Inspection on 30/11/06 for Springfield Garth - North Yorkshire County Council

This inspection was carried out on 30th November 2006.

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

Springfield Garth - North... 05/11/08

Springfield Garth - North... 30/01/06

Springfield Garth - North... 05/10/05

Springfield Garth - North... 04/11/04

Springfield Garth - North... 17/06/04

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

CARE HOMES FOR OLDER PEOPLE Springfield Garth - North Yorkshire County Council Springfield Garth York Road Boroughbridge York North Yorkshire YO51 9EW Lead Inspector Kate Shackleton Key Unannounced Inspection 30th November 2006 08:20 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 Springfield Garth - North Yorkshire County Council DS0000034398.V322964.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. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Garth - North Yorkshire County Council Springfield Garth York Road Boroughbridge York North Yorkshire YO51 9EW 01423 322189 01423 323309 Address 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) North Yorkshire County Council Mrs Yvonne Elizabeth Cook Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: Springfield Garth is a purpose built home on two levels situated on the outskirts of Boroughbridge, where there are local amenities as well as transport links with Harrogate, Ripon and York. It is a care home owned and operated by North Yorkshire County Council. It was built over thirty years ago and provides personal and social care for 30 residents over the age of 65 who have no specialist needs. There is a vertical passenger lift in the home to aid access, as there are twenty-eight bedrooms located on both floors. The home also has 2 short stay places and day care for 6 further clients. There are gardens, with benches and a summerhouse, and car parking on site. At the time of this visit the weekly charge is £368:90. The home makes no additional charges. Service users are given an information pack either at the initial visit or on admission. The Commission for Social Care inspection reports are displayed in the home for anyone to read. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • A review of the information held on the homes file since its last inspection. • Information submitted by the registered provider in the Pre Inspection Questionnaire •An unannounced visit to the home, which lasted eight hours. This visit included a tour of the premises; talking to service users, care staff, and management. Examining some records and observing staff working with service users •As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: Springfield Garth continues to provide a comfortable and supportive environment, where residents are encouraged to offer their views about their day-to-day routines. One service user said “I am well looked after and taken care of.” Other comments heard were “Everyone is so willing” and “I can’t recommend it highly enough.” Emphasis is placed on maintaining the independence of people using the service and enabling them to exercise choice in key areas of their lives. Examples given included rising and retiring times, clothes, food and activities. This ensures that service users maintain some control. Staff provide support in a discreet and helpful manner promoting positive relationships with service users. A good choice of food and drinks are available. This ensures that service users receive a varied and nutritious diet. One service user spoken to said “The food is very good” The home maintains close links with the local community, with a volunteer visiting weekly to provide different activities. The district nurse visits daily and the GP holds a weekly surgery in the home. Visitors are encouraged and made welcome. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 6 The staff are provided with comprehensive training to improve their knowledge and skills ensuring that service users receive care from a well-informed staff team whose practice is up to date. The safety of service users is an important aspect of the service delivered. It is demonstrated through good recruitment practices, risk assessments, staff training and the servicing of equipment. 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. The summary of this inspection report can be made available in other formats on request. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.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 Springfield Garth - North Yorkshire County Council DS0000034398.V322964.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3. Standard 6 does not apply to this service. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users do not receive enough information in time to make an informed choice about where to live. They are not provided with a range of care homes to choose from. EVIDENCE: The service user guide does not contain all of the information that it should. It is not given to potential service users at the outset of discussions with people who are contemplating going to live in the home. This means that they cannot make an informed decision as to whether or not they want to make an initial visit to have a look around. It is more usual that the guide is given to people when they first visit or on arrival in the home. Senior managers of the organisation responsible for the admission of people into Springfield Garth must make sure that potential service users are given a complete service users guide at the time when first discussions take place. This is usually when the organisations community care manager makes the initial visit to the service user /relatives. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 9 Service users and relatives spoken to confirmed that had not been given a service user guide prior to admission. One relative spoken to said that they had gone on to the Commissions website to read the most recent report on the home to get some information. During this visit a potential service user arrived with her family to have a look around with a view to admission. Discussions with the family found that they had not been provided with the service user guide and were not being offered a choice of home in their home town. They had been told that if they didn’t accept the place in Springfield Garth the only other place available was in another Local Authority home in a town even further away. Discussions held with the Local Authority commissioning department confirmed this to be the case. Due to financial restraints potential service users are to be only offered places in Local Authority homes even though the homes may be miles away from the service users hometown. Service users have no real choice. It is only in exceptional circumstances that alternative arrangements will be made and permission has to be sought at a senior management level. Staff spoken to confirmed that they are given all the information they need about new admissions so that they can deliver the appropriate care. A member of staff is always allocated to be responsible for helping the new person to settle in until a keyworker is allocated. Service users are given a statement of terms and conditions which sets out the rights and responsibilities of both the County Council and the service user. It also informs people of other useful leaflets which are included in the information pack and displayed in the entrance to the home. Potential service users have a full assessment prior to an admission date being arranged. A manager from the home visits to discuss the care the service can provide and answer any questions that service users may have about living at Springfield Garth. Everyone is offered the opportunity to visit for a look around and is admitted subject to a six week trial period. The homes Quality monitoring system includes a customer care survey to test service users satisfaction with the admission procedure. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal and health care needs are met. EVIDENCE: Service users case tracked confirmed good practice. Improvements have been made to the content of the care plan. Needs are clearly identified and there are clear instructions as to the level of support that staff need to provide. The promotion of independence is a key aspect of the service delivered. Plans are reviewed regularly and there are daily handovers of information to keep staff up to date. Files included a range of risk assessments. Everyone has a nutritional assessment to highlight any potential problems which would then be discussed with the primary health care team. The aims and objectives of the home reinforce the importance of treating service users with respect and dignity. In discussions with staff they were able to give numerous examples of how they do this when delivering personal care. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 11 Service users are registered with a General Practitioner and are able to access other health care professionals as and when needed. As part of the initial assessment it is discussed who is to be responsible for the administration of medication. Service users can if they want to and subject to a risk assessment self medicate. Medicines are administered and stored in a safe manner. Staff receive training in this aspect of their work. Discussions held with service users and visitors confirmed that they were very satisfied with the care service that they receive and highly commended the staff team. Comments like “I am well looked after and taken care of” and “Everyone is so willing” were heard. One visitor said “I cant recommend it highly enough.” Service users looked clean and well cared for. Staff were observed providing a service in a kind and helpful manner. Relationships between service users and staff were positive and friendly with good-natured banter being exchanged. Staff spoken to confirmed that they receive training and practical advice in caring for service users. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive a service that they are content with. EVIDENCE: Service users said that the daily routines are very flexible. They were able to give examples about the choices they can make in key areas of their lives. Staff were observed supporting people to do this thereby retaining some control. There is a key worker system which enables closer service user staff relationships where likes dislikes and needs are shared. Staff training and the homes policies and procedures focus on service users being in control of their lives. Throughout the day service users were occupying themselves watching TV, conversing with each other, their visitors and staff, reading, listening to music, and moving freely around the house. Service users spoken to said that appropriate activities are arranged. The home was just starting with the Christmas activities and was preparing for a Christmas Fayre taking place at the weekend. An activities programme is displayed and two afternoons a week staff are designated to provide some recreational activity that service users Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 13 enjoy. Religious services are held in the home and arrangements can be made for people to attend church. Service users spoken to were satisfied with the meals provided. Service users are able to contribute to menu planning at their service users meetings. They are also surveyed about this aspect of service delivery. One service user said that if she couldn’t sleep and wanted either a drink or something to eat during the night it is available. There is a choice of food at all mealtimes and special diets are catered for. Catering staff know service users likes and dislikes regarding food. The cook has had specific training in the nutritional needs of older people. Breakfast was observed and service users came to the dining room as and when they were ready. There was a wide variety of food available. Lunch was taken with service users. The meal was hot and tasty. The dining room tables were attractively set with tablecloths, cutlery and condiments. Meals are plated and served by staff. The mealtime was relaxed and unhurried. People were given enough time to eat their food and discreet support was offered where needed. Staff checked that everyone had had enough to eat. Service users mostly eat in the dining room but can have their meal elsewhere in the house. In order to further promote independence consideration should be given to enabling service users who can to serve themselves from tureens. This would require careful supervision to make sure everyone got enough to eat. Cold drinks are strategically placed around the home so that service users can help themselves. Visitors are encouraged and made welcome. A number of visitors were seen in the home at the time of this visit. Some spoken to said that they can visit at any time and staff take time to talk to them. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel able to air their concerns without any fear of repercussions. EVIDENCE: Three service users and two relatives spoken to were not aware of the County Councils complaints procedure. Despite this two service users said they would speak to the manager and one said she would tell her daughter if she had a complaint. The relative felt it would be easy to discuss any concerns with the manager. No one was aware of the formal procedure regarding taking it further if still dissatisfied and the timescales involved. The manager says that everyone is given the procedure as part of the information pack on admission and it is displayed in the home. Records examined showed that complaints are dealt with speedily. The policies and procedures regarding the safeguarding of service users are robust and in line with best practice. Staff receive training in this aspect of their work including whistle blowing. Staff spoken to were very clear about reporting any suspicion or allegation of abuse. The homes aims and objectives includes the rights of residents and staff understand the importance of actively promoting individuals rights. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a clean, safe and comfortable home. EVIDENCE: A tour of the premises showed that the home is furnished and decorated to a good standard. Christmas decorations were up and the home looked very festive. There are a number of communal lounges and other smaller sitting areas around the home. This provides service users with a choice of place to sit quietly, meet with family and friends or be actively engaged with other service users. Bedrooms do not have ensuite facilities. Service users are encouraged to bring in personal possessions and items of furniture. This helps to promote feelings of ownership. One service user said it is nice to have familiar things around. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 16 There are four bathrooms with assisted bathing facilities and toilets are placed strategically around the home. Commode facilities are available in bedrooms if needed. Call bells are within reach of service users. The home is clean and fresh. The service employs staff specifically to do domestic duties. Clinical waste is properly managed and disposed of safely. Service users and visitors spoken to were satisfied with the overall cleanliness of the home. One visitor commented that it never “smells.” Aids and adaptations are provided and regularly serviced. The home employs a handyman who is responsible for routine maintenance and the monitoring of some health and safety aspects of the premises. The garden areas are well maintained and the courtyards are made attractive with planting and other garden features. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff who are properly vetted and trained to ensure a good standard of service delivery. EVIDENCE: Since the home was last inspected some staff shifts have been changed to accommodate the introduction of flexible breakfasts. Staff were observed responding quickly and appropriately to requests from service users and spent time talking to them. Service users spoken to say that staff are always available to provide appropriate support and that they felt safe living in the home. One service user said “Everyone is very nice to me.” The rota shows that there are enough staff employed on each shift and especially at times of peak activity. The home has its own relief staff that they can call on in times of staff sickness and holidays. Agency staff are sometimes used. Staff files examined showed a satisfactory recruitment process, which endeavours to make sure that only suitable people are employed. All staff are subject to a probationary period. There is an induction programme that Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 18 ensures new staff members are given the right information to be able to do their jobs well. Staff spoken to said that the on going training programme is good, providing them with the skills and knowledge to meet service users needs. The training programme includes all the mandatory training needed to meet service users basic needs such as lifting and handling, food hygiene, and health and safety. Staff say that they are able to identify their training needs in supervision sessions with their manager. A number of staff have achieved National Vocational Qualifications level 2 or above. Training is targeted and focussed on improving the safety and quality of life for people living in the home. This ensures that service users receive a service from an informed staff team whose practice is up to date. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes the right of service users to enjoy a good quality of life. EVIDENCE: The manager is qualified and experienced in managing services for older people. People who use the service say that they receive a reliable service from staff who are courteous, respectful, and deliver services in a responsible and professional manner. They also say that the management team are approachable and easy to talk to. Regular service user meetings, staff meetings and staff supervision promotes an open and transparent management style that endeavours to meet the needs and wishes of service users. The home has sound policies and procedures in line with current Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 20 thinking. Efficient systems are in place to monitor staff adherence to policies and procedures in their practice. The Quality Assurance scheme involves a quarterly Policy Performance Review. The quality monitoring system seeks the views of service users through a “Customer care survey” There is a service improvement and development plan that sets timescales for improvements to be achieved. A senior manager of the organisation does monthly audits of the service. These visits include discussions with some service users to ascertain their views on the service they receive. Service users are encouraged to manage their own financial affairs and spend their money as they wish. Staff provide support for service users who require help in managing their finances and there is a robust procedure in place to protect service users from financial abuse and directs staff in their practice. The home works to a clear health and safety policy and regular safety checks are carried out. Following a visit from a fire safety officer in October 2004 a recommendation was made regarding work required to some fire doors. This work has not been done despite it having been referred to the appropriate buildings department. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 1 3 3 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 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 5 Requirement In order to allow an informed decision to be made, the service user guide should be given to potential service users when first discussions take place about their admission to the home. The guide must include a copy of the most recent inspection report. The work relating to some fire doors that the fire authority recommended in its October 2004 report must be done. Timescale for action 31/12/06 2 OP38 23(4) 31/01/07 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 Refer to Standard OP14 Good Practice Recommendations To promote further independence, service users should be offered the opportunity to serve themselves at mealtimes. Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Springfield Garth - North Yorkshire County Council DS0000034398.V322964.R01.S.doc Version 5.2 Page 24 - 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!