Inspection on 27/09/06 for Rylands Care Home

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Rylands Care Home 19/09/07

Rylands Care Home 04/10/05

Rylands Care Home 23/09/04

Rylands Care Home 24/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Rylands Care Home 9-11 Meadows Road Beeston Nottingham NG9 1JP Lead Inspector Richard Ramsden Key Unannounced Inspection 27th September 2006 9:30 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 Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 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. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rylands Care Home Address 9-11 Meadows Road Beeston Nottingham NG9 1JP 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) 0115 9436247 0115 9436247 Mr Vijay Mehan Mrs Mandy Jeannette Wilkinson Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Rylands Care Home is situated close to the centre of Beeston, which provides a good variety of local facilities and amenities. The accommodation is sited over three floors, with the service users accommodation on the ground and first floor. There is a passenger lift providing access to all levels. The home is comfortably furnished and has been decorated and maintained to a very good standard. The rear garden was redesigned last year and now provides a private and very pleasant environment for service users. The inspector was informed that the homes accommodation charges were between £295 and £345 per week at the time of this visit. A copy of the most recent inspection report is available in the home. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector completed this unannounced visit over one-day, it took approximately 8 hours. It included the inspection of care and other records, a discussion with the assistant manager and two members of the staff team. The inspector spoke with four residents and two visitors to the home. A partial tour of the building was also completed. Prior to completing this visit the inspector assessed the homes previous inspection reports and the service history. Twelve satisfaction questionnaires, which had been completed by the residents or their representatives, were also assessed as part of this visit. What the service does well: Individual residents care plans contain sufficient information, and are reviewed regularly enough, to ensure that staff have up-to-date information of what assistance and support each resident requires. The residents spoken with during the inspection said that they are very satisfied with the services provided by the home. They confirmed that staff are always friendly and respectful and that they ensure that the residents privacy and dignity is maintained at all times. The observed interaction between residents and staff was of a very good standard. The residents spoken with stated that the very happy with their bedrooms and confirmed that the been encouraged personal item with small items of furniture, photographs, ornaments etc. The homes manager is experienced and well qualified. She is ensuring that the home is run in the best interests of the residents. Residents and staff confirmed that the manager seeks their views about the way in which the home operates. The visitors spoken with during the inspection so that there are always made to feel very welcome and they believe the home has a friendly homely atmosphere. They confirmed that they are satisfied with the services their relatives receive. One resident said that they hope they will never have to leave the home and that they would recommend it to everyone. The premises have been maintained to a good standard and there is a secure garden area, which is accessible to all residents. There was some aspects of good practice highlighted the main body of the report. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 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. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 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 Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 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. The literature supplied to prospective residents is well presented and contains sufficient information for them to make an informed choice as to whether the home will meet their needs. Evidence on the day of this inspection indicates that the home is not obtaining preadmission assessments to ensure that they can meet the residents’ needs. The home does not provide intermediate care. “Quality in this outcome area is assessed as adequate. This judgment has been made using available evidence including a visit the service. EVIDENCE: The literature supplied to prospective residents is comprehensive and provided in a user-friendly format. Three residents records were assessed as part of this visit. Two of the records did not contain any preadmission assessments. One of the resident’s files had a preadmission assessment form, but the dates indicated that this was completed the day after the resident moved into the home. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 9 The assistant manager stated that she believes that preadmission assessments are always obtained for residents, however they could not be located at the time of this inspection. The inspector stated that the registered person should not provide accommodation to a resident at the care home unless a qualified or suitably trained person has assessed the needs of the resident. The registered person should confirm in writing to the residents that having regard to the assessment the care home is suitable for the purpose of meeting the residents’ needs in respect of his health and welfare. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 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. Residents individual care plans contain sufficient information and are reviewed frequently, enough to ensure that staff are always aware of what support and assistance each resident requires. Residents’ health care needs are being met. The homes medication is generally very well managed however it is essential that medication is stored below 25°C as it can deteriorate and become less effective if stored at a higher temperature. Residents believe that they are treated with respect and that their right to privacy is upheld. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service.” EVIDENCE: Three residents care plans were viewed as part of this inspection, the care plans appeared to address all aspects of the residents’ daily life. It was noted that all of the care plans viewed had been reviewed and where necessary updated, each month, to ensure that staff always have up-to-date Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 11 information about this care and support each resident requires. (This is good practice). The residents bathing records are initially recorded on the central record where the information cannot be viewed in a confidential format. The inspector was advised that staff then transfer the information into individual residents care plans. However it was noted that the care plans frequently showed that residents were only having one bath a month. This was a result of staff failing to transfer information appropriately. It is recommended that each residents’ bathing records are kept on an individual sheet, which can be transferred to the care plan when required. The residents spoken with during this inspection said that they believed that the health care needs are being appropriately met. The records viewed during this visit confirmed this. The homes medication systems are generally well maintained. The medication was stored securely and the records of receipt and disposal of medication were well maintained. The homes controlled medication was checked and was found to be satisfactory. The inspector was informed that none of the current residents have chosen to administer their own medication. However the home has an appropriate risk assessment format should any residents choose to do so. It was noted that staff were not recording the temperature in the rooms where medication is stored. It is essential that medication is stored below 25°C as it can deteriorate and become less effective is stored at a higher temperature. The assistant manager stated that all staff who administer medication has now completed appropriate accredited training, however it was not possible to check this, as staff training records were not available at the time of this visit. All of the residents spoken with during the inspection said that the staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. The observed interaction between staff and residents was of a very good standard. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 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): 12,13,14,15. The home is providing a reasonable variety of activities and entertainment however a few residents said, in their satisfaction questionnaires, that they would like more activities. People are encouraged to make contact with family and friends. Where possible residents are encouraged to make decisions about their individual lifestyles. Every resident spoken with said that they enjoy the food provided by the home. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service.” EVIDENCE: Two of the residents’ questionnaires received prior to the inspection stated that the home did not always provide sufficient entertainment and activities. However the people spoken with during the inspection said that they were generally satisfied with the level of activities and entertainment. The assistant manager stated that a new member of staff has recently been appointed who will have specific responsibility for planning and implementing a range of activities. It was recommended that the staff prominently display the programme of activities to be provided. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 13 All of the residents spoken with, said that they can have visitors at any time and confirmed that their visitors are always made very welcome. They stated that they could see visitors in the lounge or the dining room, if it isnt in use, but that they generally choose to see people in their bedrooms. The visitors spoken with said that staff are always friendly and welcoming. Residents are encouraged to make choices about their day-to-day lives. An independent advocate employed by Age Concern chairs residents meetings. (This is good practice). The home has a comprehensive Access to Records Policy, however the assistant manager was unclear exactly what procedures should be followed if the resident or their representative asks to have access to a residents confidential records. The home has a four weekly rotating menu, which appears to provide a well balanced diet. When the diet records were checked it was noted that one resident was having all her main meals replaced with sandwiches. The inspector asked what was being done to ensure this person’s die it is appropriate. The staff stated that although she chooses to have her meals as sandwiches she likes the sandwich is to be hot and will generally eat the same lunch as the other residents. It was recommended that the contents of the sandwiches should be included in the diet records as evidence that an appropriate well balanced diet is being provided. All of the residents spoken with said that they are very satisfied with the food provided by the home. They confirmed that the cook asks them each morning, if they want the meal suggested on the menu, or if they would prefer an alternative. (This is good practice). Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 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): 16,18. Residents and their visitors believe that their complaints would be taken seriously and that appropriate action would be taken. The homes policies and procedures are not robust enough to protect residents from potential abuse. “Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service.” EVIDENCE: The home has an appropriate complaints procedure, which is available to residents, staff and visitors. The homes complaints records show that there have been no complaints since the last inspection. The Commission for Social Care Inspection has received no complaints about the home since the last inspection. The staff were reminded that all complaints, formal and informal, should be recorded to provide an overview of the nature and frequency of complaints received. All of the residents and visitors spoken with during this inspection said that they had never had cause to complain about the services provided by the home. However they were confident that the manager would deal with any concerns appropriately. The home has a policy on how to deal with allegations and incidents of abuse. The policy states that these issues must be reported to ‘named’ senior staff. Unfortunately it would not have been possible for staff to follow this procedure, at the time of this inspection, as the registered manager was abroad on Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 15 holiday. The second person identified on the procedure no longer works at the home. The senior staff on duty was unclear what process and procedures she would need to follow. It is essential that all incidents of abuse be followed up promptly and that staff are fully aware of the process and procedures they should follow. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 16 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 accommodation has been maintained to a very good standard. At the time of inspection the home was clean and there were no offensive odours. There is an appropriate infection control policy. Staff must ensure that the laundry door is kept locked when there is no staff in situ, to protect the residents health and safety. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service”. EVIDENCE: A partial tour of the premises was completed as part of this visit. The converted accommodation is comfortably furnished and well decorated. All of the residents spoken with during this inspection said that they liked their bedrooms and confirmed that they could use them at any time. They said that they had been encouraged to personalise their rooms with small items of furniture, photographs and ornaments. The residents confirm that the home is always kept very clean. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 17 The laundry is small but well equipped with washable wall and floor coverings. The relevant sections of the homes infection control policy were displayed, so that staff can have easy access to them. (This is good practice). The laundry door has a bolt fitted to the outside & a sign warning people that there is a step directly behind the door. On one occasion it was noted that the laundry door had been left unlocked. It is important that this door is always locked, when there is no staff in the laundry, as there is a significant trip hazard. Residents may also be at risk from the laundry equipment and possibly soiled linen. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,29. The staff rotas show that adequate staffing levels are being maintained. As the inspector did not have access to staffing records it was not possible to fully assess standards 29 and 30. “Quality in this outcome area is adequate. This judgment is be made using available evidence including a visit to the service.” EVIDENCE: The staff rotas provided prior to the inspection and those viewed on the day of inspection showed that sufficient staff are being provided, to comply with previously agreed staffing levels. The residents spoken with confirmed that although the staff are always busy they still find time for social interaction. At the last inspection a requirement was made that the Registered Manager must not appoint a staff member to commence work without a POVA first check, or an up-to-date CRB enhanced disclosure. As none of the staff records were available at this inspection it was not possible to check if the Registered Person is now complying with this requirement. Consequently this requirement is still considered to be outstanding. The information supplied by the registered manager prior to this inspection showed that a considerable amount of staff training has been provided. A fairly recently recruited member of staff stated that he had not commenced the Skills For Living Induction Training although he had enrolled on the course. As Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 19 no staff records were available this standard could not be appropriately assessed. Staff records must be kept in the home available for inspection at all times. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 20 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): 31,33,37,38. The home’s manager is well qualified and experienced. The home is run in the best interests of the residents. It is unclear if residents’ financial interests are safeguarded. Residents’ records are not always stored securely to ensure the confidentiality is maintained. Where checked the health and safety of residents and staff are generally, promoted and protected. “Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service.” EVIDENCE: The manager is well qualified and experienced she has completed the Registered Managers Award. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 21 Residents, staff and visitors to the home said that the manager is approachable and that she seeks their views about the way in which the home is run. There was evidence that the manager is regularly seeking the views of the residents to help improve the services provided by the home. The senior staff was unsure if the manager seeks the views of stakeholders in the community such as GPs and District Nurses. She was also unclear if the manager produces a development plan for the home. Two senior members of staff stated that the manager does administer small amounts of personal allowance for some residents. However they stated that they did not have any access to the money or the financial records. In the information supplied to the Commission for Social Care Inspection prior to this inspection, the registered manager stated that she does not have any involvement with any residents’ finances. The manager must confirm whether she administers any money on behalf of residents. If any money is managed then appropriate records must be maintained and available for inspection. The residents’ personal records are stored in a filing cabinet in the main reception area of the home. When the inspector arrived at the home the front door was open and they were several residents but no staff in the reception area. The filing cabinet in which the residents’ personal records were stored was unlocked making the records available to anyone who entered the home. Residents’ records must be stored securely at all-times to preserve confidentiality. The aspects of health and safety, assessed as part of this inspection, were generally well maintained. An independent health and safety assessment had been completed in January 2006 and a positive report had been produced. It was noted that the homes Legionella risk assessment appeared to indicate that the homes water systems should be tested once each week, however the records showed that they were only being tested once a month. It is recommended that the registered person consult the Environmental Health Officer to see if this is satisfactory. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 22 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 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X X X X 3 Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 23 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 OP3 Regulation 14(1) (a) (b) (c) (d) Requirement Timescale for action 27/09/06 2. OP9 13(2) 3. OP18 12(1) 13(6) 19 4. OP29 It is required that the registered person shall not provide accommodation to a resident at the care home unless the needs of the resident have been assessed by a qualified or suitably trained person. The registered person should conform in writing, to the resident that having regard to the assessment the care home is suitable to meet their needs. It is required that the 27/09/06 temperature in all areas where medication is stored is checked on a daily basis. The temperature must not exceed 25°C. It is required that staff are aware 13/11/06 of the procedures they must follow if there are any allegations or incidents of abuse. The Registered Manager must 27/09/06 not appoint a staff member to commence work without a POVA first check or an up to date CRB enhanced disclosure. (This requirement is outstanding from 02/11/06) Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 24 5. OP35 16 (1) Schedule 4 (9) 6. 7. OP37 OP37 17 (1) 17 & Schedule 2 It is required that the Registered 13/11/06 Manager informs CSCI if she administers any money on behalf of the residents. If money is held on behalf of residents’ appropriate records must be maintained and made available for inspection. It is required that residents’ 27/09/06 personal records are kept securely at all times. It is required that the records 13/11/06 identified in Schedule 2 of The Care Homes Regulations 2001 are kept in the home available for inspection at all times. 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. 5. Refer to Standard OP7 OP12 OP14 OP24 OP38 Good Practice Recommendations It is recommended that residents bathing records be kept individually so that they can be viewed in a confidential format. It is recommended that the programme of activities & entertainment for the residents be prominently displayed in the home. It is recommended that staff have a working knowledge of the procedure they should follow if a resident or their representative asks to view a residents personal records. It is recommended that the laundry room door is always locked when there are no staff in situ. It is recommended that the Registered Person seek advice from the environmental Health Officer about whether the homes Legionella Policies & Procedures are adequate. Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Rylands Care Home DS0000008795.V310550.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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