Inspection on 01/07/05 for Sparrowfields

This inspection was carried out on 1st 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 18 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sparrowfields 31/05/07

Sparrowfields 05/07/06

Sparrowfields 13/12/05

Sparrowfields 16/12/04

Sparrowfields 05/08/04

Sparrowfields 03/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Sparrowfields 17-19 Alwold Road Weoley Castle Birmingham B29 5RR Lead Inspector Alison Ridge Unannounced 1 July 2005 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. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sparrowfields Address 17-19 Alwold Road Weoley Castle Birmingham B29 5RR 0121 428 2848 0121 428 2849 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) Shaw Healthcare Ltd Ms Julie Quigley Care Home 6 Category(ies) of Younger Adults, Learning Disability registration, with number of places Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate 6 Service Users with a learning disability aged 18- 65. Date of last inspection 16 December 2004 Brief Description of the Service: Sparrowfields was recently purpose built as a care home. The home accomodates six men, who all have a learning disability, and some additional needs regards challenging behaviour. The accomodation comprises of a kitchen, laundry room, main lounge with access to the garden, a quiet lounge, and a dining room on the ground floor. On the ground floor are two toilets, for staff and visitors use. On the first floor, are six single bedrooms, all with ensuite, a communal bathroom, and a room used by staff for medicines storage. The home has a small garden to the rear, which includes a shelter for smokers. At the front of the home is parking for several cars. The home is located in Weoley Castle, and is close to main transport links. Shopping and leisure facilities are available in Weoley Castle, Northfield and Birmingham would be accessable. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector, and a new Provider Relationship Manager on induction undertook this inspection. It was their first visit to the home. During the visit they were pleased to meet and talk with four of the six men who live in the home, the staff on duty and the manager and deputy manager. The inspectors looked at all the communal areas of the home, and in three of the bedrooms. The inspectors also looked at the number of staff on duty, checked that staff are checked before they start work in the home, looked at records of care, activities, and some health and safety records. What the service does well: The inspectors spoke with four of the six men who live at Sparrowfields. With one exception, all the men reported favourably regarding all aspects of living in the home. Feedback about staff, food, their room, activities, contact with family and friends was all positive. How the people who live at Sparrowfields wish to live, and be supported is recorded in an Essential Life Plan. (ELP) The inspectors found these very detailed, and very individual to each person. Three people the inspectors asked about these confirmed they had been involved in writing them, and that staff help them achieve the goals they set. The men who live at Sparrowfields get out of the home to undertake activities very regularly. The men, staff and records of care show activities are offered each day. These can include sports, courses, using local amenities, visiting family, and visiting places of interest. The inspectors found the home to be very well organised. With one exception all the records were up to date, and in very good order. The staff inspectors worked with knew where the required information was. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 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. Sparrowfields E54 S32644 Sparrowfields V235023 010705 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 Sparrowfields E54 S32644 Sparrowfields V235023 010705 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) x None of these standards were assessed. EVIDENCE: The home had no residential vacancies, and has had no new admissions since the last inspection. These standards were not assessed. Sparrowfields E54 S32644 Sparrowfields V235023 010705 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) 6,7,8,9,10 Service users needs had been well assessed and planned, ensuring their needs are continuously met, in the way they prefer. EVIDENCE: The plans of three of the service users accommodated were assessed in part. The home uses the model of Essential Life Planning (ELP) to assess and plan service users needs. The plans were very individual and the service users inspectors spoke with reported they had been involved in writing and reviewing them. All the plans had been reviewed monthly. The process by which the review decision is made needs to be made clear. The service users inspectors spoke with reported they are able to decision make. They gave examples of activities, food, decorating their room, and how to spend their money. The home places numerous restrictions on the freedom of people, by locking some of the doors, windows, and cupboards within the home. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 10 The inspector is aware of the complex needs of the service users accommodated, but could not evidence that all the restrictions were necessary, or that they had been kept under review, or that training to help people develop skills and habits that would result in restrictions being lifted were in place. Examples of this included that two ground floor toilets were locked. This was reported to be because a service user had used the facilities inappropriately. Inspectors found this person no longer lives in the home, yet the restriction had not been reviewed. An example regarding the provision of toilet rolls and towels was discussed. These were not freely available in communal bathrooms. While the inspectors appreciated this can cause problems if large quantities are flushed by service users, actions such as exploring options for storage of the items or limiting the amount available for example were not evident. Service users accommodated have significant risks associated with them. The assessments in place were detailed, and current. The inspector could not evidence how the service users were being supported to develop skills in the areas they are at risk. The information regarding service users was generally safely stored, and the interactions between staff and service users did not breach any confidential information. The ”skills room”, window opens fully, and it is recommended that information held within here be reviewed, to ensure confidential information is not at risk. Sparrowfields E54 S32644 Sparrowfields V235023 010705 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) 11,12,13,14, 17 Opportunities to undertake development and leisure activities are available, and as far as possible are tailor made to service users preferences and needs. EVIDENCE: Discussions with service users, and information contained in their files evidenced that opportunities to develop new skills are offered. This can be formally by attendance at a college course, or more informally within the home, by helping for example with basic household tasks and cooking. The inspectors spoke with service users about activities available to them. A range of in house activities including watching TV, listening to music, playing computer games, and exercise are available. Other activities offered include playing sport, bike riding, eating out, having a drink at the pub, shopping, and playing Bingo. The service users the inspectors spoke with about activities reported very favourably about them. The menu of food offered was wide and varied. It was reported that the staff and service users choose the menu. The two service users the inspectors Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 12 spoke with about food, said that alternative meal would be offered if you didn’t like what was on the menu. Both people said the food was very good. The restrictions placed on service users results in access to drinks and food being restricted. It is recommended that a supply of drinks be available to service users in the communal areas of the home, or in their room. Sparrowfields E54 S32644 Sparrowfields V235023 010705 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 Service users are supported or encouraged to undertake personal care in a way and at a time suited to them. Healthcare monitoring is provided, but not consistently recorded, which could result in service users needs being unmet. Medication is given at the right dose at the right time. EVIDENCE: It was apparent during the inspection, that service users are encouraged to undertake personal hygiene daily, but that this is not always the person’s preference. Inspectors found staff worked sensitively and supported service users with personal care at a time suited to them. It was pleasing to see that the home has commenced Health Action planning with service users. The manager reported work to complete the implementation of the plans will continue. Opportunities to attend healthcare appointments were tracked in two service users files. In one file access to the dentist, optician and community nurse was evident. In the other file only optical care was evident. Records of appointments offered and attended need to be maintained, and staff must ensure people are offered access to healthcare as required. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 14 It was evident that the home had recently recorded the weight of the service users. It was identified this needs to be undertaken regularly, as agreed with the service user, and dependent on needs in this area. The inspector identified that the plans do not detail the support service users require at night, and it has been required this be added into the plan. The plans of two service users with epilepsy were assessed. The plans contained basic good practice guidance to staff, but were not specific to the service users. It was recommended the plans be further developed to include the individuals specific care needs. These plans must be kept under review. Medication is provided by a local pharmacy in a monitored dosage system. The inspector found the day-to-day administration and management of medication to be good. Requirements have been made regarding, 1) Copying the FP10 prescription, and ensuring medication dispensed from the pharmacy is as prescribed, 2) Reviewing the homely remedy policy, which is generic. Inspectors identified some items included in the policy that would contra-indicate some of the regular medication. 3) The use of Glycerin suppositories which homes staff are not qualified to administer must also be reviewed. 4) One service user self-administers medication. A protocol for assessing competence to undertake this has been forwarded to the home. Sparrowfields E54 S32644 Sparrowfields V235023 010705 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) x None of these standards were assessed. EVIDENCE: None of these standards were assessed. Sparrowfields E54 S32644 Sparrowfields V235023 010705 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) 24,25,26,27,28,30 Sparrowfields is not domestic or homely. It is not well suited to the needs of the service users accommodated. EVIDENCE: The inspectors did not find the premises comprising Sparrowfields to be homely. The inspectors did not find the arrangement of the building to be conducive to the care and support the men accommodated require. The communal lounge is not a useable shape. The furnishings in the room were comfortable. Action to secure the laminate floor by the patio door had been undertaken, however it was still apparent the floor was lifting. The dining room was sparsely furnished. An unpleasant smell of urine was evident in the room. The home has second smaller lounge. The door to this room was locked. The inspectors have required this be reviewed with West Midlands fire service as the patio door within the room is identified as a fire escape. Furnishings in here did not compliment the space available. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 17 The kitchen has been refitted with new cupboard fronts. At the time of inspection it was awaiting decoration, and the arrival of a new cooker. The home has two ground floor toilets. Both of these were locked, and reported not to be available for service users to utilise. At least one toilet on the ground floor must be provided. Adequate storage for COSHH Items must be obtained, as at present these are located in the disabled toilet. The inspectors thank the three service users who kindly showed them their bedrooms. The rooms were very individual in style, and the service users reported being pleased with the rooms, and involved in the choosing of the colour schemes. The inspectors did identify that not all rooms have furniture as listed in standard 26. This must be reviewed with each service user, and items obtained if they wish, or evidence that it is not in the service users best interest included in risk assessments and care plans. Each of the rooms visited had some items of broken or damaged furniture. These must be replaced. Each of the bedrooms has an ensuite shower room. The cleanliness of the communal bathroom required attention at the time of the inspection, and a supply of soap, towel and toilet roll must be provided. The home had received a visit from the Food Safety team, on the day prior to inspection. The report of the visit was very positive. The inspectors identified two products in the fridge that required discarding. Air tight storage for dry goods, such as flour, pasta and cereal must be provided. Food leftover from the previous day was found in the microwave. Practices to safely store or discard leftover food must improve. Facilities for service users and staff to wash their hands after handling laundry must be provided. Sparrowfields E54 S32644 Sparrowfields V235023 010705 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) 32,33,34,35,36 Staff recruitment, training and supervision records identify that staff have relevant skills, experience and support to undertake their job role and meet service users needs. EVIDENCE: The homes training matrix identifies that staff have been provided with most mandatory training. Inspectors assessed the system for identifying if/when training is required was robust. The recruitment records of two recent staff starters were assessed. It was apparent the recruitment process followed is robust. It has been recommended that the relationship between people asking for and providing references be further clarified, as in both cases two of the three references obtained were from people describing themselves as, ”colleagues” and “friends”. Supervision records for four staff identified that three of the staff had received supervision on a regular basis, and that the records were detailed. One staff requires supervision with increased frequency to ensure they receive at least six a year. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 19 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) 37,38,39,42 The management of the home ensures service users needs are met, and by a smooth running home. EVIDENCE: The manager of the home was present for most of the inspection. She appeared highly motivated, and responsive to questions and ideas regarding the service. She has previously been assessed as meeting the required minimum standards regards NVQ Level 4 training. The atmosphere of the home was open and inclusive. Inspectors were able to talk privately with service users, and service users confirmed feeling confident to raise ideas and concerns. It was also apparent that the service manager for the home is accessible to service users. Records of staff meetings were frequent, and open. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 20 Records of service users meetings showed no meting had been held since December 2004.Evidence that service users are consulted with must be available. The record of fire alarm tests was one week overdue, and due again at the time of inspection. All other fire records were up to date. The home checks and records the temperature of hot water. With the exception of the wash hand basin in the kitchen this was well controlled. A requirement regards this outlet was made at the time of inspection. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 21 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 x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 2 2 2 x 1 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sparrowfields Score 3 2 1 x Standard No 37 38 39 40 41 42 43 Score 3 2 2 x x 1 x E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 22 Yes 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 YA6 Regulation Requirement Timescale for action 1/9/05 2. YA16 3. YA19 4. YA19 5. YA20 6. YA24 and YA30 15(2)(b-c) The review process for service users plans must clearly state the process followed to reach the decision. 12(1)(a) Restrictions placed on service and users must be kept under 12(4)(a) review. Strategies to help people develop skills that would enable the relaxing or removal of the restrictions must be provided. 12(1)(a) Health appointments must be and offered, and a record of 13(1)(b) appointments offered and attended maintained. 12(1)(a) Weight monitoring must be undertaken regulalry according to service users needs, and as agreed by them. 13(2) Medication The FP10 prescription must be copied. The homnely remedy must be reviewed. Self administration of medicines must be underpinned with a risk and skills assessment. 23(2)(f)(g The dining room must be ) adequately furnished and odour removed/effectively managed. 1/9/05 1/8/05 and ongoing 1/8/05 1/9/05 1/9/05 Odour control by 15/7/05 Page 23 Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 7. YA24 23(4)(b) 8. 9. YA27 YA24 23(2)(j) 16(2) and 23(2)(f) The locked lounge door on route to a fire exit must be reviewed with West Midlands Fire service, and action identified by them undertaken. At least one toliet must be available on the ground floor. Bedrooms must contain furniture as listed in standard 26 unless it is the expressed wish of the service user not to have such items, or this is recorded in their care plan as not being in their best interest. Broken bedroom furniture must be repaired or replaced. Left over meals must not stored in the oven. All uneaten food must be stored safely to ensure the risk of food poisoning is reduced. All bathrooms must be maintained in a clean state, and toilet roll and handtowels must be provided. Secure storage must be obtained for all COSHH products. Airtight storage must be provided for dry food products. Food products must be used or discarded on or before the use by date. Hygienic handwash and drying facilities must be provided in the laundry Evidence of service users meetings and consultation must be available in the home. Fire alarm tests must be undertaken weekly and a record of this maintained. Hot water delivery temperatures must be maintained at 43 degree celsius. Refer by 25/7/05 1/8/05 1/10/05 1/8/05 25/7/05 10. YA30 13(3) 11. YA30 13(3) and 23(2)(d) 13(4) 13(3) 25/7/05 12. 13. YA30 YA30 1/8/05 25/7/05 14. 15. 16. 17. YA30 YA41 YA42 YA42 13(3) 12(2) and 16(2)(mn) 23(4)(c )(iv) 13(a) 1/8/05 1/8/05 25/7/05 8/7/05 Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 24 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 YA10 YA17 YA34 Good Practice Recommendations It is recommended that information stored in the skills room be reviewed to ensure confidentiality and security of the data is maintained. It is recommended that drinks be available freely to service users. It is recommended that the policy regards who can supply a references be reviewed to ensure these are from impartial, professional sources. Sparrowfields E54 S32644 Sparrowfields V235023 010705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sparrowfields E54 S32644 Sparrowfields V235023 010705 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. 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