Inspection on 01/02/06 for Pine Meadows Care Centre

This inspection was carried out on 1st February 2006.

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

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

Other inspections for this house

Pine Meadows Care Centre 09/10/07

Pine Meadows Care Centre 01/11/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Pine Meadows Care Centre Park Road Leek Staffordshire ST13 8XP Lead Inspector Pam Grace Unannounced Inspection 1st February 2006 10:15 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 Pine Meadows Care Centre DS0000066464.V281206.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. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pine Meadows Care Centre Address Park Road Leek Staffordshire ST13 8XP 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) 01538 392520 01538 392530 Four Seasons 2000 Limited Mrs Barbara Jackson Care Home 70 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (20), Mental disorder, excluding learning of places disability or dementia (2), Old age, not falling within any other category (70), Physical disability (50), Physical disability over 65 years of age (25) Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 20 Dementia (DE) - Minimum age 60 years on admission. 2 Mental Disorder (MD) - Minimum age 50 years on admission. Nursing day care services for 5 persons who are either elderly persons over 60 yrs, or suffering from PD aged 30 - 50 years - 5 beds. 50 Physical Disability (PD) - Minimum age 60 years on admission. 10 Physical Disabilities (PD) - Aged 30-60 years. LD(E) - two named service uses for the duration of their contract. Date of last inspection 20th September 2005 Brief Description of the Service: Pine Meadows Care Centre is a purpose built establishment consisting of two floors. The establishment is set in landscaped gardens and is close to Leek town centre and local amenities. The establishment is divided into three units; Acorn, Fir Cones and Chestnuts. Fir Cones Unit is a separate 20 bedded Dementia Care Unit, and is located on the first floor of the establishment. The Acorns unit provides personal care to elderly and younger service users with physical disabilities, and the Chestnut unit provides personal care and nursing care to elderly service users and younger service users with physical disabilities. There is ample dining and sitting accommodation provided on all three units. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection was carried out over one day by two inspectors. A tour of the home was undertaken and discussions were held with service users, visitors and staff. Discussions were also held with the registered manager of the home. Relevant records and documentation were examined. The registered manager assisted the inspectors throughout the inspection. At the end of the inspection, feedback was given to the manager, and deputy manager, outlining the overall findings of the inspection, and the requirements and recommendations made. Service users spoken with were very positive about the care they were receiving. There were also service users who were unable to communicate, the inspectors noted that they appeared well cared for, and were happy in their surroundings. Conditions in the home were determined by direct observation, and sampling other services provided, such as medication, and aspects of health and safety measures. Staff spoken with said that there has been a positive change of ownership from the Bettercare Group to Four Seasons Health Care. Two of the previous five requirements were not met. There were 10 requirements – including three immediate requirements, and three recommendations, made as a result of this unannounced inspection, What the service does well: Care plans were clearly written, and evidenced that service user’s health and social care needs were being met. Staff demonstrated great respect for service users, and service users were addressed in an appropriate manner. Service users and visiting relatives spoken with confirmed their satisfaction with the services provided at the home. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Pine Meadows Care Centre DS0000066464.V281206.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 Pine Meadows Care Centre DS0000066464.V281206.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): 1,3,4,5 Prospective service users are given information about the home, before making a choice about where to live. They are also able to visit and assess the quality, and suitability of the services offered by the home. Not all service users on the EMI unit could expect to have his/her needs assessed and be assured that these will be met prior to taking up residency in the home. EVIDENCE: The inspector was informed that suitably qualified staff, prior to service users being admitted to the home, carried out pre admission assessments. The community care plan provided by the social worker, as part of the individuals needs assessment process, were seen within a service user’s care plan. However, the care plan examined during the inspection of a recently admitted service user did not contain a full pre admission assessment profile. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 9 The inspector noted that following admission and during the few weeks that followed, there was evidence that assessed needs had been formulated into a care planning system. Staff, service users and relatives spoken with confirmed that service users are given information about the home, before making a choice about where to live. They are also able to visit and assess the quality, and suitability of the services offered by the home. The manager confirmed that the home’s statement of purpose is currently being revised. The Inspector requested that a copy is forwarded to CSCI. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 10 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): 7,8,9,10 Appropriate arrangements are in place for identifying and meeting the health and personal care needs of service users in the home. The health and welfare of all service users were not all protected by the medication procedures followed in the home. Staff delivered care in a courteous and respectful manner. EVIDENCE: Service user care plans were sampled and examined. They evidenced that individual health, personal and social care needs had been established, and were being met. However, it is required that all care plans are reviewed monthly. Care plan audits are in the process of being undertaken by the manager. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 11 One care plan was looked at in detail and contained an action plan of care and appropriate risk assessments were in place. Entries made were signed, dated and in black ink. However although the inspectors were informed that nursing and care staff were allocated to particular service users to care for, this was not clearly defined in the care notes of individuals. This should involve a named carer being responsible for ensuring labelling of clothes, checking levels of toiletries etc or where there were relatives involved, to liaise directly with them to ensure all service users had sufficient stocks and supplies. Each service user should have a plan of care assessed, implemented and evaluated by a trained nurse and additionally all service users should be allocated a key worker. Some care plans seen had not been reviewed, however, they were clearly written, and evidenced that service user’s health and social care needs were being met. The medication procedure was identified and the administration, and storage of drugs were not all found to be in order. MAR charts were examined and those examined had been completed in line with NMC requirements. All service users had a current photograph in place. Medication – which is required to be kept at cool temperatures at Pine Meadows EMI unit was kept in an unlocked fridge in an unlocked treatment room. All medication must be stored safely, in locked cupboards in a locked room. The room on the EMI unit which houses some medicines was not locked during the visit and on two occasions a service user gained access to the room, while the inspector was present. This area should remain locked at all times as service users may access potentially hazardous substances. The EMI unit shares a clinical room with another unit on the top floor. This room was cramped, not particularly clean and very untidy. Stocks of beer, and other extraneous items should not be kept in a clean utility room and must be removed and stored elsewhere. Trained nurses administer medication to all service users who have nursing needs. There were no service users self-medicating at the time of the inspection. Medication disposal from nursing homes is being implemented however, an anomaly was found on the destruction of controlled medication on the EMI unit. Two members of staff should be present when any destruction of medication is undertaken and signed for at that time. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 12 The nurse in charge of the EMI Unit during the inspection explained to the inspector that she had signed the witness column in the controlled drugs book because she has been requested to do so but had not actually witnessed the destruction of the drugs. The inspector noted during the inspection that service users were treated with respect and their privacy was upheld. Staff were seen to knock on service user’s bedroom doors prior to entering, and waited for consent to open the door. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 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 the following standard(s): 13, 15 Service users maintain contact with family and friends on a regular basis. Service users receive a balanced diet, however, the kitchen and all catering areas seen did not meet satisfactory standards of hygiene and cleanliness. EVIDENCE: There was evidence from talking to service users and visiting relatives that contact is maintained with family and friends on a regular basis. There were no restrictions placed on visiting times, and the home provides a relaxed and friendly environment. The kitchen area was thoroughly inspected and all catering areas seen did not meet satisfactory standards of hygiene or cleanliness. This whole area needs an immediate deep clean, to meet Environmental Health Regulations. Robust cleaning schedules must be introduced and maintained. It is also required that a daily record of food provided to service users is kept. The inspectors noted that during the visit a service user was celebrating their 100th birthday, and that a buffet lunch was provided by the home. Pine Meadows Care Centre DS0000066464.V281206.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): 16 Complaints received by the home have been listened to, taken seriously, and acted upon. EVIDENCE: The home has a clear complaints policy and procedure. This is on display in the main entrance of the home. There had been one complaint received by CSCI since the previous inspection. This had been appropriately investigated by the home’s manager, and had not been upheld. Service users and relatives spoken with said that they had no cause to complain at present, but commented that they would speak to the home manager or one of the nurses if they needed to. They were aware that the home has a complaints procedure. Pine Meadows Care Centre DS0000066464.V281206.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): 19,26 The home was accessible, safe and reasonably well maintained but was not very clean or hygienic in the kitchen/catering areas or the EMI unit. EVIDENCE: The home had been adapted to meet the needs of individual service users. There was evidence that bedrooms had been personalised by service users. However, some bedroom carpets were very malodorous and in need of a deep clean or being replaced. The domestic staff explained how the laundry and domestic rota works and their duties in relation to this. A discussion was held with the care staff regarding the general cleaning schedule of the home, all staff spoken to thought the home was not as well Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 16 kept as it could be. The cleanliness of the environment was a disappointment in general. Staff reported a poor supply of incontinent equipment, crockery, flat linen, and all the necessary stocks needed in their working environment. Sufficient stocks and supplies must be available to all staff at all times in regard to; incontinence pads, wet wipes, gloves, laundry skip bags and personal laundry baskets, crockery, cutlery and lipped/spouted beakers. The kitchen area was thoroughly inspected and all catering areas seen did not meet satisfactory standards of hygiene or cleanliness. This whole area needs an immediate deep clean, to meet Environmental Health Regulations. Robust cleaning schedules must be introduced and maintained. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 17 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): 28,29,30 Care staffing numbers and skill mix was appropriate to the needs of the 20 EMI service users at the time of the inspection. Most staff are trained and given the necessary skills to care for the service users in the EMI unit in the home. EVIDENCE: At the time of the inspection there were 20 service users accommodated in the EMI Unit with nursing needs. When the inspector was trying to ascertain the daily staff, skill-mix and input, it was determined that there was some disparity. The trained nurse hours were different from the care staff hours. Through discussions with staff members, it was identified that the unit was staffed as follows: From 8am-4pm there was an RGN and three care staff (7.30 – 3.30pm) and from 4.15pm-8.15 pm there was an RGN and three care staff (3.30 – 8.30). During the night, from 8pm-8.15am there was one RGN and one care staff (8.30 –7.30am). There were not sufficient domestic, and or laundry staff working in the home. This was discussed at length with the management and immediate requirements were left in this regard. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 18 There were insufficient staffing levels identified in the domestic and laundry areas. The tour of the home revealed many malodorous areas, poor cleanliness and unsatisfactory laundry regimes. Sufficient staff must be employed to ensure full cover is maintained in all areas over a seven-day period, to meet the needs of the residents in your care. Agency and bank staff must be used where shortfalls cannot be covered. Recruitment procedures were not examined in depth at this inspection. One member of staff who had recently been employed in the home, was engaged in conversation and confirmed to the inspector that she had submitted two written references and had undergone a full CRB, check prior to commencing employment with the company. Discussions with various staff members identified that mandatory staff training had taken place on a regular basis including moving and handling, fire safety and fire drills. POVA training was discussed and the deputy care manager confirmed that he has been delivering this to all disciplines of staff. All members of staff spoken to on the EMI unit confirmed that they had received this training along with Dementia care awareness and managing difficult aggressive behaviours. The management confirmed that this training will be consistently addressed as a matter of course NVQ training was on going throughout the home and the majority of care staff were either undertaking this or awaiting funding. COSHH training had been delivered and all staff spoken to were aware of the relevance of the data sheets. Records of staff training were not examined on this occasion but two members of staff confirmed that they had received a full induction programme, which was completed with the assistance of a named mentor. The manager confirmed that the home does not currently employ RMN nursing staff. This was discussed in depth, and it was recommended by the inspectors that qualified staff should undertake appropriate training in regard to dementia care, and the management of aggressive and or violent behaviour. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 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 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): 38 The health, safety and welfare of service users and staff must be promoted and protected. EVIDENCE: Complaints and accidents had been recorded as required and audited by the manager on a regular basis. There has been a steady decline in the amount of complaints received by the home. One complaint had been received by CSCI since the previous inspection. This had been appropriately investigated by the manager, and had not been upheld. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 20 The manager and staff spoken with confirmed that staff had received mandatory health and safety training, including regular fire drills, moving and handling, dementia care, and the management of aggressive or violent behaviour. The manager also confirmed that the home does not currently employ RMN nursing staff. This was discussed in depth, and the inspectors recommended that in order to reflect an appropriate skill mix and registered status of the home, qualified staff should receive training on dementia care and the management of aggressive and or violent behaviour. There were insufficient staffing levels identified in the domestic and laundry areas. The tour of the home revealed many malodorous areas, poor cleanliness and unsatisfactory laundry regimes. Sufficient staff must be employed to ensure full cover is maintained in all areas over a seven-day period, to meet the needs of the service users in your care. Agency and bank staff must be used where shortfalls cannot be covered. The cleanliness of the environment was a disappointment in general. Staff reported a poor supply of incontinent equipment, crockery, flat linen, and all the necessary stocks needed in their working environment. Sufficient stocks and supplies must be available to all staff at all times in regard to; incontinence pads, wet wipes, gloves, laundry skip bags and personal laundry baskets, crockery, cutlery and lipped/spouted beakers. The kitchen area was thoroughly inspected and all catering areas seen did not meet satisfactory standards of hygiene or cleanliness. This whole area needs an immediate deep clean, to meet Environmental Health Regulations. Robust cleaning schedules must be introduced and maintained. The medication procedure was identified and the administration, and storage of drugs were not all found to be in order. Feedback was given to the manager by the inspectors at the end of the inspection visit. Immediate requirements and recommendations were made in regard to the above. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 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. 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 3 X 2 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 22 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 2 3 Standard OP3 OP7 OP9 Regulation 14 (1)(a) 15 13(2) Requirement A pre-admission assessment must be undertaken, and appropriately documented. Care plans must be reviewed monthly Previous timescale of 30/09/05 not met All medication must be stored safely, in locked cupboards in a locked room. Two members of staff should be present when any destruction of medication is undertaken and signed for at that time. A record of food provided to service users must be kept Previous timescale of 20/09/05 not met The kitchen and all catering areas must meet satisfactory standards of hygiene and cleanliness. This whole area needs an immediate deep clean, to meet Environmental Health Regulations. Robust cleaning schedules must be introduced and maintained Sufficient stocks and supplies DS0000066464.V281206.R01.S.doc Timescale for action 28/02/06 28/02/06 01/02/06 4 OP9 13(2) 01/02/06 5 OP15 Sch 4 (13) 13(3), 16(2)(j) 01/02/06 6 OP26 01/02/06 7 OP26 12(1)(a) 01/02/06 Page 23 Pine Meadows Care Centre Version 5.1 8 9 OP26 OP27 23(2)(d) 18(1) 10 OP38 12(1)(a) must be available to all staff at all times in regard to; incontinence pads, wet wipes, gloves, laundry skip bags and personal laundry baskets, crockery, cutlery and lipped/spouted beakers. Malodorous bedroom carpets must be deep cleaned and or replaced. Sufficient staff must be employed to ensure full cover is maintained in all areas over a seven-day period. Agency and bank staff must be used where shortfalls cannot be covered. The manager must promote and make proper provision for the health and welfare of service users. 01/02/06 01/02/06 01/02/06 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 OP7 OP7 OP30 Good Practice Recommendations All service users should be allocated a key worker. Where a named carer or key worker is allocated to a service user, this should be documented and recorded in the care plan. Each service user should have a plan of care assessed, implemented and evaluated by a trained nurse. Qualified staff should undertake appropriate training in regard to dementia care, and the management of aggressive and or violent behaviour. Pine Meadows Care Centre DS0000066464.V281206.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Stafford Office 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 Pine Meadows Care Centre DS0000066464.V281206.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. 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