Inspection on 04/05/05 for Mountford House

This inspection was carried out on 4th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mountford House 13/08/07

Mountford House 04/09/06

Mountford House 20/10/05

Mountford House 18/01/05

Mountford House 16/08/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Mountford House Cyril Road Truro Cornwall TR1 3TB Lead Inspector Lynda Kirtland Announced 4 May 2005 10.00am 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. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Mountford House Address Cyril Road Truro Cornwall TR1 3TB 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) 01872 274097 01872 223990 Cornwall Care Limited Mrs Beverley Wills Care Home 37 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (8), Old age, not falling within any other category (23), Physical Disability (6) Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to Service users to include up to disability (PD) Service users to include up to (DE(E)) Service users to include up to (MD(E)) Total number of service users 23 adults of old age (OP) 5 adults aged 50 years and over with a physical 12 adults aged over 65 years with dementia 8 adults aged over 65 with a mental illness not to exceed a maximum of 37 Date of last inspection 18 January 2005 Brief Description of the Service: Mountford House is one of eighteen homes owned by Cornwall Care Ltd. It is registered to accommodate thirty-seven older people in need of personal care and who are over retirement age. Admissions are on a planned basis and emergency admissions are avoided whenever possible.Mountford House core services are: 1) Residential home: provides long term care to service users who are in need of personal care and are over retirement age. 2) One respite bed 3) 6 bedded Rehabilitation unit : referrals are received from health professionals for service users who due to a physical health need are needing a period of rehabilitation before they return to their own homes in the community. 4) Day care facility. 5) Domiciliary care services are inspected under differing national minimum standards and are therefore not inspected during this inspection process. Mountford house is near to local facilities and has good transport links to the local town. Mountford House is a large purpose built Care Home situated just outside the City of Truro. Accommodation is on the ground floor and consists of four wings. Each wing has a separate lounge, bedrooms and bathing facilities. One wing has a small sitting room for the few smokers living at the home. All rooms have call bells. Meals are prepared in a well-equipped kitchen on the lower ground floor and served in a central dining room on the ground floor. All parts of the home are accessible to all service users. Grounds are accessible for all who use the home. There is limited parking at the home. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited Mountford House on the 4 May 2005 and spent the day at the home. This was an announced visit. On the day of inspection 34 service users were resident at Mountford House House. The inspector met with 14 service users a representative, a number of staff and the registered manager to gain their views on the service that Mountford House provide. In addition the inspector examined records, policies and procedures and toured the building. This report summarises the findings of this inspection. What the service does well: What has improved since the last inspection? Mountford have a competent management and staff team, which have allowed the day-to-day operations of the home to be run in a consistent manner. With the recommencement of the Resident Meeting, service users commented that they felt more able to approach the management team with any issues. The introduction of the ‘suggestion box’ for concerns/ideas in developing the Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 6 service is another avenue to raise issues or ways to improve the facilities the home has to offer further. The last inspection identified two requirements in respect of gaining service users views and ensuring that they were aware of the complaints procedure. These have been complied with. Four recommendations were also identified, for minor alterations to environmental factors occur, two remain in progress and two have been complied with. Cornwall Care Ltd is continuously looking at how to develop the service they provide further. The homes restraint policy could be amended further to ensure that staff area aware of what ‘restraint’ entails and that training in this is provided. Future training in the areas of care planning and adult protection are in process. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5,6 Mountford House has comprehensive information, which informs service users and their representatives about the services that the home provides. Prior to admission, service users and their representatives participate in a pre admission assessment with members from the management team to identify individual care needs. A trail period of stay within the home is offered. The rehabilitation unit provides intermediate care in dedicated accommodation with specialist facilities, equipment and staff to deliver short-term intensive rehabilitation and enable service users to return home. EVIDENCE: Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 9 Cornwall Care ltd has produced a corporate Statement of Purpose and Service users guide that has been individualised to reflect the services that Mountford House provides. These documents are available on audiocassette if requested by service users. Residential Home: From discussion with service users and their representatives, plus inspection of three service users files it was evident that they are consulted in Mountford House pre admission assessment. Care needs identified by the referring professional assessments were incorporated in the assessment process and transferred to care plans This assessment is detailed and identifies the service users individual physical, emotional, social, educational and leisure needs and how the home would aim to address them. A months trail period is offered to all new service users after which a review is held with all parties present to consider if the placement is appropriate and if so a long-term placement will be provided. Service users and their representatives commented that the preadmission and ‘moving in period’ are carried out sensitively by staff and could not see how this process could be improved. They also stated that this was undertaken with their participation and that their care needs were identified accurately Financial expectations and accountability are clearly stated in the service users contract with the home, which has been signed, by the service users or their representatives and the home, or referring local authority. Rehabilitation Unit: from discussion with service users it was evident that they felt that the admission to the home was approached sensitively. Service users commented that the information Mountford House provided to explain their and the local community facilities was useful. In addition they commented that staffs reassurance that the rehabilitation unit is separate to the main care home was appreciated, as some were anxious on arrival to the home that they would not return to their own homes. Service users told the inspector details of their work/exercises programme and how with the staff they are working toward returning to their own home with appropriate supports systems. The rehabilitation unit has a designated wing of the residential home for six service users aged 55 years plus of either gender. The service users all have individual rooms on the ground floor and a shared lounge/dining area on the lower ground floor. Access is via a lift or stairs. There are sufficient toilet/bathroom facilities. Food and laundry and other facilities are included in the running of the care home. Other facilities that are in the rehabilitation area are the therapist room, kitchen facilities and a lounge/work area. A small kitchen is also available so that service users self -care skills can be assessed in this area. Planned exercises with the group are held during the day as well as activities. Individual exercises are recorded in the service users file. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 10 The rehabilitation unit has a part time rehabilitation co-ordinator, plus rehabilitation care staff (RCS). There is a minimum of one member of RCS at all times during the day/evening. Service users attend their planned daily exercises/ activities from 10am to 4pm. Night staff for the home are available for the rehabilitation unit if needed. The majority of RCS have attended the ‘Promoting Independence’ course and trained to NVQ2. The rehabilitation Coordinator stated that there is in house training which all staff attend e.g. moving and handling, dementia and continence training. The rehabilitation coordinator undertakes supervision of the RCS, and the registered manager supervises her. Staff viewed the training positively as they felt it assisted their every day work in this unit. A physiotherapist (9 hours a week) and Occupational Therapist (9 hours a week) are employed via Royal Cornwall Health Trust. Funding for this unit is via the CHPCT and Social Services. A member of the health team is present at the home Monday to Friday. Throughout the home the inspector observed staff that displayed great skill in communicating and providing personal and emotional care to all service users. Staff training is a priority to Cornwall Care Ltd and the staff commented that the training they receive assist them in their daily work. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 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) 7,8,10,11 Service users and their representatives are consulted in the implementation and subsequent reviews of their individual care plans. Care plans ensure that physical, emotional, social, educational and leisure pursuits are assessed and action to address the care needs are detailed for all staff to meet in a consistent manner. Service users are treated with dignity and privacy at all times EVIDENCE: Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 12 From discussion with service users, staff and inspection of documentation it was evident that individual care needs are identified appropriately. From inspection of service users files, and in discussions it is evident that Mountford House encourage service users and their representatives to express their views in the formation of their care plans. The care plans are detailed documents, which clearly identify service users skills and where assistance is needed. From this the care plan specifies what actions staff should take to ensure that the care need is approached in a consistent manner. Staff confirmed that they are involved in the care planning and reviewing stages of the individuals care plan. The registered manager stated that corporate training is occurring in the development of care planning process, which will be cascaded to all staff. Service users commented that health needs are met by the staff at the home and by external professionals to a high standard. Detailed records of all health professional visits to individual service users further evidenced this. Appropriate risk assessments i.e. falls, are evident on individual files. All service users spoken with stated that staffs display a high standard of respect in their daily interactions. Service users stated that staffs ensure that their privacy and dignity is maintained and could not see how this area of care could be improved. In addition the inspector observed staff communicating with service users in a professional manner at all times, alongside a sense of humour when appropriate. Cornwall Care Ltd has relevant policies on this area of care, which are incorporated, in staff’s induction process as well as through NVQ training. Cornwall Care Ltd has implemented a comprehensive policy addressing palliative care. The registered manager stated that service users views and wishes in respect of their health deteriorating, or in the event of their death are gained and included on the individuals care plan. Family are encouraged to be as involved as they wish with their relatives care and the registered manager will attempt to accommodate relatives overnight at the home if this is needed. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 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 Service users social, educational and leisure needs are identified and Mountford House aim to provide a variety of activities in the home. Service users visitors are encouraged to visit their relative. Service users are encouraged to retain links with the local community. EVIDENCE: Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 14 From discussions with service users in the main they commented that there is ‘enough to do’ during the day at Mountford House. Service users recalled a variety of activities that are provided: i.e. bingo, board games, trips out, celebrations, keep fit and church services. The inspector observed a variety of activities, both group and individual, occurring during the inspection and saw information on display advertising future events. The registered manager stated that the level and provision of activities would be discussed in the forthcoming Residents Meeting. Mountford policies and documentation demonstrate that they aim to encourage service users to pursue their hobbies and interests. Individual interests are recorded in service user care plans and their ‘life story book’. The registered manager has commenced ‘Residents Meetings’ to encourage service users to share their views on the facilities that the home provides. Service users have opportunities to access advocates and some choose to have relatives act on their behalf. Service users stated that the home is welcoming to their visitors. Service users made in the main positive comments to the inspector in the variety and quality of food provided. It was evident from discussions with service users and staff that there is a choice of main meal and that alternative meals will be provided. Cornwall Care ltd has provided training to all homes managers and chefs in the ‘Food Project’. This focuses on the nutritional and social aspects of food. It’s aim is to provide a service users focused meal provision encouraging meal times to be social occasions whilst allowing service users the opportunity to maintain their own independence and skills i.e. encouraging self serving of food, menu cards to be introduced and to improve the presentation of meals. Mountford House will be implementing the ‘food project’ and therefore this standard was not assessed in detail. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 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) 16,17,18 Cornwall care Ltd has a corporate complaints and whistle blowing policy. The complaint policy is on display and the management team encourage service users and their representatives and staff to voice any concerns so that they can be addressed. The registered manager ensures that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues, which helps to protect service users. EVIDENCE: Cornwall Care Ltd has completed policies in respect of the complaints procedures. Mountford House and CSCI have not received any complaints about the home. From the inspectors discussions with staff and service users all stated that they had ‘no grumbles or worries’. As required at the last inspection, the registered manager addressed with service users in their Resident Meeting how to express any concerns they may have with staff to ensure that they are aware of the process of how to make a complaint and given reassurance that all concerns are taken seriously, will be listened too and acted upon. A ‘suggestion box’ has also been implemented to encourage any anonymous concerns to be highlighted. From discussion with some service users they confirmed that they had a postal vote to use in the forthcoming general Election. They also confirmed that there is access to local advocacy groups, solicitors or that family members will act on their behalf. Cornwall Care Ltd has a corporate Adult Protection policy. The Domiciliary Care Adult protection policy has been amended so that staffs are aware of how and Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 16 within what timescales they would need to initiate the policy. The home is considering using this policy for the main home. The company does provide training in the area of abuse, both at induction and also via the NVQ training. The registered manager stated that the management team would be attending a course in respect of adult protection and POVA guidance and processes. In addition the registered manager has access to the DOH guidance’ No Secrets’ and the Local Authorities Adult Protection Procedures. These were observed to be in the managers’ office. Policy documents infer that restraint could be used in certain circumstances. It is recommended that this policy be revisited. If the possibility of use of restraint is to remain then the parameters should be stated and staff given appropriate training. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 17 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) 24,25,26 Mountford provide a good standard of décor and furnishings creating a comfortable and safe environment for those living there and visiting. Maintenance work is ongoing. EVIDENCE: Only the previous recommendations in respect of the environmental standards were inspected on this visit. It was noted that compliance is in progress i.e. reviewing the provision of electrical sockets in service users rooms, programme of replacing windows, and consideration for the sluice facilities to be updated. As the work is in progress the standard has been marked as met but the recommendation for this to be completed remains in the report. The inspector observed that the homes décor and furnishings are comfortable and was clean throughout. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 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) 27,28, Mountford House ensure that suitable trained staffs are employed in sufficient numbers at all times. EVIDENCE: On the day of inspection four care staffing the residential, domestics, handyperson, kitchen staffs, laundress, administrator and managers were on duty. Two care staff was on duty in the rehabilitation unit and physiotherapist. Staffing ratio during waking hours is aimed to be 1:8. At night there are two waking night staff plus a manager on call. The registered manager stated that there is a vacancy for one shift per month at night. There are no other vacancies. Service users were all complimentary about the care and approach they receive from the staff team. From discussion with staff they all commented that they felt that there is sufficient staff on duty and that they ‘work as a team’. The inspector observed staffs that were competent in their work. Seventy eight percent of staff has achieved a minimum of NVQ level 2 or above. Some staff has completed first aid training. Cornwall Care Ltd prioritises staff training and from discussion with staff and inspection of staff files this demonstrated a commitment to staff updating their training. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 19 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) 31,32,34,35,37 The registered manager is competent in her role. She ensures that the management approach creates an open, positive and inclusive atmosphere. Financial accounts are maintained. EVIDENCE: Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 20 The registered manager has undertaken relevant training to update her knowledge in the area of older persons care. The staff team and service users spoke positively regarding the accessibility of the management team to voice any ideas as to how to improve/change the service and that likewise they could express any concerns to the management team. Staff and service users, meet with the management team approximately 3 monthly, minutes were inspected. Staff felt that these meetings were beneficial and also commented that they felt consulted in the future developments of the home. Cornwall care Ltd is a not for profit charity and accounts are maintained at Cornwall care Headquarters. The registered manager stated that the home is financially viable and has relevant insurance in place. Cornwall care Ltd have cooperate policies in the management of service users monies. Service users are encouraged to manage their own monies and hold their own accounts. However they can sign an agreement to request that Cornwall care assist them in the management of a small amount of their monies. From inspection of service users monies records were accurate and tallied. Records held by the home are stored in a confidential manner and in line with the Data protection Act. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 x 3 3 x 3 x Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 22 no 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP25 OP26 OP18 Good Practice Recommendations A planned and timed programme of replacing windows should be implemented. The sluice facialities should be considered to be updated The homes policies refer to the possible use of Restraint. It is recommended that this policy be revisited. If the use of restraint is to remain, the parameters should be clearly stated and staff afforded appropriate training. Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Mountford House D52-D04 S9158 Mountford House V214842 040505 Stage 4.doc Version 1.20 Page 24 - 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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