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Inspection on 20/06/05 for Mimosa

Also see our care home review for Mimosa for more information

This inspection was carried out on 20th June 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

All the residents stated that they liked living at the home and said that they were involved in aspects of running the home. They said they liked the staff and that they provided them with any help they needed. Residents said they were involved in choosing the meals and went to do the food shopping. They said they were consulted over where to go on holiday and for trips out. Residents stated that they could spend time in their rooms or in the lounge. The home had developed good care plans that showed what support each resident needed. Residents were involved in making sure the plans were up to date. The home had put together risk assessments for each resident so that residents did not take unnecessary risks. Resident`s health and personal care needs were being met and residents said that they went to see the doctor when they wanted and had regular health and medication checks. Residents had the opportunity to go to college and they said they liked doing this. Residents were able to do physical activities such as going to a gym and playing badminton. Resident went on holiday and paid for this themselves. The home is well managed and staff are supported and kept up to date over any changes in the home.

What has improved since the last inspection?

Some changes have been made since the last inspection. The home has assessed the level of risk of hot water for each resident and has made sure the fire risk assessment is up to date. The home along with the resident is checking every six months that the care plans are up to date.

What the care home could do better:

Although the home was meeting the care needs of the residents but there were some parts of the fabric and furnishings of the home that needed attention, some of which were outstanding from the last inspection. Two of the bedrooms and the dining room needed to be decorated. The stairs carpet needed to be replaced as it is in a poor condition and the dining room carpet was very dirty and needed to be cleaned or replaced. These actions would improve the home and make it more homely for the residents. The home also had to ensure that any radiators that posed a risk particularly in the bathing areas were covered to prevent residents being harmed. Whilst staff had good relationships with residents some staff have not had training in the abuse of adults, which could potentially lead to incidents not being picked up, and properly acted upon. Also some staff were not up to date with training in lifting and handling. Both these were on the last inspection and have to be addressed by the home. The home`s method of employing staff was in most cases satisfactory but one staff file did not show that two references had been sought and the home needs to make sure that these are always sought and are kept on the file. The home also needed to make sure that it had the right information on all the residents` files to ensure that they are fully aware of all the residents` needs.

CARE HOME ADULTS 18-65 Mimosa 4 Shirley Road Hanley Stoke on Trent Staffordshire ST1 4DT Lead Inspector Jane Capron Announced Monday 20 June 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. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mimosa Address 4 Shirley Road Hanley Stoke on Trent Staffordshire ST1 4DT 01782 208590 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) Delam Care Ltd Mrs Pauline Adams Care Home 5 5 5 Category(ies) of LD registration, with number MD of places Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Mimosa is a residential care home providing 24 hour care for 5 service users with a learning disability and mental health concerns. The accommodation provided for one double and single bedrooms. The home has a lounge and separate dining room and there is a small attractive garden area at the rear. The home has bathing and shower facilities. There is no on site parking. The home shares the use of two people carriers with other care homes in the vicinity owned by the same company. The home is located close the park in Hanley and in the area there is a local shop. A short distance away there are other amenities such as medical services, a hairdresser, shops and leisure facilities. Residents attend a local college for a number of sessions a week and join with service users from the neighbouring care home to go out on trips and on holiday. The home had an activity worker attached to the home for two days a week. Service users are involved in day to day activities associated with running the home including ensuring their bedrooms are tidy and clean and with such tasks as washing up, laying the table and shopping. The home has a staffing level of one care staff on at any time and the manager also has responsibility for the care home next door. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over a four-hour period. All of the residents were spoken to during the inspection. The manager and two staff were spoken to. A sample of residents’ plans was examined as well as medication records and financial records. The rooms of the home were inspected. Documents relating to health and safety were also seen. No complaints had been received since the last inspection and no additional visits had been made to the home. What the service does well: What has improved since the last inspection? Some changes have been made since the last inspection. The home has assessed the level of risk of hot water for each resident and has made sure the fire risk assessment is up to date. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 6 The home along with the resident is checking every six months that the care plans are up to date. 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. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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 Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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) 2, 3, 4 Assessments are completed prior to admission providing residents with a level of confidence that the home can meet their needs. However the home’s needs to ensure that the relevant documents are kept on file. Introductory visits and trial periods provided residents with the opportunity to be as sure as possible that they wanted to live at the home before making a definite decision. EVIDENCE: The home provided prospective residents with the opportunity to visit and meet residents and staff before deciding to move to the home. The most recent resident confirmed she had chosen to move to the home. The placement was made for a trial period and only confirmed following a review. Prior to admission the local authority completed an assessment with contributions from other relevant professionals although a copy could not be located on file. This resident was already well known to the home having lived at a home close by for many years. The residents stated that their needs were being met. They confirmed that they accessed health care services and that the staff provided them with the support to ensure that their personal care needs were met. Observation showed that staff and residents communicated freely together. Staff spoken to were aware of the needs of each resident. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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) 6,7,8,9 The care plans provided the staff with the information they needed to be able to meet the needs of the residents. The systems for participation and decision-making within the home provided residents with the opportunity to have control over a range of aspects of their lives and to develop and maintain their skills. The risk assessments allowed residents to take reasonable risks and for there to be NO unnecessary restrictions placed upon them. EVIDENCE: Individual support plans were in place that identified the health, personal care and social needs of the residents. These showed the abilities of the residents and identified the areas where support was needed and identified how the support should be provided. Residents and staff reviewed the plans on a six monthly basis. Residents were involved in a range of activities related to running the home. These included planning the menus, resident meetings, doing the food shopping, helping in the kitchen and laying the table and doing domestic tasks such as cleaning their bedrooms. Residents were supported to take decisions Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 10 over their daily lives. They chose and bought their own clothes, chose where to spend their time - in their own rooms or the communal rooms, which courses to attend at college and what activities to participate in. Residents stated that there was a relaxed atmosphere at the home and they could choose what to do. Risk assessments were in place covering a range of daily living tasks including the risk of hot water, accessing the community, bathing and the use of keys. These were kept under review. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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, Residents benefited from a range of social and educational activities both in and out of the home. Links with the community enhanced the residents’ lifestyle. The meals offered both choice and variety and were well liked by the residents. EVIDENCE: Residents had the opportunity for personal development. The home supported residents to attend college undertaking a number of courses related to developing their communication and independent living skills. Residents also undertook independent living tasks in the home such as cleaning their bedrooms, vacuuming, setting the table and going shopping. Staff supported residents to attend church if they wished. All residents went to college during the week. One attended most days whilst several others chose to attend for a shorter time. Courses included sewing, arts, decorating, communication and drama. There was the opportunity for residents to engage in physical activities with one resident attending a gym and playing badminton. Resident’s individuality was encouraged and supported. Residents all accessed the community on a regular basis. They went shopping, both for the home and for personal items; they went to local health resources Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 12 and at times went to the pub. Residents had the opportunity to take part in activities both in and out of the home. The home organised some trips at the weekend, went out for picnics and to a weekly club. A group had recently been to a football match. In the home there was a TV and video/ DVD in the lounge and they had film evenings. Residents had TVs in their bedrooms. Residents did baking on occasions, some craftwork and had games evenings. For these activities they often joined with the home next door. The residents had plans to go on holiday to Wales later in the year. The residents paid for their own holidays. All residents liked the meals and said that they were involved in choosing the menus and going food shopping. Individual food preferences were accommodated. The home provided a varied menu. There was no resident that wanted specific food to meet cultural or religious needs. The weight of residents was monitored. Meals tended to be taken together and mealtimes were a social occasions where staff and residents chatted together. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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) 18,19,20 The personal care and health care needs of the residents were being met with residents being supported by staff and a range of health care professionals. The home’s system for administering medication was satisfactory with the residents’ medication needs being met however the lack of a secure storage facility for self-medication could potentially place residents at risk. EVIDENCE: The personal care and health care needs of the residents were identified in the care plans. Records and discussions with residents confirmed that the staff supported residents to maintain their own personal care. The main need was for support and encouragement although some practical support was needed with shaving and hair washing. Residents had a good range of clothing, which they chose and bought themselves. Residents’ appearance reflected their own personalities. The home operated a key worker system. Residents stated that they had choice about when they got up and went to bed. Bathing and showering could be taken daily at a time of residents’ choosing. The home was meeting the health care needs of the residents. Residents had health screening, received services including psychiatry. They attended the dentist, the chiropodist and the optician. The home had a monitored dosage system for the administration of medication. The home had the necessary storage facilities for medication. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 14 Medication records were completed correctly. Staff had received some training in medication and it was reported the manager assessed that staff’s competency although no evidence was seen of this. One resident managed their own medication and had been assessed as being able to do this successfully. No secure facility for medication storage was evident in the room. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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) 23 Whilst the home had procedures in place for the protection of vulnerable adults and were understanding of incidents of aggression, the absence of adult protection training for some staff could lead to incidents of abuse not being identified and acted upon correctly. EVIDENCE: The home had an adult protection procedure in place. Some staff had received training and had the necessary knowledge to be alert to issues of adult protection. Staff understood that issues of aggression and verbal abuse could be related to residents’ conditions and anxieties and were aware of the agreed methods to respond to such incidents. Staff had received training in non-crisis intervention. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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) 24,26,27,28,30 Whilst the home was suitably located and designed there were areas were the décor needed attention to provide the residents with a homely environment that fully met their needs. The home provided bedroom accommodation where the residents were able to express their individuality and to have privacy. The homes cleaning systems provided the residents with an environment that was clean and reduced the likelihood of infections. EVIDENCE: The house was suitably located to access the community with shops within walking distance. The home was indistinguishable from the homes nearby. The home’s premises were suitable for the residents with adequate communal areas and providing three single bedrooms and one double room. Those sharing the double room were happy to do so and had shared for a number of years. Certain areas of the home were quite worn needing decorating, and some carpets, particularly the dining room and the stairs carpet, which had tears in it, needed replacing. Two of the bedrooms needed decorating, as they are not suitable for their occupants. A number of these issues have been raised previously but have not been addressed. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 17 All bedrooms had been personalised and were lockable. The person recently admitted liked their room and had suitable seating and furniture and had bought their own fridge for the room. Residents had TVs in their rooms but did not have TV aerials. The home had adequate toilet and bathing facilities, having a shower downstairs and a bath upstairs. These were lockable. The home shared a laundry with the adjoining home. At the rear there was a small garden that had been well designed with seating and a small water feature. The home had suitable cleaning schedules in place and was clean and tidy throughout. Systems were in place to control the spread of infections. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 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) 33,34,36 The level of staffing provided was suitable to give the residents the support they needed and to have a varied lifestyle. The home’s recruitment procedures were in the main protecting the residents however the home needs to always evidence that all pre employment checks have been completed. The residents benefited from staff that were supported and were being kept up to date with developments about the home. EVIDENCE: The staffing levels allowed for one care staff on duty throughout the day and for one staff sleeping in. Additional staff were provided to enable the staff to take residents for appointments. The Care Manager who had time off shift was also available to enable the care staff to take residents out. Due to the close relationship between the residents of this home and the one next-door staff at times joined together to arrange social activities such as a BBQ or a film night. There was also one staff member who worked off shift one day a week to support residents doing activities and to attend college. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 19 A sample of personnel files showed that the home undertook CRB and POVA checks and references were sought, although there was only one reference evident on one file. Staff were supported in their roles. They were provided with terms and conditions and job descriptions. Staff received individual supervision and staff meetings were held. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 20 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) 37,38,39,42 The residents were generally benefiting from a well run home although there were some issues relating to health and safety that were outstanding and potentially could have an adverse affect on the residents. The home had systems in place to assess the quality of the service, enabling shortfalls to be identified and addressed and to develop a higher quality of service to the residents. EVIDENCE: The manager was suitably experienced and experienced to manage the home. She operated an open management style and was supportive to staff and residents. Staff meetings were held where staff could be kept up to date and had the opportunity to express views. The manager had regular contact with residents. The manager had the responsibility to ensure the home was run in line with legislation and current standards. The home had systems to assess the standard of the service provided including regular audits of practices and environmental issues. There were no formal Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 21 interviews of residents but their views were sought at residents’ meetings and through informal discussions. The home had Health and Safety procedures in place. Regular testing and servicing of the fire equipment and alarms and fire drills were being held. Boilers were serviced and the home had the necessary gas and electric certificates in place. Records were kept of the regular testing of temperatures of food stored and food cooked. The water temperature was tested and on the day of the inspection there was no hot water but this had been reported and was addressed during the inspection. Risk assessments were in place for the residents’ ability to manage hot water and hot surfaces but some radiators in high-risk places such as the bathing areas needed to be covered. Procedures for the safe handling and storage of hazardous products were in place. They were systems in place for staff training but the records could not confirm that all staff had received training in lifting and handling. Mimosa E51 E09 S64017 Mimosa V227918 200605 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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 3 3 x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mimosa Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 2 x E51 E09 S64017 Mimosa V227918 200605 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. 2. Standard 2 20 Regulation 14(1)(b) 13(2) Requirement To ensure that copies of assessment documents are maintained on file. Tp provide residents that self medicate with a suitable secure facility in which to keep medication. To ensure that staff have the necessary knoweldge to protect residents from abuse (previous timescale not met) To ensure that the all parts of the home are reasonably decorated : i. that the dining room be decorated ii the dining room carpet be cleaned or replaced iii. That the torn stairs carpet is replaced iv. that the double bedroom be decorated ( previous timescale not met) v. That the back bedroom upstairs be decorated in a suitable style That all pre- employment checks be made. That all staff undertake training in lifting and handling (previous timescale not met) Timescale for action 10 July 2005 10 July 2005 1 September 2005 i. 1 September 2005 iii1 September 2005 iii. 1 September 2005 iv. 1 September 2005 v. 1 October 2005 1 July 2005 1 September 2005 Page 24 3. 23 13(6) 4. 24 23(2)(d) 5. 6. 34 42 19(1)(b) (i) 18(1)(c) (i) Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 7. 42 13(4)(c) To ensure that radiators and particularly those in bathing areas are covered. 1 August 2005 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 20 24 Good Practice Recommendations To ensure that assessments of staffs ability to adminster medication is evidenced To provide tv aerials in bedrooms. Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Mimosa E51 E09 S64017 Mimosa V227918 200605 Stage 4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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