Inspection on 21/04/05 for Mill House

This inspection was carried out on 21st April 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 but made no statutory requirements on the home.

Other inspections for this house

Mill House 04/06/10

Mill House 11/08/08

Mill House 13/08/07

Mill House 31/08/06

Mill House 29/11/05

Mill House 26/11/04

Mill House 07/07/04

Mill House 29/01/04

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

CARE HOMES FOR OLDER PEOPLE Mill House 51 Mount Pleasant Bilston Wolverhampton WV14 7LS Lead Inspector Bhag Jassal Unannounced 21 April 2005 09:00 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 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. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mill House Address 51 Mount Pleasant, Bilston, Wolverhampton, WV14 7LS 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) 01902 493436 01902 493436 Mr Ragavendrawo Ramdoo Mrs B Ramdoo Janice Parker Care Home 24 Category(ies) of Mental Disorder - over 65 (24) registration, with number of places Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26/11/04 Brief Description of the Service: Mill House provides care for twenty-four older people who have some form of dementia, but who are not in need of skilled nursing care. The home is located on a main road with ease of access to the local high street and all of its amenities. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 9.00 am and lasted 8 hours and 15 minutes. All twenty-four places were occupied. The inspection included discussions with service users, staff and relatives/friends. The daily routines were observed and service user and staff records, policies and procedures were examined. Inspection of the premises and facilities was also undertaken. What the service does well: What has improved since the last inspection? The home has updated the admission procedure, which is made available to prospective service users and their relatives. The home has up-dated and reviewed the service users’ care plans at regular intervals. Several carers are undertaking accredited medication training, and NVQ Level 2 courses. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 6 The home has implemented a social and leisure activities programme, which reflects the service users’ preferences, capacities and choices, and records of these activities are now being appropriately maintained. All staff vacancies now have been filled, and all new staff are provided with the TOPSS induction and foundation training. All staff have been CRB checked, and they all receive regular supervision. The home has implemented a quality assurance plan and the feedback received from the service users’ relatives/friends and representatives is being analysed. A number of bedrooms have been redecorated and the dining/lounge areas on both floors have been provided with new carpets. The Registered Providers have provided a business and financial statement for the home, which appeared to be healthy and satisfactory. What they could do better: The Registered Providers and the Registered Manager must ensure that the home’s policies and procedures, including the home’s Statement of Purpose and Service Users’ Guide are appropriately amended and updated. All the requirements pertaining to the improvements to the home’s environment, furniture, equipment and fittings, safe working systems and risk assessments are addressed as a matter of priority in order to have safe and comfortable environment for the service users. Those members of staff who have not as yet received safe working practice topics training must do so, which would enable them to improve further their care practices and professionalism. There is recognition by the Registered Manager that specialist training (i.e. Dementia, Adult protection and mental health needs) in addition to mandatory training is required to support staff to care for service user group living at Mill house. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 7 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. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 and 5 The home has a satisfactory and functional admissions procedure providing an effective needs assessment and suitability evaluation for both privately funded service users and those placed by the local authority. EVIDENCE: The service users are assessed before moving into the home. Relatives are provided with the opportunity to visit the home to assess its quality, facilities and ability to meet an individual’s needs prior to admission. The final drafts of the home’s Statements of Purpose and the Service Users’ Guide provides the essential information on the services offered to enable potential service users and their relatives to make choice of a care home. The home has produced drafts of Statement of Purpose for the home and a Service Users’ Guide, which are still to be amended, updated and finalized shortly. A sample of four service users’ care plans and files were seen at the inspection. All contained evidence that the service users receive the benefit of a full assessment prior to admission. The home also carryout their own assessments and these details are documented on care plans, which are drawn up by the senior staff with the assistance from the service users and their Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 10 relatives. There was evidence to show that all the service users have been provided with contacts. The home has updated its admission procedure, which is now made available to all perspective service users and their relatives. The Registered Manager stated that relatives had viewed the home on behalf of their elderly relatives prior to admission to Mill House. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8,9,and 10 The staff are aware and sensitive to the individual needs of each service user and meet these in a professional manner. There is a clear and consistent care planning system in place, which provides with the information they require to meet service users’ health and personal care needs. Lack of accredited training in safe handling of medication by care staff potentially could place service users at risk. EVIDENCE: There was evidence to show all the service users undergo a comprehensive assessment of their needs prior to admission to the home. A care plan is produced which is based on the assessment of needs. The home operates a key worker system, which helps to ensure that the recommendations arising from the care plans are implemented. The four service users’ care plans were examined and these were kept up to date and reviewed on a monthly basis. The home maintained records of all health checks carried out by the doctors, psychiatric consultants, opticians, dentists, district nurses/Community psychiatric nurses and chiropodists. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 12 The home also ensures that nutritional screening is undertaken, including weight gain or loss records are maintained and appropriate action is taken if required. In 2004, an inspection was undertaken by a Pharmacy Inspector into the management of medication and requirements arising from that inspection has been implemented with the exception of accredited staff training in medication. Case tracking demonstrated an effective review process together with the home’s ability to meet the changing needs as they occur. One situation reviewed covered the increased care being received by an individual service user due to the ageing process, deteriorating mobility and mental health. It was observed on the day of inspection that no personal care interventions were taken in communal areas, which demonstrates dignity of service users being respected. In addition, consultations with the health and social care professionals are carried out within the service users’ bedrooms. The Inspector spoke at length with eight service users and all of them commented positively about their care and considered that they have every thing that they need. They also stated that the “ carers are very kind and they do their best to give us good care and look after us “. One service user said “this home is comfortable and staff are dedicated and they really care for us”. The service users have access to a payphone, which they can use in private. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 , 13, 14 and 15 Mill House provides a good quality and lifestyle for the service users in residence. Meals at Mill House are of a good homely type offering both choice and variety and catering for special dietary needs. Staff work with service users and their relatives/friends to understand their individual lifestyles and preferences in order that these can be continued when they moved to Mill House. EVIDENCE: There was evidence that the home provides an activities programme in accordance with the service users’ choices, preferences and capacities in relation to – social and leisure activities and cultural interests. Records of activities enjoyed by the service users are maintained. There was evidence to show that the home welcome the service users’ relatives and friends to visit the home at reasonable times. The visitors’ book showed considerable activity. A relative of one service user stated that they visit at various times of the day as they wish. All relatives and friends who spoke to the Inspector said they are given a warm friendly welcome by all the staff whenever they visit. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 14 Observations made during the inspection showed that staff allowed service users to carry out their daily living routines. Several service users told the Inspector the “ food was very nice “. Two relatives and two friends of service users stated that the food was very good offering a good variety. This was confirmed by the four weekly set menus made available in the home to the service users. Lunch was served during the inspection and appeared to be presented well. The meal was home cooked using fresh produce. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Concerns or complaints are dealt with promptly and professionally. Service users are protected from abuse by the home’s policies and procedures. The arrangements for the protection of service users from abuse are satisfactory. EVIDENCE: The home has a clear complaints procedure, which is explained in the home’s Statement of Purpose and the Service Users’ Guide, which are given to all prospective service users or their families/representatives before moving into the home. Two relatives spoken to were fully aware of the complaints procedure and how to make a complaint if needed to. They were satisfied that any issue taken to the manager was dealt with correctly. Relevant policies and procedures in relation to the protection of vulnerable adults were seen at the inspection. The Registered Manager stated that all the staff are made aware of the adult protection issues through induction training. Several carers have undertaken adult protection training in February 2005. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 24 and 25 The general standard of the environment is good providing service users with homely place to live. There are still a number of areas, which remained to be further improved to ensure safe and comfortable environment. EVIDENCE: The home is accessible, well maintained and suitable for its purpose. The home also meets the service users’ individual and collective needs. The home has a good rolling programme in place for redecoration and maintenance. The gardens and grounds are also being well maintained. The home has ample communal space for dining and lounge areas including a quite room for the use of service users and their families and friends. It was noted that new carpets have been fitted in the dining and lounge areas on both floors. However, new carpets still remained to be fitted in the corridors on both floors. The home has not yet undertaken a risk assessment in all of the premises and facilities by suitably qualified persons including an Occupational Therapist and that a suitable loop system is also provided in the home. Hand rails to be fitted over the radiators in all the corridors. Carpets in bedrooms 5, Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 17 6, 11, 14, and 17 must also to be replaced. Non-slip floor covering in the hairdressing room must also be provided. The extractor fans in the WCs/shower rooms must be maintained in a working order at all times; and suitable prints/pictures to be provided in bedrooms which have bare walls. All the radiators in the home must be suitably covered and /or replaced as a matter of priority. All bedrooms are to be provided with tables to sit at and suitable bedside lights. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The home is now staffed to a level that ensures service user needs are met at all times. The home continues to support staff to complete training, however further work to develop individuals in specialist areas related to the service user group cared for at Mill House could be developed further. EVIDENCE: The information provided by the home and the available staff rotas showed that the home is not adequately staffed. The Registered Manger stated that there are still vacancies for care and ancillary staff. The home had to be staffed by Agency staff until permanent members of staff are recruited. This staffing deficiency was fully discussed with the Registered Providers and the Registered Manager. Following the inspection, a letter was sent to the Registered Providers to address the staffing deficiencies as a matter of priority and urgency. The written response received from the Registered Providers was positive and now the home is staffed to a level that ensures that the service users needs are met at all times. It was noted from the staff training records that several members of staff are currently undertaking their NVQ Level 2 and other safe working practice topics training courses. The members of staff who have not yet received training in Dementia must so as a matter of priority. Discussion with the Registered Manager and examination of the most recent staff files demonstrated that thorough recruitment procedures had been followed in line with home’s recruitment policy. Two written references and Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 19 enhanced CRB checks are being undertaken before new staff actually commences their duties. The home has introduced the TOPSS Induction and Foundation training for all new members of staff. All individual members of staff have training profiles, which include details on training courses completed and courses currently being undertaken with dates and names of agencies providing the training. However, the home need to provide specialist staff training i.e. caring for service users with dementia, mental health needs and adult protection from abuse. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 36 and 38 The home is managed by an experienced Registered Manager, who lead the staff group with confidence. The staff are clear about their roles and responsibilities. Good systems of communication are in place to seek the views of service users and their families/friends. The Service users’ monies are appropriately handled by the Registered Manager. Staff are regularly supervised to enable them to carry out their work. Health, safety and welfare of service users and staff are promoted fully by safe working systems put in place by the manager and staff. EVIDENCE: The Registered Manager has completed her NVQ Level 4 in care and management course and other core training courses. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 21 The home has a quality assurance system in place. The quality assurance questionnaires were issued to all the families/representatives of service users in February and March 2005 seeking their views in number of areas relating to the home. The responses were showed to the Inspector. The comments were generally positive. The Registered Manager stated that the responses received through the questionnaire will be analysed and report prepared by the end of June 2005 and will be made available to all the relevant stakeholders. Monies held at the home on behalf of the service users are handled in line with the home’s policy of handling service users’ money. A sample was checked and found to be satisfactory at the inspection visit. All staff are appropriately being supervised on regular basis. This was confirmed by several members of staff during the meetings held with them. Records of supervision were examined during the inspection. Accident and fire prevention records examined were appropriately maintained. Matters pertaining to fire safety and environmental health were found to be satisfactory and all the issues were appropriately addressed. However, it was noted that the home has not yet completed the risk assessments on the premises and facilities, and the staff still have to complete their safe working practice topics training and updates in order to comply with the TOPSS specifications and standards. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 2 2 1 x 2 1 x STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 1 x 3 3 x 1 Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 23 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 Requirement The Registered Providers must ensure an updated Service Users Guide is available that includes al the information in Regulation 5 of the Care Homes Regulations 2001. This Guide must be made available in suitable format, including in large print. The Registered Providers must ensure that the Statement of Purpose for the home is amended and finalised , and it must contain all the information set out in Regulation 4 and Schedule 1 of the Care homes Regulations 2001. The Registered Providers must ensure that all members of care staff receive accredited medication training in accordance with NMS 9.7; and to ensure that all service users records contain a photograph of each service user. The Registered Providers must replace old and worn carpets in all the corridors on both floors. The Registered Providers must ensure that a risk assessment is undertaken in all of the areas of Timescale for action 31/07/05 2. 1 4 Schedule 1 31/07/05 3. 9 13,17 and Schedule 3 31/07/05 4. 5. 20 22 23 16 and 23 31/07/05 15/08/05 Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 24 6. 24 16 and 23 7. 25 13 and 23 8. 30 12, 13 and 18 9. 33 12, the premises and facilities by a suitably qualified persons, including an Occupational Therapist, and that a suitable loop system is installed; and handrails are also ffitted over the uncovered raiators in all the corridors. The Registered Providers must ensure that the service users bedrooms are provided with suitable tables to sit at and suitable bedside lights; and carpets in bedrooms 5, 6,11,14, and 17 are replaced, and nonslip floor covering in the hairdressing room must also be provided; The extractor fans in WCs/shower rooms must be maintained in working order at all times; and suitable prints/pictures must also be provided in several bedrooms, which have bare walls. The Registered Providers must ensure that all the radiators are suitably covered and/or replaced as a matter of priority in order to ensure safety for service users. The Registered Providers must ensure that all new members of staff receive Induction and Foundation training to comply with the National Training Organisations workforce training targets; and the home must achieve 50 of NVQ Level 2 trained staff; and all the members of staff who have not yet received training in Dementia must do so as a matter of priority; and specialist training in caring for service users with dementia, mental health needs and adult protection from abuse must also be provided for all staff. The Registered Providers must 15/08/05 31/08/05 31/08/05 15/08/05 Page 25 Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 15,and 24 10. 38 11. 21 ensure that the Quality Assurance development plan is fully implemented, and a report on the outcome of the questionnaires feed back must be completed and made available to all the relevant stakeholders. 12, 13, 16 The Registered Providers must and 23 ensure that Risk Assessments, including fire risk assessments on all the premises and facilities are undertaken, recorded and implemented; and that risk assessments are also carried out on all safe working practice topics and significant findings of risk assessments are recorded and implemented; and also all members of staff must receive training in safe working practice topics, including moving and handling, fire safety, food hygiene, first aid, and infection control; and there must be a fullu qualified First-aider on duty at all shifts. 23 The Registered Providers must ensure that new and suitable flooring is provided in the bathroom/WC on the first floor; and an extractor fan is fitted in the staff WC on the ground floor. 15/08/05 31/07/05 12. 13. 14. 15. 16. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Mill House Refer to Good Practice Recommendations E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 26 Standard 1. 2. 3. 4. Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection 2nd Floor, St Davids Court Union St Wolverhampton WV1 3JE 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 Mill House E56 000030207 Mill House V222717 UI 210405 Stage 4.doc Version 1.30 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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