Inspection on 26/09/05 for Merryfield

This inspection was carried out on 26th September 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Merryfield 29/06/07

Merryfield 18/10/06

Merryfield 07/03/06

Merryfield 03/03/05

Merryfield 07/09/04

Merryfield 06/01/04

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 Merryfield 20 Merryfield Close Damson Wood Solihull B92 9PW Lead Inspector Brenda ONeill Unannounced 26 September 2005. 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. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Merryfield Address 20 Merryfield Close Damson Wood Solihull West Midlands B92 9PW 0121 711 7274 0121 711 7274 susiesheldon@hotmail.com Damson Care 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) Susan Sheldon Care Home 3 Category(ies) of Younger People, Learning Disability (3) registration, with number of places Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 3 March 2005 Brief Description of the Service: The service at 20 Merryfield Close is provided in a domestic three bedroomed house in a residential area of Solihull. It is registered to provide care, support and accommodation to three adults with learning disabilities. The current service users are three men. Local facilities and amenities are within walking distance of the home, with the main shopping areas of Shirley and Solihull also within reasonable distance. Staffing is provided by a small staff team, with sleeping-in provision. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over one afternoon and early evening and was the first of the statutory inspections for the home for 2005/2006. During the visit a tour of the premises was carried out, one resident’s file was sampled as well as other policies and procedures, care records and health and safety records. The inspector spoke with the manager, proprietor and all three residents. What the service does well: What has improved since the last inspection? Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 6 Two of the residents had started new college courses which they seemed to be enjoying. One of the resident’s bedrooms had been redecorated making it a more pleasant environment for him. The bathroom had had new flooring fitted as it had been well worn. Some of the policies and procedures had been amended and updated including accident, missing persons and adult protection procedures ensuring staff had access to the appropriate information. A complaints procedure had been developed for any visitors to the home or any other parties who may wish to complain. A premises risk assessment had been undertaken and documented detailing how any general risks in the home were minimised. The manager had completed the required units of the registered manager’s award giving her the necessary qualification for her role. 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. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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 Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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) 1, 3 and 5. The service user guide needed to be further developed to ensure any prospective residents had the required information, in a format suitable for them, to make an informed choice about where they live. The residents’ needs were being met at the home. EVIDENCE: There was a statement of purpose and service user guide at the home. The statement of purpose was appropriate but the service user guide did not include all the required information. It also needed to be made available in a format suitable for the existing and any prospective residents. There had been no new residents admitted to the home for a considerable amount of time and two of the residents files had been inspected in depth at the last inspection therefore the remaining one was sampled during this visit. This evidenced that residents were issued with a contract which had been periodically updated and was signed by them. All the residents were spoken with and were very happy with the service they offered and their lives at the home. There was documented evidence of the support needs of the residents and of these being met by staff, for example, personal care needs, developing independent living skills, and accessing medical professionals when necessary. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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, 7 and 9. There was a good system in place for care planning and risk assessments that involved consultation with the residents. Care plan reviews needed to evidence that residents had been involved and what the outcomes were. The residents made decisions about their everyday lives wherever possible. EVIDENCE: The resident file sampled included a comprehensive care plan covering all aspects of the individual’s life including, community integration, behaviour, work, domestic, pleasure and physical support needs and documented how staff were to meet them. Also included as part of the care plan were personal details, risk assessments, behaviour management plans, medication and monthly reports which gave an overview of the month and any appointments and events. The care plan was being reviewed six monthly but this was only evident by the date being entered there was no documentation about what was reviewed and if discussed with the resident. All residents were fairly independent and this was encouraged at the home, for example, choices of daily activities, coming and going from the home as they wished (within the bounds of their risk assessments), attendance at health care appointments. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 10 Two of the residents had recently chosen new college courses to attend, the other did not like college so attended a local church centre regularly to help. All residents had their own bank accounts and were supported in the management of these. One of the residents chose to have part of his allowances monthly and another part weekly. The file sampled evidenced an array of risk assessments including, behaviour management, smoking, medication and the use of every day equipment in the home. One of the risk assessments was in relation to time spent out of the home and the resident had agreed to sign to say when he would be back on each occasion so that staff would know when to assume he was missing, the agreement included who would be contacted in these circumstances. Read and sign sheets had been attached to the risk assessments to indicate that staff had read and agreed to follow them. It was noted that some of the risk assessments on the individual’s file were well out of date and no longer applied. These needed to be removed from the working file so that staff were only working with current information and to avoid any confusion. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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) 11, 12, 13, 14, 16 and 17. Residents had the opportunity to develop and maintain life skills and were supported and enabled to engage in appropriate leisure activities. There were no rigid rules or routines in the home and the residents were satisfied they could spend their time as they chose within the bounds of their risk assessments. EVIDENCE: Independent living skills were being maintained and developed by residents at the home with the support of the staff. One resident told the inspector that he helped prepare vegetables and clear up after meals. All residents were encouraged to participate in keeping their rooms clean and tidy. They told the inspector they were going shopping the day after the inspection for groceries as they had eaten everything! One of the residents travelled independently to college, another walked to his chosen daytime activity. All residents had their own bank accounts and were involved in managing their own finances. Two of the residents had just started new college courses which were gardening for pleasure, animal care and textiles. One of the residents told the inspector he had been at college that day and undertaken some gardening. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 12 The manager was aware that one of the residents who was middle aged was not as keen on attending college as he used to be and that alternative activities would soon have to be identified for him. The other resident continued to regularly help out at a local church centre which he spoke avidly of to the inspector and although hard work he seemed to thoroughly enjoy and had made many friends there. All residents accessed the local community on a regular basis, for example, on the day of the inspection one had been supported to attend a dental appointment, there were regular meals out, trips for shopping both locally and further afield, to local pubs and to go and watch football matches. There was a vehicle available to assist with transport when needed. Each individual’s preferred leisure pursuits were reflected in their bedrooms, one who played a play station, another collected videos and the other had a very large collection of CDs. They had recently returned from a holiday in Brean and told the inspector they had tried staying in a chalet but preferred a caravan. One of the residents was an avid football fan and regularly attended matches. One of the residents was due to have a birthday and told the inspector that the manager was taking him and another resident out for a meal to celebrate. The residents confirmed they were able to spend their time as they chose and daily routines were minimal. Residents were asked what they would like to eat, if they wanted to go to the local shops, they were seen to spend time watching television, playing a play station and reading during the course of the inspection. Any restrictions on the residents were only in place after a risk assessment had been carried out which they were aware of. All residents had a front door key and a key to their bedrooms. All residents appeared happy with the catering arrangements at the home. The weekly menu was displayed on the notice and was drawn up in agreement with the residents. One resident confirmed that staff knew his likes and dislikes and these were catered for. During discussions with the manager it was evident she was very keen to ensure the residents had a healthy diet and demonstrated how she encouraged this. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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) 18,19 and 20. The resident’s personal and health care needs were being met whilst maximising their independence and control over their lives. The medication system was well managed ensuring the residents received their prescribed medication appropriately. EVIDENCE: Where residents needed support with their personal care this was clearly detailed in their care plans. Two of the residents were fairly independent and one needed a little more support. The daily diaries for the residents evidenced where personal care had been supported and where prompts had been given. The manager informed the inspector that the residents continued to enjoy good health and apart from general colds and one resident having a chest infection they had all been well. One of the residents was attending a dental appointment on the day of the inspection. Any health care appointments attended were documented in the daily diaries. The residents were supported by staff to attend the local doctors surgery as necessary. The staff at the home had access to the relevant health care professionals if they had any concerns about the residents’ mental well-being. Only two of the residents were receiving medication at the time of the inspection, neither of these were self medicating. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 14 Medication was administered via a 28 day monitored dosage system and continued to be well managed. All medication was being acknowledged as received and signed for when administered. The only issue that arose was that there needed to be individual guide lines for any resident receiving PRN (as and when necessary) medication for staff to follow to ensure it was given at the appropriate times. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 15 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) 22 and 23 The home had a robust complaints procedure for residents, which had been discussed with them, and also for any other parties who may wish to complain. Staff had received training in the prevention of abuse and managing confrontation to ensure the protection of the residents. EVIDENCE: There was an appropriate complaints procedure and it was available in a format suitable for the residents which had been discussed with them. Since the last inspection a complaints procedure had been developed for any visitors to the home or any other parties who may wish to complain. The home had not received any complaints and none had been lodged with the CSCI. The adult protection procedure had been further developed since the last inspection and complied with the multi agency guidelines. The manager had also obtained a copy of the multi agency guidelines for adult protection drawn up by Birmingham social care and health as all the residents were placed at the home by them. The inspector was aware that all staff had received training in the prevention of abuse. The home had a procedure for managing confrontation and staff had undertaken training in this topic. The home had a policy of no restraint and information in relation to this had been included in the policies and procedures for the home since the last inspection. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 16 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 and 30. The home provided residents with a safe, well maintained and comfortable place to live. EVIDENCE: The home was found to be safe, well maintained and comfortable. Furnishings and fittings throughout were of a good standard. The home would not be able to accommodate residents with any mobility difficulties as it was not accessible to wheelchairs and there was no lift. There were several risk assessments in place for individual residents for the use of equipment such as the microwave and kettle. There were also risk assessments for the use of the shower and bath. A general risk assessment for the premises had been completed since the last inspection. Each of the residents had a single bedroom, two of which were on the first floor and one downstairs. One of the bedrooms had been redecorated since the last inspection. None of the bedrooms had a wash hand basin however there was evidence on personal files that the residents had been offered this facility and it had been refused. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 17 The occupant of the ground floor bedroom had to go upstairs to the toilet and bathroom and his room had only a small window that only gave a view of the garden fence and appeared to give little ventilation. These issues were discussed with the resident at this inspection and the previous one and he was quite happy with his room. The bedrooms reflected the individual personalities and preferences of the residents including, a large CD collection, personal computer, play station, Elvis memorabilia and video collection. All residents had a key to their bedroom. The home had one combined toilet and bathroom with a shower fitted over the bath. The issue of an additional toilet being installed in the house was discussed with the proprietor. He stated this had been discussed at past inspections and he had asked a plumber to explore this issue and no space could be found to accommodate this due to the size and location of the house. The communal space was adequate with a lounge and dining kitchen which were both domestic in character. The home was found to be clean, hygienic and odour free. The COSHH substances were stored securely and there was a COSHH file however this needed to be further developed to include the data sheets for all products used. The proprietor stated he had tried to obtain the appropriate data sheets but they had not been sent to the home as promised. He was to pursue this further. The washing machine was situated in the kitchen however there was no incontinence in the home and the laundry system was appropriate. The kitchen was well equipped and met with the needs of the service users. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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) 33 The staffing levels appeared adequate to meet the needs of the residents and there were good relationships evident. EVIDENCE: Only one member of staff had left the home since the last inspection to return to college. Another member of the team had increased their hours to cover the shortfall so there had been no new staff recruited. The numbers of staff on duty depended on the activities the residents were taking part in. The proprietor attended the home almost daily and was seen as part of the staff team. One member of staff slept in at the home every night. Staffing levels appeared to meet the needs of the residents. The residents knew the staff team well and were very comfortable in their presence. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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) 37, 38, 39, 40, 41 and 42 The manager ensured the smooth running of the home in a competent manner. Some issues needed to be addressed to ensure the health and safety of the residents and staff. EVIDENCE: The manager had several years experience of caring for people with a learning disability and the management of residential care homes. She demonstrated throughout the inspection her knowledge of the residents needs. There were evident friendly relationships between the manager and the residents and they did not hesitate to speak to her at any time. The manager had completed her NVQ level 4 in care had recently completed 3 units of the registered manager’s Award giving her the required qualifications for her role. As at the last inspection service users were relaxed and confident in interaction with others, including the inspector, and the impression was gained of a relaxed, easy-going home where residents’ needs were met in an informal, therapeutic way. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 20 The home had some informal ways of monitoring the quality in the home including, occasional questionnaires for the residents and health and safety audits. The home continued to need a formal system for monitoring the quality of the service offered with a view to continuous improvement based on seeking the views of the residents. Some policies and procedures were viewed and where amendments had been needed following the last inspection these had been completed and included minor additions to the missing persons and accident procedures. Individual resident files were well ordered however one needed to be updated in relation to risk assessments. Health and safety were generally well maintained. The premises were safe, there were health and safety checks carried out regularly on all areas of the home, there was evidence on site of the servicing of the gas equipment, portable electrical appliances and the electrical wiring. It was noted that there were gaps in the checks being made on the smoke detectors and they were not always checked weekly as required. Also the fire training for staff was out of date, as the manager believed it was to be done yearly however the requirement is every six months. Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.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 2 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 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 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Merryfield Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 2 2 x E54 S4526 Merryfield V244104 220805 Stage 4.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 1 Regulation 5(2) Requirement The manager must ensure the service guide includes all the required information and is available in a format suitable for the residents. (Previous time scales of 13/11/04 and 01/05/05 not met.) There must be documented evidence of what was discussed at reviews and any outcomes. Any out of date risk assessments must be removed from the working files of the residents. The manager must ensure there are individual, written guidelines for staff to follow for any resident receiving PRN medication. The COSHH file must be further developed to include individual data sheets for substances used. (Previous time scale of 01/06/05 not met.) All staff must be checked against the POVA register prior to their commencing their employment. (Previous time scale of 01/04/05 not checked for compliance as no new staff had been recruited.) Staff files must include all the information/documentation Timescale for action 01/12/05 2. 3. 4. 6 9 20 15(2) 13(3) 13(2) 01/11/05 01/11/05 01/11/05 5. 30 13(3) 01/12/05 6. 34 19(1) 01/12/05 7. 34 19(1) schedule 01/12/05 Page 23 Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 2 8. 39 26 9. 10. 42 42 23(4)(c) (v) 23(4)(d) detailed in schedule 2 of the Care Homes Regulations. (Previous time scale of 01/05/05 not checked for compliance at this visit.) The registered provider must ensure that appropriate quality assurance monitoring systems are in place. (Previous time scales of 13/11/04 and 01/07/05 not met.) The manager must ensure the smoke detectors are checked on a weekly basis. The manager must ensure that staff receive fire training every six months. 01/12/05 01/11/05 01/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Merryfield E54 S4526 Merryfield V244104 220805 Stage 4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!