service and the staff, and looking at the records, which must be kept by the home to show that it is being run properly. These include records relating to the care of people who use the service. The service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Some of the manager’s comments have been included within this inspection report. The information from these sources helps us understand how well the home is meeting the needs of the people using the service. What the service does well: The home provides a welcoming and homely place for people to live. There is sufficient information to help people to make up their minds if they wish to move into Lawfords House. People’s needs are assessed before they move in, so that staff know how to provide the care that is needed. Care plans are clearly written, and focus on the individual needs of the people who use the service. Staff at the home respect people’s privacy and dignity. Medication is managed safely. There is a range of social activities, and visitors are welcomed. People who use the service are encouraged to make choices about their everyday lives. The home provides a varied menu of nutritious food. The home makes its complaints procedure readily available. People who use the service are confident that the manager will deal with any concerns quickly and effectively. There are sufficient staff to provide the care that is required. Staff are caring and kind, and people who use the service know that their needs will be met. The manager works hard to ensure that the people who use the service are looked after well and are happy. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 The home does not provide intermediate care, so we did not inspect Standard 6. Quality in this outcome area is good. The home provides sufficient information to help people to make up their minds if they wish to move into Lawfords House. The home carries out an assessment of people’s needs before they move in, so that staff know how to provide the care that is needed. This judgement has been made using available evidence including a visit to this service. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home has produced a brochure which gives brief information about Lawfords House. The Service User Guide is very detailed, and explains what life is like for people who live at the home. The manager told us that people are offered a six week trial stay at Lawfords House to help them make up their minds as to whether they wish to live there permanently. We spoke to one person living at Lawfords House who had taken this opportunity, and she felt that it had given her a chance to try the home out without committing herself to living there on a permanent basis. We looked at records of two people who use the service, and these showed that the home had carried out an assessment of people’s needs before they moved in. This assessment is important, because the information within it helps the staff to know what care they need to provide, and it enables the home to be sure that it can meet people’s individual needs. We spoke to four people who use the service and they all told us that they had been made extremely welcome by the manager and staff when they first arrived at the home. One person said “They were lovely to me when I got here”. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. Care plans are detailed and focus on the individual needs of the people who use the service. Some care plans are not reviewed or updated regularly. People who use the service know that their privacy and dignity will be respected. Medication is managed safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home carries out a full assessment of people’s needs, and then a care plan is drawn up to show how the needs will be met. Most care plans are detailed and showed a good understanding of people’s individual needs and preferences. For example, one care plan states “Please put high cushion for her so this enables her to stand from a sitting position” and “Please remember Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 11 A (name of resident) has rights and choices, always remember her privacy, dignity and confidentiality”. The manager told us that the people who use the service and their relatives are asked if they wish to be involved in planning their care. We saw that one care plan included the sentence ““This care plan was done with input from B (name of resident), her friend and her social worker and information from her GP and the hospital”. We spoke to two people who use the service and they told us that they had not wished to be involved in planning their care, but both felt that their input would have been welcomed. Care plans are reviewed regularly, and we saw that they had been updated to take into account people’s changing needs. In some cases, the care plans do not reflect the level of risk which has been assessed. For example, we saw that one person had been assessed as at high risk of falling, but there was no evidence of any strategy for managing the risk. However, when we spoke to the resident, she told us that she had had several falls whilst she was living in her own home, but had had no falls since moving into Lawfords House. The manager showed a good understanding of the factors which make falls more likely, and she also explained clearly how the home was reducing the risk for this particular resident. It is important that there is a written plan for reducing risk, so that all staff are aware and can refer to it if necessary. At the previous inspection, the home was required to make changes to the way that medication is managed. The requirement related specifically to the recording of medication administered by staff, and the management of “as required” medication. We found evidence that the home has complied with the requirement. We looked at records for two people whose medication is administered by staff, and these were clear and accurate. The plan for managing one person’s “as required” painkillers was detailed, and clearly explained how much medication the resident could be given and at what intervals. The home encourages people to manage their own medication if they wish. The Service User Guide states “your choice, this will be assessed prior to your admission”. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. The home provides a varied range of activities, and is careful to treat each person as an individual. Visitors are welcomed, and people who use the service are encouraged to make choices about their everyday lives. There is a varied menu of nutritious food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager told us that the home provides a range of opportunities for social activities. One person told us that there are “lots of things like Scrabble or cribbage if you want to do them”. We saw an indoor greenhouse in one of the lounges, but it did not appear to be in use. There was a selection of books and some games available. One resident told us that she regularly goes into town on her mobility scooter, and that she values this independence. Several people who use the service Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 13 told us that the home organises regular activities such as music sessions and games. One person said that he prefers not to join in with organised activities, and that the home respects his choice. We saw that one resident was doing some intricate embroidery, and she told us that the home encouraged and supported her to continue with this interest, to the extent that the deputy manager had taken some of her finished work to be framed. The home provides a varied and nutritious diet for the people who use the service. The menus show that there is a choice of main course and pudding at every meal. Fresh fruit is always available. We received many positive comments about the food, including “the food is like you would cook yourself”, “the food is excellent”, and “very good, you always get a choice. Today it was scampi and I don’t like scampi, so Val (the cook) asked me what I would like and I chose egg and chips”. We saw that the care plans include a nutritional assessment, and that if people need support to eat, this is clearly recorded. For example, one care plan states “please cut up her food, not too small just normal, as A (name of resident) cannot cut her food herself” We saw hot drinks being served throughout the day. One resident told us “If I’m not down for a coffee, they notice and bring it up for me”. . Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. The home has a clear complaints policy and procedure, and this is readily available. People who use the service know how to raise any concerns and are confident that the manager will deal with them quickly and effectively. Staff have a good understanding of the protection of vulnerable adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints procedure is clearly laid out, and we saw that it is displayed in the reception area, and that all residents have a copy in their Service User Guide. The residents whom we spoke to all said that they would raise any concerns with the manager, and that they were confident that she would do her best to resolve any issues. The home’s recruitment procedures help to protect the people who use the service by making sure that all pre-employment checks are carried out. These checks include a Criminal Records Bureau (CRB) check, and two written references, one of which should be from the most recent employer. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 15 We looked at two staff files, and these showed that all the necessary checks had been carried out. The records also showed that staff had been given training in the protection of vulnerable people. The manager had a good understanding of the ways in which people can be protected from abuse, and was aware of the current guidance from Herefordshire Council on this issue. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 25, 26 Quality in this outcome area is adequate. The home is kept clean, but there is a need for greater investment in refurbishment to make the home more comfortable for the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is welcoming and friendly, with a very informal atmosphere. Some parts of the home need refurbishment, and the general impression is of somewhat shabby décor in the communal areas. However, the dining room and lounge area have recently been painted, which only serves to emphasise the need for redecoration in other areas. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 17 The home encourages people who use the service to bring items of their own furniture if they wish to, and to personalise their bedrooms with ornaments and photographs. We saw that one person had a collection of soft toys, and another had examples of her embroidery on the walls of her bedroom. All the bedrooms have a lockable drawer, and lockable boxes are also available on request. All areas of the home were seen to be clean, and residents told us that their bedrooms are cleaned regularly. There is a lack of storage space within the home, and this means that items are often stored in unsuitable places. For example, we saw that a hoist used for assisting people to mobilise had been stored in a resident’s bedroom, in spit of the fact that it was not being used for the resident. The manager told us that she had nowhere to store it. We also saw that, in one upstairs bathroom, there was a roll of carpet in the bath. The manager told us that the bath is not used, and the carpet is only there temporarily. In the upstairs shower room we saw tins of paint in the shower cubicle, and two commodes and a stepladder were partially blocking access to the wash basin. As there is no sluicing area on the upper floor, this wash basin is being used to sluice out commodes until a new sink is installed. The manager told us that the shower is not used at the moment, and that the commodes and stepladder were only being stored there temporarily. The home must make more suitable arrangements for the storage of items of equipment. Since the previous inspection, the kitchen has been upgraded with a new stainless steel table and a new commercial fridge. We saw several flies in the kitchen. At the previous inspection a year ago, we saw that the fly screen on the kitchen window was torn, leaving a hole that flies can get through. We saw that the fly screen is still broken. The manager told us that a new one is ready to be fitted, but could give no reason as to why this had not been done. Following the previous inspection, the Environmental Health Officer from Herefordshire Council visited the home to advise on food safety precautions, and recommended that an electronic fly killer should be installed. This has not been done. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. There are sufficient staff to provide the care needed by the people who use the service. Staff are caring and responsive to the individual needs of the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw staff working with people who use the service throughout the day. The staff were kind and took time to make sure that people had been given the care that they needed. People who use the service told us “All the staff are fine. I look on a lot of them as friends”, “They’ve been really wonderful to me, every one of them” and “If you ring the bell, they answer. If you ask them to do anything for you, they will”. The staff are undoubtedly one of the strengths of Lawfords House. Everyone we spoke to had only positive things to say about them. They were described as “helpful”, “supportive” and “jolly”. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 19 We looked at the records for two members of staff, and the home’s training records. These showed that staff receive training in areas such as fire safety, the protection of vulnerable adults, first aid, food hygiene, moving and handling, and medication. This training helps to ensure that they have the skills they need to provide care for the people who use the service. One member of staff had not been given any training in infection control or moving and handling, despite having worked at the home for over a year. At the previous inspection last year, we recommended that the home should have a planned annual training programme supported by a budget identified for this purpose so that staff training is kept up to date. This has not been put into place by the owners, so the manager tries hard to access free training. We looked at staffing rotas, and these showed that there are sufficient staff on duty at all times to meet the needs of the people who use the service. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. The manager works hard to ensure that the people who use the service are looked after well and are happy. The registered providers do not fulfil their obligations to the home, and have not provided the resources needed to make the home more comfortable for the people who use the service. This judgement has been made using available evidence including a visit to this service. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager demonstrates a good understanding of the needs of the people who use the service. She told us that she tries hard to make sure that the home is run in the best interests of the residents. The previous history of this home indicates that the owners do not fulfil their responsibilities, and that this is a stumbling block to any improvements which the manager wishes to make. The manager completed the Annual Quality Assurance Assessment (AQAA) in full, and gave us useful information about the home. The owners are required to visit the home every month and provide a written report. At the previous inspection we saw that these visits had not been carried out regularly. We looked at the records since the last inspection, and the most recent report was dated January 2008. The manager told us that, as she has no financial control, she is unable to make some of the necessary changes to the home. This includes the installation of a sluicing sink upstairs. However, even where the manager could make improvements, such as replacing the fly screen in the kitchen, these have not always been carried out. We asked the manager how the home finds out the views of the people who use the service. She told us that she gives out questionnaires to residents, relatives and professionals who visit the home. She aims to do this annually, and the results are sent to the owners. We saw no evidence that questionnaires had been completed within the past year, or that the owners had used the information from the previous questionnaires to make any improvements to the home. We looked at the records of accidents and incidents which must be kept by the home, and these had been completed satisfactorily. The fire safety records showed that monthly checks of fire doors had not been carried out since December 2007. The manager told us that these checks have been done, but that she has not completed the paperwork. The manager told us that the home does not take responsibility for people’s money. At the previous inspection, the owners had plans for extending the home. These plans have not resulted in any changes at the home. In the past, the owners have often told us that they are planning improvements, but have not actually carried out any improvements. Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 X X X 3 2 2 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 1 X N/A X X 2 Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 14 (2) (b) Requirement You must make sure that care plans reflect the level of risk which has been assessed. This will help to ensure that people who use the service receive the care that is needed. Timescale for action 16/12/08 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. Refer to Standard OP7 OP19 Good Practice Recommendations Information in the care plans should be detailed enough to explain to staff the specific care a person needs. You should develop a structured plan for upgrading the premises with an allocated budget and timescales so that the standard of the accommodation improves. You should replace or repair the fly screen in the kitchen, to help protect people from the risk of food poisoning. 3. OP19 Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 24 4. OP30 You should have a planned annual training programme supported by a budget identified for this purpose so that staff training is kept up to date. The owners should have a business and financial plan for the Home so that improvements to the service are planned and financed effectively. 5. OP34 Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 25 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 Lawfords House DS0000024721.V370349.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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