Inspection on 20/03/06 for Oakwood Rest Home

This inspection was carried out on 20th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Oakwood Rest Home 14/05/07

Oakwood Rest Home 05/06/06

Oakwood Rest Home 19/09/05

Oakwood Rest Home 17/02/05

Oakwood Rest Home 16/09/04

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

CARE HOMES FOR OLDER PEOPLE Oakwood Rest Home 78/82 Kingsbury Road Erdington Birmingham B24 8QJ Lead Inspector Susan Scully Unannounced Inspection 20th March 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oakwood Rest Home Address 78/82 Kingsbury Road Erdington Birmingham B24 8QJ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0121 373 8476 0121 382 9167 Unity One Ltd Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Category of registration is to provide personal care and accommodation for thirty elderly people. 30 (OP) Employ a recognised management consultancy for the first twelve months following change of registration. Ensure that there are a minimum of four care staff on duty at all times one of whom is a senior. Ensure that there is a minimum of two care staff throughout the night, one of whom is a senior. 19th September 2005 Date of last inspection Brief Description of the Service: Oakwood Rest Home is a Residential Care Home providing residential care for up to thirty older persons. The home is situated on the Kingsbury Road, close to bus routes to Sutton Coldfield and Birmingham. It is a short bus journey from the shopping centre of Erdington, where there is a range of local facilities. Oakwood Rest Home was originally three adjoining properties, and provides accommodation on 3 floors, accessible by a shaft lift. The accommodation comprises of twenty single bedrooms, fourteen with en suite facilities and five double rooms, all with en suite. There are 2 lounges, and a dining room that is situated off the large main lounge. Bathing and toilet facilities are situated on all floors of the home. There is a car park at the front of the building, and at the rear, there is a large enclosed garden. Access to the garden is gained via the large lounge. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place over a one-day period by two inspectors. Records were sampled pertaining to residents daily records, care plans, risk assessments and Healthcare needs. Other records seen included staff files, Health and Safety records, Policies and Procedures and records pertaining to staffing levels. What the service does well: What has improved since the last inspection? What they could do better: The Inspectors discussed the outstanding requirements with the Acting Manager and Deputy Manager. There have been some improvements in the care plans, however not significant enough to be able to ensure all the identified needs of residents are being met. A Consultancy has been working with the staff for six months, although there is new documentation available this has not been implemented. It was disappointed to note that care-plans contain little information for staff to be able to identify resident’s needs. Care plans require additional information to ensure all residents’ needs are identified. Risk assessments for residents did not show the control measures to minimise the risks. This was of particular concern as one resident uses a hoist, and one resident is being cared for in her room. Documentation pertaining to risk assessments for residents is a system using a scoring method. Risks identified do not reflect control measure to be taken in the event of the score indicating a high risk, and no information is available to show how staff have determined the score. Water temperatures are checked on a regular basis. Recent records indicate very high temperature, such as 52°C and 56°C, in resident bathrooms and Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 6 ensuites. The control measures that had been given to staff were to carry out regular checks on water temperatures. The risk assessment also identified thermostatic values to be fitted. This had been identified on 15 September 2005. There were no notices in bathroom to ensure staff tested the water before bathing or thermometer available to enable them to do so. The dishwasher was not working to enhance the process of infection control, and had not been for at least six month. Medication records showed entries written by staff that did not have two signatures for verification of the medication prescribed. In areas of the kitchen large amounts of grease and dirt was seen and infection control for one resident was poor. Regular cleaning of the kitchen must be completed. Food that had been prepared had no preparation date or use by date. All food prepared in advance must have the preparation date and used by dated. Staff files did not contain all the relevant information required by the standards. 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. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 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 the following standard(s): 1 Oakwood has a Statement of Purpose and Service Users Guide to enable residents to have the information they require before making a decision as to use the service. EVIDENCE: Information contained in the Statement of Purpose and Service User Guide gives information pertaining to the service offered, aims and objective, and admission criteria. Some amendment are required so as not to mislead service users and include: Where indicated residents may smoke, it must be made clear this is outside the building. Where it specifies all care staff will be registered with General Social Care Council it must be made clear this does not come into force until 2007. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7, 8, 9 Care planning documentation does not ensure that resident’s needs are assessed and being met and significant improvements are required. Action being taken by the Provider will improve these. Healthcares needs were not recorded in sufficient detail to be able to audit. This puts residents at potential risk and measure must be taken to address the omissions. Medicines administration, recording and storage arrangements are mostly satisfactory, two signatures are required for all hand written entries on Medication Recording Charts. EVIDENCE: Care plans had previously been identified as requiring development to attain a greater person centred approach. The Provider has instructed a consultant to assist staff in implementing a system of care planning to enable the needs, goal, and aspiration of residents. Some information had been given to staff to use in the interim period. The Information was not sufficient to enable staff to provide adequate care. For example: One resident uses a hoist, information given to staff was (uses a hoist two cares required.) There was no information Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 10 to say whether the resident could assist, or if only trained staff were allowed to use the hoist. There was no information to say which sling was required, or whether the resident could weight bear. There was no information to say when the hoist was to be used. For example in all transfers. This was the only need of the resident identified in the information given for staff to work from. All other information was locked away in the office when the management team was not on duty. This is totally unacceptable. Another example showed one resident was suffering from chicken pox and was being nursed in her room. The information provided to staff for infection control was satisfactory. There was no information to say that the resident required further support with social interaction from staff considering she had not been out of her bedroom for over a week. Other information stated that the resident was on a fluid balance chart and turning chart, when sampled the charts indicated very little fluids and food had been taken. The inspector advised the staff to contact the GP and raise concerns regarding the resident’s intake of fluid and food. It is recommended staff receive care plan training. The new style care plans show some insight into the information required, although the details included for staff should be further developed. For example, “provide help with personal care’’, should give greater detail such as to the degree of help required. This would ensure staff provided tailored assistance to individual’s needs that did not reduce independence. Healthcare needs such as aliments and previous medical history was recorded. New Healthcare needs and any diagnoses were not recorded in detail. For example records showed one resident had been visited by a CPN, information was not recorded why the visit was arranged and went on to say staff were to encourage the resident to wash and cream her feet as she was incontinent chiropodist said it would keep her feet clean. This was very confusing information in a resident file. When the inspectors asked for clarification the Acting Manager said, “the reason the CPN was called was the resident was refusing all personal care’’. The information recorded was not accurate and would portray to staff conflicting information of why the CPN was called. In one risk assessment, a score of 11 was recorded. The method used for recording risk assessments is to use a scoring method 11 being a high risk. There were no control measures in place for the risk to be managed or an explanation of what the risk was. Again, this would cause confusing information for staff if they did not know what the risk was. The storage and recording of medication was satisfactory. Two signatures are required for all hand written entries. The Acting Manager said a stock of homely remedies is not kept in the home. When one resident file was sampled, the inspector identified the resident had been given paracetamol that was not prescribed. When the inspector question how this had been given the acting manager said, it was her own stock. This is unacceptable and could place the Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 11 resident at serious risk. No medication must be given to residents unless full consultation has been sought from the resident GP. The practice must cease immediately. A homely remedies Policy is required. The Acting Manager must contact the resident GPs for any homely remedies given to residents to ensure there is no adverse reaction with current medication being taken. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 15 Residents records do not show how resident are consulted regarding the care they receive, activities or in general consultation about their rights and choices. Food preparation areas are not cleaned in accordance with Policies and Procedures and adequate methods are not used to maintain good hygiene practices. EVIDENCE: There are no records to show how residents exercise choice and control over their lives. Daily records consist of entries such, as slept well, eaten well, no concerns, appears fine. One review had been completed with no consultation with the resident. The inspectors advised the Acting Manager it was an ideal opportunity to review all care plans in consultation with the residents when transferring information on to the new care plans. While the menus were not sampled in detail, the inspectors went into the main kitchen to view the preparation areas where food was prepared and served. Certain areas of the kitchen such as the cooker, microwave and dishwasher were dirty and required cleaning. The cooker had a build up of grease. The cleaning rotas were not available and the Acting Manager had no access to this information as it was locked away. Food that had been prepared had no preparation date. The use by date indicated 21 March 2006, yet the menu for Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 13 21 March 2006 did not contain this item. The dishwasher was not working and had not been for some time. The Acting Manager said, “this would enhance infection control particular when any infection is present in the home’’. It is recommended that the dishwasher is fixed. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Records do not give enough detail to prevent resident being harmed when using Manual Handling equipment. EVIDENCE: Records pertaining to resident’s daily life in the home would not demonstrate there were adequate procedures in place to protect the resident from harm. For example, risk assessments for Manual Handling are not detailed to prevent accidents occurring. The risk assessments do not show how the risk is being motioned or reviewed. One resident requires the use of a hoist the risk assessment does not give details of whether the resident can assist with transfers, or how much assistance is required. There was no Occupational Therapist Assessment completed. The risk assessment does not give information identifying what measures have been put in place to minimise any injuries. There were significant amounts of jewellery and watches in a box in the safe. There was no inventory for these items. The acting manager said she had asked around and could not find the owner of these items. She had inherited these items when she took over as Acting Manager. An inventory must be produced and items recorded as unknown owners. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 15 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 the following standard(s): No judgement. EVIDENCE: Not assessed. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29, 30 The home’s recruitment Policies and Procedures do not protect the residents. Training records were not updated to reflect an adequate audit trail. EVIDENCE: Staff files sampled did not contain all the information required by this Standard. Missing information included Criminal Records Checks, References and induction. Induction records were not seen, the Acting Manger said these were with the consultant. Records of a confidential nature must not be removed from the premises. Supervision had not been completed on the three files sampled. Regular supervision must be completed at least six times per year. The Acting Manager had introduced a training matrix, but unfortunately, this had not been updated so an adequate audit could not be completed. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, 38 The Appointed Manager had not applied for registration with CSCI at the time of inspection. The new management structure was working well and it is anticipated with further development in Policies and Procedures will benefit the service provided. Staff supervision had not been completed on the three files sampled. Records pertaining to Fire Safety were adequate and up to date. EVIDENCE: The Acting Manager said she was getting to know the residents families quite well and was encouraging all friends and family members to play an active roll in the life of the residents. Staff files sampled did not contain a job description to interlink with the work they were required to perform. There has been turbulence recently at Oakwood with staff changes and management. However, it was pleasing to see the new management structure was working Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 18 well. The Acting Manager has a lot of work to do to bring Oakwood in line with The National Minimum Standards and it is appreciated this will take time, however care plans are a priority and must be the base to work from. Supervision had not been completed on the three staff files sampled including induction for new starters. The Acting Manager confirmed that this had lapsed and identified changes in the management structure that would support the re-establishment of supervision sessions. The Acting Manager also confirmed the need for regular staff meetings and the re-establishment of rules of conduct. She asserted that the meetings did not affect the relationships within the staff group and staff conducted themselves in a professional manner in their daily duties. This was confirmed through observation during the visit. Health and Safety records were seen and included Fire Safety, Fire Safety Training and Fire Drills. Risk assessments must be completed for any risk identified pertaining to the building and residents. Risk assessments must identify how the risk is being managed, monitored and reviewed. All hot water outlets must be fitted with a regulator to prevent scalding. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 1 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 1 X 2 Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4(1)(a-c) 4(2) Requirement The Responsible Individual must undertake further development of the homes Statement of Purpose and Service Users Guide and separate them into two documents. Previous time scale 01 April 2005. Partly met. A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. The Responsible Individual promotes and maintains service users’ health and ensures access to health care services to meet assessed needs. A homely remedy policy must be produced in full consultation with the resident GP under no circumstance must staff members given medication from their own source. The Responsible Individual must ensure that a variety of suitable activities are provided for the service users on a regular basis. DS0000056587.V276366.R01.S.doc Timescale for action 01/05/06 2 OP7 14(2) 15(1) 01/05/06 3 OP8 13(4) 01/05/06 4 OP9 13(2) 01/05/06 5 OP12 16(2)(mn) 01/05/06 Oakwood Rest Home Version 5.1 Page 21 6 OP14 12(2)(3) 7 OP16 22 Sch4(11) 8 OP18 13(5) 9 OP18 13(6) 10 OP22 16(2)(c) 11 OP28 18(1) 12 OP29 18(1) 13 OP30 18(1)(a) Previous time scale 01 June 2005. Not assessed. The Responsible Individual must ensure that service users are enabled to maximise their capacity to exercise personal autonomy and choice. Previous time scale 01 April 2005. Non Compliance. The Responsible Individual must ensure that all complaints are investigated and the outcomes are documented. Previous time scale 01 April 2005. Not assessed. The Responsible Individual must make suitable arrangements to provide a safe system for Manual Handling. The Responsible Individual ensures that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self-harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies. The Responsible Individual must ensure that all bedrooms en suite facilities are fitted with call bells. Previous time scale 01 June 2005. Not assessed. The Responsible Individual must ensure that the required numbers of staff are trained to NVQ level 2 by 2005. Previous time scale 01 April 2005. Not assessed. The Responsible Individual operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. The Responsible Individual DS0000056587.V276366.R01.S.doc 01/05/06 01/05/06 01/05/06 01/05/06 01/05/06 01/05/06 01/05/06 01/05/06 Page 22 Oakwood Rest Home Version 5.1 14 15 OP31 OP33 38(2)(c) 24(1)(ab) 16 OP36 18(2) 17 OP37 17(1)(2) 18 19 OP38 OP38 14(4)(c) 13(4) 23(4)(c) (v) ensures that there is a staff training and development programme which meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. An application must be received at CSCI for the appointment of the Acting Manager. The Responsible Individual is required to implement a formal quality assurance system, to ensure that the care delivered is of the required standard at all times. Previous time scale 01 June 2005. Non compliance. The Responsible Individual must ensure that al staff must receive formal documented supervision at least six times per year. Previous time Scale 01 March 2005. Non compliance. The Responsible Individual must ensure that all the required documentation is present in the staff and service users files, as detailed in Schedule 3 & 4. Previous time scale 01 April 2005. Not assessed. All water outlets must be regulated. The Responsible Individual ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. 01/05/06 01/05/06 01/05/06 01/05/06 01/05/06 01/05/06 Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 23 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 OP26 OP7 Good Practice Recommendations It is recommended the dishwasher be in working order to enhance infection control. Care staff should receive training in care planning and risk assessments. Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Oakwood Rest Home DS0000056587.V276366.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!