Inspection on 12/01/07 for Meadowbank Care

This inspection was carried out on 12th January 2007.

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.

Other inspections for this house

Meadowbank Care 13/02/06

Meadowbank Care 08/07/05

Meadowbank Care 04/03/05

Meadowbank Care 15/09/04

Meadowbank Care 22/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Meadowbank Care 44 Braywick Road Maidenhead Berkshire SL6 1DA Lead Inspector Ruth Lough Unannounced Inspection 12th January 2007 09:40 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 Meadowbank Care DS0000011310.V325473.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. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowbank Care Address 44 Braywick Road Maidenhead Berkshire SL6 1DA 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) 01628 781186 Meadowbank Care Home Limited Mrs Caroline Li Mr James Li Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2006 Brief Description of the Service: Meadowbank cares for 15 older people. It is set in a residential area close to the train station, local amenities and the town centre. The home is on two floors and there is a passenger lift in place. There are a variety of aids and adaptations around the building to allow residents to move about more independently and there is a spacious garden that the residents can, and do use. The home has fifteen single bedrooms. There are five bedrooms that have shower and toilet en-suite facilities. There are three toilets and one bathroom on the ground floor and two toilets and bathrooms on the first floor. The current fees range from £405.00 to £750.00 per week. Service users are charged additionally for hairdressing, chiropody and newspapers. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit that took place over one day. The inspection included a review of information provided by the home and service user and relatives surveys returned prior to the visit. Eight service users and 5 relatives questionnaires were returned to the commission. The documents and records that were available on the day were used as part of the information gathering. Service users and visitors opinions of the service were also obtained during the day visit. Discussion with and observation of the management and care staff was also included. Contact was also made with local healthcare practitioners who visit the home. What the service does well: What has improved since the last inspection? What they could do better: The home should to continue with further development of the processes it has in place to monitor the quality and performance of the service. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 6 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. Meadowbank Care DS0000011310.V325473.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 Meadowbank Care DS0000011310.V325473.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): 3, 6 is not applicable. Quality in this outcome area is good. Service users are thoroughly assessed before being admitted to the home to ensure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users and relatives when asked if they had received enough information about the home before they or their relative came to live there stated;“Having stayed at Meadowbank previously. I was familiar with it so wished to return here when I needed more help.” “We looked at several homes in the area and decided this one appeared to be best in every respect”. Service users and relatives also confirmed during the visit that they had been given copies of the Statement of Purpose and Service User Guide before making a decision to move into the home. Service users are offered the opportunity to visit and stay before they make the final decision to make the home their home. All visits are recorded in detail. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 9 The records of two service users who had been admitted to the home since the last inspection visit were reviewed. This was to see how the home carried out its assessment of the service users needs before they came to live in the home and how they planned to meet these. Both service users records showed that the manager had carried out a detailed assessment the service users health and social needs, recorded service users choices and risk assessed their safety and mobility. Where possible information is taken from any relatives or supporters of the service users. Any information from medical and social services professionals is recorded. Meadowbank Care DS0000011310.V325473.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 and 10 Quality in this outcome area is good. The service users are provided with the care and support that they need and wish for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users were asked if they thought that they received the care that they needed of which they commented, “Very pleased” and “ They care for me well.” Relatives comments were, “We are sure that without the support of Meadowbank, Mum would not still be with us”, “ My mother is quite capable – just needs company and knowledge that someone is on call if she has a fall.” The care plans, medication charts and other related documents were reviewed for two service users to see how the home plans and provides care to them. Service users, staff and relatives were able to provide futher information. The care plans show that staff are given information about the health care and medical needs of the individual and the medication they required. The service users weight, blood pressure, nutritional and skin condition are recorded and Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 11 the risks for their mobility, falls and safety are assessed. For one service user they have implemented a risk assessment and action plan to aid her to continue exercising her dog who lives with her in the home. They use body maps to record concerns of tissue damage, weakness or discolouration of the skin. Staff are given good instructions of how to meet the service users needs for personal care which includes service users choices of how they wish to be supported. The staff record the outcomes for the service users in dialy records in appropropriate language and note their enjoyment of the day and the activities in the home. The care plans are regularly reviewed by the manager and also when service users needs change. Each service user is allocated a key worker. There are good records to support that the home seek support for service users health needs from the GP, district nurse and specialists should they need them. The service users are able to see opticians, dentists and chiropodists in the home and are equally supported to attend any consultations outside the home. Any visiting health professional records their visit in the service users care plan. The GP’s who responded to the questionnaires from the CSCI gave comments about the care and the home that included “Very well run. Happy resident. Happy GP!” Another wrote “Meadowbank is a friendly home where residents seem to be treated as individuals. I have no concerns about any of my patients who live there.” The manager takes responsibility for the auditing, training and storage of the medications for service users. Eleven of the staff are able to carry out medication administration and there is regular retraining for staff plus the manager carries out observation of their practice periodically. The home use a monitored doseage system (MDS) that is provided by a local pharmacy. All medications are locked away securely and service users are provided with facilities if they are assessed to be able to self medicate. Staff are provided with photographs of the service user with the MDS presciption to support a safe process for administration of medications to the right individual. Staff were observed communicating well with service users in a respectful manner and ensuring that their privacy was not compromised when entering their rooms. Meadowbank Care DS0000011310.V325473.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, and15 Quality in this outcome area is good. The service users are provided with support to continue with their lives as they wish and are able. The home ensures that there is varied nutritional diet for service users. These judgements have been made using available evidence including a visit to this service. EVIDENCE: The care plans, daily records and discussions with service users, staff and visitors were part of the process to review if the home supports service users with activities, social inclusion and have sufficient diet and meals. Service users gave comments about the provision and support they were given with activities and interests. These were, “I am invited to take part but my declining eyesight makes this difficult sometimes,” “Cards to play etc” and “ Activity limited owing to having some trouble with walking and having to use a walking frame.” From the survey of the eight who responded to the question ‘are there activities that you can join in?’ 2 said ‘always’ and 6 ‘usually’. Service users during the visit stated that the staff always ask if they want to join in and do try to find something to meet their interests where able. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 13 The care plans have detailed records of service users personal choices for food, activities and their social lives. Service users and their relatives are supported to give a detailed personal history profile about themselves which supports staff to ensure that they are able to meet service users expectations and wishes. There is a variety of activities provided in the home for service users and staff and relatives support them to continue with others in the community such as family events, shopping and church. Some service users have been able to go on visits to the river, garden centres, restaurants and attend art classes. Activities in the home range from puzzles and games, exercise classes, musical events and crafts. The home usually is able to offer 2 activities a day whether they are communal events or with staff supporting an individual on their own. The staff record service user involvement with activities in a central document and in their daily records. Service users were asked their opinion about the food and the meals provided. Of the eight service users who commented 2 stated that they always liked the meals and 6 said usually. One said,“Very good helpings, ” and a relative wrote, “Due to her age, Mum only now has a small appetite, but has no complaints about the content!” The home employs a specific staff member to provide the main meals of the day with care staff providing support at other times. The menu has been created with information provided by service users sought through individual discussions and service users consultation processes. The menu is on a four weekly rotational basis with most meals as requested by service users as traditional fare with 2 choices of hot dishes and a choice of 2 desserts. The menu is changed to reflect seasonal produce and any special events. Service users are able to have changes to the planned menu should they wish or need. Special diets are provided should they be needed. Staff always ensure that there is food and drink available between mealtimes. The routinely place fresh fruit and biscuits in service users rooms and in the communal areas for them should they want them. The staff keep very good records of what the service users eat. Meadowbank Care DS0000011310.V325473.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 and 18 Quality in this outcome area is good. Service users and visitors have confidence that their concerns will be listend to and acted upon. Staff are trained and understand about protecting vulnerable people from possible abuse. These judgements have been made using available evidence including a visit to this service. EVIDENCE: The home’s records for complaints, concerns and compliments were reviewed. The information and training given to staff about protecting vulnerable adults was examined. Discussions with service users, staff and visitors were carried out to seek their opinion of how the home handle complaints and concerns. Service users were asked if they knew who to speak to if they were unhappy and they all responded that they did and gave comments, “A senior care is on duty and I know the management are available if needed” and “ looked after very well.” One relative commented, “Although we have never had cause!” Service users and relatives are given information about how to complain in the statement of purpose and service users guide. The home have had one concern reported to them since the last inspection which was investigated and action taken and the problem was resolved. The CSCI has not received a concern or a complaint about the service. The home record all the formal complaints in a record book and note down the actions taken. Currently the Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 15 staff only record minor concerns in the individual service users daily records and not centrally for audit purposes. The is a rolling programme of training given to staff about protecting vulnerable adults and information is kept for staff to read. Staff are provided with the contact details of the local authority should there be concerns or if they wish to seek advice. The management and staff when spoken to identified that they had a good understanding of the need to protect service users, whistle blowing and what actions to take. Meadowbank Care DS0000011310.V325473.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 and 26 Quality in this outcome area is good. The premises is maintained well and is kept to a high standard of cleanliness. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is not pupose built but an adapted family residence that currently provides accomodation for 15 service users. The proprietors have gradually added a rear extension with 4 en-suite bedrooms and an assisted bathroom and a very large sun lounge that extends the majority of the width of the building. The home has a moderate sized garden, mainly laid to lawn with shrubs, with areas for service users to sit and enjoy in the warmer months. There are 3 areas of communal space that includes the large sun lounge, a small quiet room and the dining room. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 17 There is a programme of routine maintenance for the fabric of the building and the furniture and fittings. The proprietor has ensured that this has included renewing carpeting and floor coverings and curtains. It was evident on walking around the home that the majority of the rooms had been redecorated and replacement furniture put in. Recent improvements include replacing the kitchen facilities to ensure a safer working environment, improve storage and access. New fridges and freezers have been installed in the storeroom. Much of the minor maintenance is carried out by staff in the home with support from contractors for specific tasks such as plumbing and major redecoration. Records are kept for all these activities. The home was seen to be kept very clean and hygienic in all areas seen. The service users, relatives and visitors were very complimentary about the standard of cleanliness in the home. Service users stated that the staff were very thorough when cleaning their rooms and took care with their clothing and property. The staff are responsible for all the laundry and service users clothing. The laundry area is sited away from where there is food preparation and storage and has the appropriate washing facilities to deal with soiled and contaminated laundry. Staff and service users are supplied with liquid soap and papers towels in all the toilets, bathrooms and areas where handwashing is necessary to prevent cross infection. Meadowbank Care DS0000011310.V325473.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): 27,28,19 and 30 Quality in this outcome area is good. The home has sufficiently skilled and experienced staff employed who are provided with a good programme of training to maintain their knowledge. Service users are protected by the recruitment and employment practices for staff by the home. These judgements have been made using available evidence including a visit to this service. EVIDENCE: The records for recruitment and training for 2 staff members were reviewed. Service users and visitors were asked about the staffing levels, the quality of care provided and the response to service users. Service users and visitors confirmed that there was always staff available and that they were usually quick to respond when called at all times of the day. Other comments made were “and also helpful” and “ My friend appears to be very happy in her room and I am always made welcome by the staff when I visit.” The home employs 16 staff to provide for the care and support to service users living in the home. There are 2 managers, 1 deputy manager and 3 senior carers who take responsibility for the management of the staff team so that there is sufficent support at all times. The manager of the home supplied Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 19 information that the majority of the service users with medium needs ( needing support of 1 carer) and one service user with high needs. The manager provided information about the number of staff who had obtained a qualification in care. Of the 14 care staff, 8 ( 57 ) had obtained an NVQ or above. Inclusive of this, all senior carers had NVQ 3 and the deputy was near to completing NVQ4. The home enrol all new staff for NVQ 2 training after their probationary period. The recruitment and personell files of the 2 carers employed since the last inspection supported that an application form, full work history, written references and the necessary C.r.b. and pova checks were obtained. Applicants are requested to complete a health declaration and any information about their work status ( work permits) are recorded. The home does not record the interview process or the decision to employ the applicant although copies of the letters offering the post are kept. There is a record of the induction process and of the trial employment period of 12 weeks. Copies of the supervision at the end of the trial period are held. Copies of both contracts and any changes to contract are kept. Records of training and qualifications of the staff are obtained and any training needs are identified. They are expecting to carry out another training needs analysis before the end of the financial year. The training obtained for staff since the last inspection visit has included all the key health and safety topics and those that support the needs of the service users. These have included medication, dementia, emergency situations, deafness, stroke, communications, care plans, principles of care and end of life. Much of the training is provided in the home by the managers who have obtained training certificates to do this and some has been resourced from external providers. Meadowbank Care DS0000011310.V325473.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 and 38 Quality in this outcome area is good. The home is managed well and very effectively. Service users are consulted regulary about the service and how it is provided. Service users, staff and visitors are protected by the safe working practices. These judgements have been made using available evidence including a visit to this service. EVIDENCE: The records for the management, administration and safe working practices of the home were reviewed. Service users, staff, visitors gave their opinion during the visit. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 21 The has been no change in the management structure of the home since the last inspection visit. The responsibilities of management continue to be shared by the 2 managers who have specific responsiblities parallel to the joint working activities. One manager is responsible for the development of care planning, supervision and training. The other leads in the administration and maintenance of the home. They communicate well and ensure that the deputy is involved in changes that occur in the home. Both managers continue to be actively involved in the care provision and support given to service users in conjunction their own responsiblities. Both managers are registered nurses and have undertaken NVQ 4 training and personal development for their roles and their professional registration. The home and the staff continually communicate with service users, their relatives and other stake holders such as GPs and DNs to seek their opinion of the services provided. They do this formally through questionnaires annually and the reviews of the service users care. The relatives did comment that staff made a point of speaking to them everytime they visited the home or made contact with them. The home have developed other areas of audit they record well such as supervision, appraisal, staff meetings. They also record outcomes of meals and menu provision and activities carried out in the home. They confirmed that they are looking at the formal methods of recording the other routine checks they carry out such as record keeping, hygiene, environment and medication administration,to be included in the programme of continual audit. The home does not handle service users personal money but does offer secure facilities for service users valuables in their rooms. If service users have additional items that are not included in the fees such as hairdressing, chiropody and newspapers they are invoiced by the home. The majority of the service users are supported by their families to manage this. There are systems in place for maintaining health and safety in the home. Staff are provided with information and training for safe working practices including food hygiene, fire, infection control, moving and handling and first aid. The is a programme of regular maintenance and checks for the equipment, lift, emergancy lighting and call bells. The gas, electical and water systems are checked regularly and records kept of any visits by professionals for repairs for these. Staff are given information for COSHH ( Control of substances hazardous to health) and secure facilities are provided to store these. There are risk assessments for safe working practice topics and safety information displayed in various areas around the home. Any accident or incident is recorded and reported to the relevant authority. Meadowbank Care DS0000011310.V325473.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 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 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 3 X 3 X X 3 Meadowbank Care DS0000011310.V325473.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. 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 2 Refer to Standard OP16 OP29 Good Practice Recommendations That the system for recording and monitoring concerns and complaints is reviewed to assist with collating information for quality assurance processes. That the interview meeting with prospective staff that is carried out in the recruitment process, is recorded. Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Meadowbank Care DS0000011310.V325473.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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