Inspection on 05/07/05 for Roborough House

This inspection was carried out on 5th July 2005.

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

The inspector 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

Roborough House 01/12/09

Roborough House 04/06/09

Roborough House 09/04/08

Roborough House 18/06/07

Roborough House 14/08/06

Roborough House 07/12/05

Roborough House 24/01/05

Roborough House 07/07/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Roborough House Off Tamerton Lane Roborough Plymouth PL6 7BQ Lead Inspector Rachel Proctor Announced 5 July 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Roborough House Address Off Tamerton Lane, Roborough, Plymouth, Devon, PL6 7BQ 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) 01752 700788 01752 721088 nina@bartonplace.com Roborough House Ltd Mrs Patricia Mary Norman Care Home 35 Category(ies) of Dementia (12), Physical disability (35), Physical registration, with number disability over 65 years of age (35), Terminally of places ill (4) Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: This home is registered as a Care Home with Nursing for a maximum of 35 Service Users in the category of PD 35, PD(E) 35, TI 4 Maximum of 3 service users with mild learning disability needing to convalesce following surgery or other general health care needs, max of 6 weeks To include DE (12) categories of care Date of last inspection 24.01.05 Brief Description of the Service: Roborough House is owned by Goldmax Resources, trading as Roborough House Ltd. It is a 35 bedded home for young physically disabled ,terminally ill and elderly who require nursing care. It can also accommodate a maximum of 3 Service Users requiring personal care only.It is an old building that has a modern extension. It is arranged on 2 floors with access to most areas via 2 passenger lifts and a step lift. There are 2 lounges , a dining room and conservatory on the ground floor. The manager supports a team of trained nurses and carers who are able to deliver care to a wide variety of Service Users. The home has recently changed ownership and extensive refurbishment and building work is taking place to improve the environment.The grounds are extensive and suitable for use by wheelchair users with ample parking for Service Users vehicles and staff and visitors. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. The inspection took place on the 5th July between 9:30 a.m. and 4:30 p.m. The inspector spoke to residents and staff. A tour of the home was completed with the manager. This included some of the residents rooms, residents assisted bathrooms and the communal areas. Some records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Many of the areas in the older part of the home are in need of refurbishment repairs and renewals. Carpets are worn and woodwork has been chipped. However ongoing major refurbishments are taking place and the inspector has been reassured that all outstanding repairs and renewals will be completed when the building work is finished. The residents and staff remain positive and all said they were looking forward to the improved environment the new extension would provide. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 6 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. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, Prospective residents of Roborough house can be reassured that their individual needs will be assessed by a staff team who are competence and capable. EVIDENCE: Since the last inspection the manager has introduced a new assessment process for the residents. These assessments include the physical, psychological, health care and social care needs of the residents. However not all the residents plans viewed had the new style assessment and care plan introduced. One resident care plan viewed during the inspection did not have the changes in the care the manager reported recorded. A reassessment of this residents care needs had not been completed since June 2004. Each of the residents spoken to during the inspection said that staff had assessed their care needs and were providing their care in a way that met their needs. A risk assessment process is in use in the home its covers the manual handling risks, pressure sore risks and activities the residents have chosen to undertake. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9, Although the resident’s needs are being met at Roborough house; the manager needs to ensure that all the residents plans of care are reviewed on a regular basis and as their care needs change, to ensure the residents care requirements continue to be met. EVIDENCE: One resident asked said they had not seen their plan of care, when this residence plan of care was viewed not been updated since June 2004. The resident did say that the staff were providing the care for them in the way they expected and there were more than satisfied with the care they received at Roborough House. Two other residents plans had completed risk assessments for the activities those residents had chosen to undertake. These included the use of an electric wheelchair. The manager had introduced a system of recording when staff had made decisions on the residence behalf. An example of this was seen during the inspection. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 10 One resident had advised that the staff team at Roborough House understood their care needs. Staff were helping them to maintain as much independence as they could, staff were assisting with the things they were unable to do for themselves. The risk assessment processes in place enabled the residents to make informed choices about the tasks they wish to undertake. Several of the residents enjoyed smoking; a smoking area had been designated for them to use, those that required supervision to have a cigarette were being given this. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 17, The amount and type of activities available to the residents could be improved on. The meals and mealtimes at Roborough house are an enjoyable social occasion for the residents. EVIDENCE: Two residents told the inspector they would like more activities provided. Although they did acknowledge that recently the homes driver had been asking them on a daily basis if they would like to go out. Two comment cards received from residents also indicated that they would like more activities provided. The manager confirmed that staff could accompany residents outside the home to enable them to undertake their chosen activity. A pool table had been donated to the home; this was stored in one corner of the residents lounge. The manager confirmed that there would be spaced set this up for the residents once the new build an extension had been completed. The residents being assisted to eat their meals were being given assistance by the staff in a discreet sensitive way. Where residents required puréed food the Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 12 foods have been puréed separately to allow them to experience the different tastes of the food they were eating. The meal presented on the day of inspection was nutritionally balanced and attractively presented. Very little wastage was seen at the lunchtime meal. All the residents asked said the meals had improved and more choices available. The chef advised that the food is prepared fresh daily and he always takes into account the likes and dislikes the residents. The lunchtime meal was unhurried with the residents eating their meals at their own pace. Some residents had chosen to eat their meals in one of the lounge areas others in their own rooms, the staff facilitated this. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20, Each of the residents at Roborough house has a care plan, however not all had been reviewed to ensure that the changes in care that the residents require are being addressed. The medication practices for the use of prescribed treatment creams must improve to protect residents. EVIDENCE: The residents asked said the staff were friendly and supportive towards them and enabled them to choose the way they wanted their care delivered. One resident said the staff enabled them to maintain as much independence as they were able with day-to-day living. Each of the residents had a designated worker and support worker, the service uses guides provided in each of the residents rooms had been personalised and included the name of the key worker for the residents reference. The residents had been provided with a variety of aids and adaptations throughout the home to assist them. Individual residents had been assessed for specialist equipment; this included light writers and specialist hoists. Manual handling assessments are completed for each resident these provide staff with the information regarding which aids, hoists the residents need to safely aid their mobility. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 14 Other Health Care professionals input into the residents care were recorded. The manager confirmed that they regularly use specialist nurses from within the local Health Care team. The registered nurses monitor and assess the care needs of the residents. Psychological assessments are in place and part of the care planning process for residents. These are used to enable the residents to discuss concerns relating to a disability and health care plans. The manager confirmed that each of the residents had a life history completed and recorded in their plan of care. Three examples of these were seen. The residents asked confirmed that they had been asked about their life experiences so far and what was important to them. Although the residents asked confirmed that their health is monitored and they receive assistance with those things they are unable to do for themselves. One of the residents care plan did not have the changes that had occurred in their care requirements recorded, a reassessment of the care needs had not been recorded as a result of their care changes. The manager had introduced a separate recording method for health professionals who visited the residents. This included the GP, chiropodist, specialist nurses, opticians and dentists. A tour of the home found prescribed creams in three residence bedrooms that were prescribed for a different resident. Two of these prescribed creams had passed their expiry date. Each resident had a separate record of the medication they were prescribed and received. Registered nurses are responsible for the administration of all medication for the residents who are unable to manage their medication. The controlled drug record was completed. Medication was stored in a locked room within a locked cupboard. The manager advised that she had recently changed the pharmacy that supplied the medication for the residents. The inspectors saw medication prepared in blister packs for individual residents. The manager confirmed that she would be exploring the options available for the disposal of medication. A record of medication returned an ordered was available. Oxygen is stored in the treatment room and has been secured to a wall. Reference material relating to medication is available for staff use in the office. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, The residents can be assured that any concerns they have will be dealt with in a sensitive open way by the staff team. EVIDENCE: Three complaints had been received by the home since the last inspection. These had been partially substantiated. The actions taken by the manager to address the concerns raised were documented. Residents reported that they had confidence in the staff team and felt they could express their concerns and wishes freely. The complaints procedure is available for residents and staff. Each of the residents had a copy of a service users guide, which included information on how to complain. One resident who had raised concerns said staff dealt with their concerns sensitively and they were satisfied with the response. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 30, The redecoration and improvements that have been made since the last inspection will need to continue, until all areas have been refreshed, this will then ensure all the residents have a pleasant safe environment to live in. EVIDENCE: At the time of the inspection Roborough House was undergoing major changes. A new extension to increase the number of beds available is nearing completion. Some of the existing residence rooms now have the views obscured by the brick walls of the new extension. Although the residents asked said they were unaware that the new build would obscure their view they did not feel this would bother them as they had the opportunity to be freely mobile around the home in their wheelchairs and liked their existing room. The manager confirmed that the older part of the building was due to be knocked down and rebuilt once the new extension was completed. The residents were asked if they had been kept informed about the plans, they said they were aware that the owners were planning to upgrade the whole environment. However all said they would be pleased once the building work finally finished. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 17 A tour of the home revealed that some of the existing carpets in communal corridors were badly stained. Doorframes into individual residents rooms had been knocked and paint finishes were damaged, some of the corridor walls also had plaster, which had been knocked and chipped. The manager confirmed that the whole environment including corridors and residents rooms would be redecorated and refurbished once the building work completed. Some of the residence rooms had been redecorated and re-carpeted since the last inspection. These rooms were in a part of the building that would be unaffected by the building developments going on. The majority of staff asked said they were looking forward to having an environment to work in that was better able to meet the needs of the younger disabled residents group they cared for. The commitment to ongoing improvements of the environments were evident during the inspection. Windows restrictors on the first floor had been removed in two of the residence rooms. The manager was unable to confirm why they had been removed. This posed a possible risk of falls for the residents. One of the resident’s bathrooms had unlabelled spray containers containing liquid on a shelf. The COSHH information data sheets for the chemicals used for cleaning in the home were not easily available for staff use. The manager confirmed that the COSHH information data sheets for the chemicals used in the kitchen for cleaning were available. Staff was observing infection-control practices in the home caring for the residents. Alcohol hands sanitised for was available outside the rooms of the residents at risk. Staff also had small individual hands sanitised in liquid dispensing bottles attached to their uniforms. The yellow bag system is in place for the disposal of clinical waste. Hands sanitizer was available at the entrance to the home. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 35, Residents can be assured that the manager and the staff team have the skills and experience to ensure their individual care needs are met. EVIDENCE: The Commission has recently confirmed the new manager as the registered manager. She has several years experience working at the care home and is the first level registered nurse. The homes recruitment practices and policies were discussed with the homes business manager. Three staff files were reviewed. These contain preemployment checks, application forms and proof of identity. The business manager confirmed that CRBs are applied for all new staff. Copies of CRBs were available for inspection. A checklist is provided at the front of each staff members file to confirm that the records required are contained in their staff file. The training matrix was provided, this showed the training that staff had undertake or had planned. Copies of certificates for training courses completed were available in the staff files. The manager confirmed that staff are completing first aid training and the majority of shifts had a first aider as well as the registered nurse on duty. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 19 The list of training provided for staff included clinical based training i.e. tissue viability, infection control and continence care. The clinical training provided links to the health care problems the current residents have. The residents spoken to say that the staff team who cared for them understood their needs. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41, 42 The residents at that Roborough house can be reassured that their views will be taken into account. However attention should be taken to ensuring that best practice for health and safety of the residents is followed. EVIDENCE: The manager reported that residents meetings had started as a result of the quality-monitoring questionnaire completed. The residents asked said they were pleased residents meetings had started again. Notices about the date of the next meeting were displayed throughout the home. Although the questionnaires had not been analysed the manager had taken action on the results. The inspector was told a copy of the completed questionnaire analysis would be provided for the residents and the Commission. The results of the resident’s questionnaires and the comment cards received from residents all made reference to wanting more varied activities to be provided or available to them. One resident advised the inspector that the driver employed by the home regularly asks if anyone wants to go anywhere. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 21 Individual trips out are organised in conjunction with the staff team, the resident and the homes driver. The inspector was advised that the previous owner had checked the water systems for legionella. The business manager confirmed that a company had been booked to recomplete the checks this month and a copy of the completed report would be provided for the commission. During a tour of the home two first-floor windows in residents bedrooms did not have window restrictors fitted. The manager confirmed that the window restrictors would be refitted as soon as possible and said she thought it was due to the building work currently being undertaken in the home. The information for the chemicals used for cleaning in the home (COSHH) were not easily available to staff. The cleaner on duty was unaware of where this information was kept. The kitchen area did have the information for chemicals used (COSHH). Roborough house is in the process of having a major extension completed. Building work was in progress during the inspection. The residents asked said the manager was keeping them informed of progress and there were really looking forward to the improved environment the building would provide. Two of the residents whose view was now obscured by the building said they were still satisfied with their rooms because of their size and location and had not asked to move. Risk assessment processes are in place for the activities the residents undertake and the environment of the home. The risk assessments were available for inspection. Two residents advised that they had had some concerns about the security of the building during the work but the manager had reassured them. The policies and procedures for Roborough house were available to staff in the office. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 2 x x x 3 Standard No 31 32 33 34 35 36 Score 3 x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Roborough House Score 3 2 1 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 2 2 x D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 23 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 YA 20 Regulation 13(2) Requirement Timescale for action Immediate 2. YA 42 13 (4 (a, c)) Prescribed treatment creams must only be used for the service user has been prescribed for. COSHH information must be 12/07/05 easily available for staff. Where risk assessments identify window restrictors are fitted these must be in place. 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. 4. Refer to Standard YA 6 YA 13 YA 19 YA 24 Good Practice Recommendations All service users should have their changing needs and personal goals reviewed on a regular basis or when their needs change. The service uses should be consulted about the activities and entertainments provided. All service users should have their plans of care updated on a regular basis or when their care needs change. The providers should continue the refurbishments in order that it meets the service uses individual and collective needs in a comfortable and homely way (carried forward from last inspection) The service users care plans should be reviewed and D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 24 5. YA 41 Roborough House changes documented on a regular basis and as their care needs change. Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Roborough House D52-D04 S61085 Roborough House V225874 050705 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!