Inspection on 29/06/05 for The Lodge

This inspection was carried out on 29th June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Lodge 12/01/10

The Lodge 19/02/09

The Lodge 17/09/07

The Lodge 30/08/06

The Lodge 08/12/04

The Lodge 24/08/04

The Lodge 01/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 THE LODGE Bridge End Eldersfield Gloucestershire GL19 4PN Lead Inspector Dianne Thompson Unannounced 29 June 2005 - 15:00 and 10 July 2005 - 11:00 th 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Lodge Address Bridge End Eldersfield Gloucestershire GL19 4PN 01452 840088/840654 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Glevum Farm Trust Miss Sandra Carol Wisby CRH 9 Learning Disability 9 Category(ies) of LD registration, with number of places THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8 December 2004 Brief Description of the Service: The Lodge provides residential accomodation for a maximum of six adults, one of whom is over the age of 65, who have learning disabilities. The home is located in Eldersfield and forms part of a working farm. The farm is staffed separately from the residential accommodation and offers day activites in farming and horticulture to individuals from the surrounding communities. The day activities of service users who live in the home are not limited to the on-site facilities and are developed in a way which reflects individual interests outside the farm environment. The property is owned by Glevum Farm Trust. The trustees are registered as providers and as such carry responsibilities for the overall development and management of the home. Mr E Davies is identified as the Trust Manager, Company Secretary and Responsible Individual, with Miss S Wisby as registered manager. The Glevum Farm Trust operates another establishement in New Street, Ledbury, Herefordshire, which is included in the registration as an annexe of the Lodge. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over two days, the Lodge on a weekday, during the afternoon and evening, and New Street in Ledbury on a Sunday morning. Two members of staff were on duty and 5 residents were present during the visit to the Lodge. There has been one new admission to the home since the last inspection. The inspector spent time talking with residents, talking with staff and was given a tour of the home by two of the residents. Files for three residents were examined, together with documentation for the running of the home. One resident was seen during the visit to New Street and no staff were on duty at the time. The manager was not working at the time of the inspection, but all residents and staff were helpful, informative and co-operative throughout. What the service does well: What has improved since the last inspection? What they could do better: More detailed recording needs to be completed, particularly in the level of care and support provided, and risk assessments. Knowledge and information is communicated verbally within the staff team, but greater emphasis needs to be placed on making sure information is recorded. Risk assessments need to be completed or updated. Risk assessments identify risks and provide evidence to support the decision-making process. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 6 A review of the service in Ledbury needs to be completed to make the flat a more homely environment, similar to the comforts provided at the Lodge. 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 LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5 Information is provided about the home to help new residents decide whether they might like to live at the Lodge and if the home can meet their needs. This would be further improved with some amendments to the House Rules. EVIDENCE: Included in the terms and conditions of the home were House rules, which were seen in a resident’s file. Two aspects of these rules need to be amended, e.g. smoking arrangements do not specify where the designated areas for smoking are, and residents ‘should not enter other residents rooms’ should include ‘unless invited’. There was evidence that residents have signed the house rules but there was neither date nor signature by a Glevum representative on the document. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9, The care planning system in place provides details of residents care needs. Care plan reviews held six monthly or as residents needs change, would provide up to date details of current needs and identify any action staff need to take. Similarly, risk assessments need to be completed and reviewed which will ensure that the safety of residents and staff is promoted. EVIDENCE: A sample of three residents care records was looked at in detail. The daily logs are recorded in one book, which refers staff to individual files. Separate files are held for health needs, and care plans. Although the staff team have acquired knowledge of the residents through working and care practices, such detailed information is not always recorded. Information should be fully recorded to make sure that staff do not solely rely upon verbal communication with each other, particularly in relation to health issues or concerns. For example, one resident became upset during the inspection and staff indicated that the resident had not been himself for almost a week. The inspector was informed the resident had a high temperature earlier in the week, yet there was no information recorded in the file to track this. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 10 In order to evaluate any health concerns and identify or eliminate possible causes it is essential to maintain adequate recording systems. For example, a dental appointment had been arranged for the following day based on a suspicion that a tooth problem might be causing pain, and linked to the associated change in behaviour for the resident. This information was neither recorded nor evaluated in terms of care provision. The inspector was informed of the home’s smoking policy. Currently, two of the residents are smokers. There is no risk assessment in files relating to their smoking, and/or designated smoking areas within the home. A risk assessment is necessary to evaluate the circumstances should either resident smoke in their bedrooms. Risk assessments in the files are out of date and need to be reviewed. Individual care plan reviews are irregular. For example one recent review had taken place on 30/3/05 and the previous review recorded as taking place on 26/3/03. Reviews should be completed six monthly or more often as requested by residents, to meet the required Standards. The recommendation of the previous inspection i.e. the seeking of independent financial appointees for residents is restated in this report. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15, 17 Residents and staff state that a range of activities is taking place in the home, although records do not always support this. The home provides a healthy diet and residents are offered a choice of foods. EVIDENCE: One resident told the inspector that he goes to Tewkesbury AOC, and he also enjoys going dancing with the over 60’s on a Wednesday evening. Other activities included rainbow club on Monday evenings, shopping in Tewkesbury; dancing on Wednesday evenings with the over 60’s club, visits to Gloucester docks, and holidays. Information about residents’ likes/dislikes or interests is inconsistent. A holiday to Dawlish in Devon took place recently, where one of the residents said he saw planes in a museum, and especially liked seeing Concorde. This information was not evident in the resident’s file. Similarly, another resident’s interest is identified in a care plan but there is no information about how this interest is being facilitated or supported. This removes the opportunity for THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 12 building further on planned experiences or supporting residents in their hobbies and interests. There was evidence that support for residents to maintain family contact has been discussed and included in care plans. However, it was noted that an agreement made in a review meeting for staff support for family visits has not been maintained as agreed. Residents are offered a healthy and nutritious diet and said they enjoyed their meal taken during the inspection. All residents are offered a choice of main meal. During the inspection this consisted of chicken or steak, with vegetables, salad, chips, onion rings and/or beans. The inspector observed both choices being offered and choices being made by the residents. A meal-planning meeting was held at the Lodge during the inspection. All residents and duty staff were involved in discussions about the planning and choices of food options for the forthcoming week. This was appropriately recorded on the menu planning sheets. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, Staff provide support for residents at the Lodge, which appears in part to have been established by knowledge of individual needs through ‘custom and practice’ over many years. This knowledge however needs to be more fully translated into care plans for all residents. EVIDENCE: The home uses separate files for the care and support for residents. The inspector was told that this system works within the home, however the information in care plans needs to be more detailed. For example, it is stated that a resident’s behaviour may present as anger. There are no guidelines about how this resident’s anger can be recognised and no guidelines on how staff should respond. One of the residents is identified as having poor eyesight. It is not clear how this is being monitored or how this may affect what the resident is able to do. Explicit information is needed in care plans to identify implications for staff in providing care/support for the resident. Another resident has low blood pressure. There is no information in the file about how this is monitored, when it is checked and how often. It is recommended that care plans include this information along with the implications for the care/support of the resident. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 30 The Lodge provides a home environment for six people with learning disabilities. In addition to the Lodge, further accommodation for up to three people is provided in New Street, Ledbury. The internal décor to the property in Ledbury needs to be improved to meet the required standards, to include the repair and maintenance of equipment. EVIDENCE: The Lodge was not purpose built as a home for people with learning disabilities. Originally built as a farmhouse it provides homely and comfortable accommodation. However, it does not meet all the environment standards, in particular the size of the attic bedroom, as detailed in previous reports. Access to local amenities is available via the homes vehicles. There are two cars for the home’s use, and at weekends and evening the farm’s land rovers are also available. There is little public transport locally, with only one weekly bus to Eldersfield or Gloucester. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 16 There is a large kitchen area, a large lounge and dining area and an additional smaller lounge for shared activities. There is a small garden around the home and the residents have safe access to the farmland. One resident was pleased to show the inspector his bedroom pointing out his TV, radio and lockable cabinet. All rooms seen by the inspector were individual and have been personalised by the residents. Two beds were seen without valance covers to the base. In the attic room the divan base had no legs, due it was assumed, to the low ceiling. This attic room does not meet with current regulations regarding size, but was registered prior to the current legislation. The home is clean and hygienic, although there was a distinct urine smell evident in the stairway and landing to the bedrooms. The inspector was informed that the carpet has been cleaned, but the smell remains. The carpet should be replaced if cleaning has not removed the urine smell. Some of the curtains in the home are hanging off their hooks and need re-hanging, particularly to the landing window and the bay window of the lounge. Residents have their own room keys and a key to the front door of the home. 99, New Street: The flats are in the centre of Ledbury, within close proximity to the shops and local amenities. One resident is living here at the moment, with minimal staff support. This property was previously operating under ‘The Lighter Touch’ providing support for people to live more independently. Earlier this year the home was re-registered as an annexe to the Lodge. The resident at home gave the inspector a tour of the ground floor flats. One flat is occupied at present, and consists of lounge/bedroom, kitchen, and shower room. The kitchen walls were being repainted. It is of concern that there are significant paint splashes to the tile flooring in the kitchen. It is recommended the paint be removed or the tiles to the floor are replaced. There are two chairs in the kitchen. One is broken and should be repaired or replaced. The flat did not have a lounge facility – it is more like a bed-sit arrangement and does not appear very comfortable or homely. The resident informed the inspector he would like to be able to sit on a sofa to relax and watch his TV. A separate bedroom would provide greater privacy, as the entrance door opens directly into the bedroom/lounge. It is recommended the resident’s wishes be further explored by the home and facilitated as far as possible. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 17 There is a lack of storage space. Bookshelves, cupboards and worktop would provide more storage and working space. There is no telephone in the flat, although there is one upstairs and in the hall. A telephone in individual flats would be beneficial. For example, a coinoperated phone could be obtained which can be programmed to provide direct links in the event of an emergency or any concerns such as illness, e.g. use of named individuals or lifeline. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion EVIDENCE: Staff were observed to be interacting with residents in a respectful and comfortable manner. Time was spent talking to residents and the staff on duty. One resident said that the staff were ‘ok’ and that they treated him ‘ok’. Supervision files were not available at the time of the inspection. Staff training files were not available at the time of the inspection. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42, The manager was not present at the time of the inspection. The members of staff who were on duty were open, approachable and helpful throughout the inspection. The health and safety of all residents and staff must be considered at all times, with appropriate risk assessments completed. EVIDENCE: The windows in the Lodge, which were open at the time of the inspection, have been fitted with window restrictors. These were not operating within the required guidelines of restricted opening. The registered manager informed the inspector, following the inspection that the windows are scheduled for replacement in August 2005, and that interim repairs are therefore considered an unnecessary expense at this time. The manager states that a risk assessment has been completed which considers the potential risk of residents falling from windows. The inspector requested a THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 20 copy of this risk assessment to be sent to CSCI. At the time of writing this report no copy of the risk assessment has been received. There is no evidence of a fire risk assessment, and no escape route plan linked to identified fire zones on the fire alarm panel. The inspector issued an immediate requirement notice for the home to complete. This was duly complied with and a copy sent to the inspector within 7 days of the inspection. Fire drills are recorded in the log, but on closer examination it is evident that the majority of drills are false alarms. ‘False alarm’ evacuations should not replace regular fire practice/drills. The record log identified residents who were present at the time of evacuations, as numbers present. People present during all evacuations should be clearly identified, to ensure all residents and staff take part in and complete regular training in fire escape procedures. There is a doormat to the kitchen door, which does not fit the door well adequately and is therefore a safety hazard. This needs to be rectified or replaced. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 2 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 1 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 x 2 Standard No 11 12 13 14 15 16 17 x 2 x 3 2 x 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 THE LODGE Score 2 2 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 22 yes Are there any outstanding requirements from the last inspection? 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 YA6 Regulation 15 Requirement All care plans must be reviewed with residents at the request of the resident or at least once every six months and updated to reflect changing needs. Residents care plans must cover all aspects of care as set out in Standards 6 and 2.3 The registered persons must apply to the Commision for Social Care Inspection to vary the conditions of registration in respect of any building work undertaken to alter the premises. Specifically this relates to alter the bedroom/staff sleeping in room. (This is restated from the previous inspection report.) All of the items of furniture specified in Standard 26.2 must be provided in rooms occupied by residents. If the provision of any item poses an unacceptable risk to the resident or they decline the provision, details of the discussions and decision about this should be recorded in the assessment of residents needs. (A timescale of 01.07.05 has not been met). E52 S18687 The Lodge V235233 290605.doc Timescale for action 30.09.05 2. 3. YA6 YA25 15 39 By 30.9.05 and ongoing Before any work begins of the alterations 4. YA26 16 30.09.2005 THE LODGE Version 1.40 Page 23 5. YA29 16 (2) (b) 6. YA30 16 (2) (k) 7. YA42 13 (4) (a) (c) 8. YA42 13.4 9. YA42 13.4 10. YA42 23.4 A telephone must be provided for residents use to maximise independence, and improve emergency arrangements. The carpet to the stairs and first floor landing must be replaced as cleaning has not removed the smell of urine. An immediate requirement was served for repair to window restrictors which failed to operate within the restricted opening. The timescale has been extended for the replacement of all windows which is scheduled for August 2005. Risk assessments must be completed to ensure that all residents are so far as resonably practicable free from hazards to their safety. All areas of the home to which residents have access are so far as reasonably practicable free from hazards to their safety, specifically this means replacement of the door mat to the kitchen door. Fire Drills and practices must be conducted at suitable intervals, to include records of those residents and staff involved. 30.9.05 30.09.05 30.8.05 Immediate and ongoing. Immediate and ongoing. Immediate and ongoing. 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 YA5 YA5 Good Practice Recommendations The home should include in the House Rules, specific designated smoking areas identified within the home. The home should amend the statement in the house rules that residents should not enter residents rooms to include unless invited. E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 24 THE LODGE 3. YA5 4. YA7 5. 6. 7. 8. 9. YA12, YA14 YA24 The House Rules are an agreement between the home and the resident which requires signatures. The home should ensure that a representative signs the agreement as well as the resident, as specified. Further options for an appointee/agent who is independent from the service should be explored for those residents for whom the registered manager currently acts as appointee. (Restated from the previous report) The home should ensure that all activities in or out of the home are recorded, so that an accurate record is available of service users lifestyles. The property in Ledbury should be refurbished to provide a comfortable and homely environment, which includes the maintenance and repair of equipment. THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 Page 25 Commission for Social Care Inspection The Coach House John Comyn Drive Droitwich Road Worcester WR4 7NW 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 THE LODGE E52 S18687 The Lodge V235233 290605.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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