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Inspection on 04/07/06 for Springwater Lodge Care Home

Also see our care home review for Springwater Lodge Care Home for more information

This inspection was carried out on 4th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents spoken with indicated that they feel safe residing in the home and that they are well taken care of. The fixtures and fittings are maintained to a very high standard creating a homely environment. A number of resident choices are evident in pastimes, hobbies and meals, which are varied and well presented; most comments about meals were positive. All residents spoken with indicated that they are satisfied with the overall care given in the home. St Wilford`s Walk, the new area for residents with dementia is providing a pleasant environment to a high standard where residents with dementia can receive good quality care from staff who have received appropriate training. Residents spoken with in this area were positive about their environment and the care they received.

What has improved since the last inspection?

Residents` plans are kept under review and where incidents happen families are informed as soon as possible. The information regarding complaints is now up to date and staff training is now up to date and staff confirm that they are able to access a variety of courses.

What the care home could do better:

Care plans could be improved by making them more individual to the resident where as at present they have a more generic approach. Although medication is generally handled in accordance with policy and procedure there are minor shortfalls that need to be improved upon, the thermometer for the fridge was not working and where staff have given medication to a resident from another source i.e. hospital medication and not the blister pack then this must be written somewhere to ensure a clear audit trail is made. Although residents were not negative about the food it was evident from looking at the food stock that there is a heavy reliance on frozen food and very little use of fresh fruit or vegetables. The Registered Person must ensure that sufficient supply is available at all times. A recurring theme from staff and relatives was that there did not seem to be enough staff on duty to meet the needs of the residents. The Registered Person must look at the dependency levels within the home and show that there are enough staff on duty to meet those needs.

CARE HOMES FOR OLDER PEOPLE Springwater Lodge Care Home 10 Smithy View Calverton Nottingham NG14 6FA Lead Inspector Susan Lewis Key Unannounced Inspection 4th July 2006 10:00 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 Springwater Lodge Care Home DS0000040348.V288122.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. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springwater Lodge Care Home Address 10 Smithy View Calverton Nottingham NG14 6FA 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 9655527 0115 9655310 springwaterlodge@highfield-care.com None Southern Cross Care Homes No 2 Limited Manager post vacant Care Home 50 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (50), Physical disability (6) of places Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No one falling within category OP to be admitted into Springwater Lodge Care Home when there are 50 persons of category OP already accommodated in the home No one falling within category PD to be admitted into Springwater Lodge Care Home when there are 6 persons of category PD already accommodated in the home No one falling within category DE to be admitted into Springwater Lodge Care Home when there are 12 persons of category DE already accommodated in the home The maximum number of persons accommodated within Springwater Lodge Care Home is 50 13 September 2005 Date of last inspection Brief Description of the Service: The fees for this home are £319 -£600. Springwater Lodge is a detached, two storeys and purpose built care home in the village of Calverton, established in 1990. It is set back from the main road, within 500 yards of local amenities. It offers personal care for people over the age of 65 years and can cater for a broad range of needs. The home is registered for fifty beds six of which may be used for people with physical disabilities and two beds for palliative care. The living accommodation comprises of 41 single and one double room all with ensuite facilities spread over two floors, as well as bathing and toilet facilities and a lounge and dining room. A passenger lift provides access to the first floor. There is a visitor’s lounge, which is also utilised by service users as a quiet/reading room. The home has recently varied its registration to include the category of dementia. St Wilford’s Walk is created specifically to meet the needs of up to 12 residents with the primary need of dementia and it is pleasant and clean with doors of residents bedrooms colour coded to ensure residents are able to find their bedroom. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records, talking with them where possible, and looking at their accommodation. The inspection was unannounced and took place over 8 ½ hours one Tuesday in July 2006, and was conducted by one inspector as part of the key inspection process. A tour of the building took place and a selection of residents’ bedrooms was inspected. Residents’ records were inspected and residents and staff on duty were spoken with. Visiting relatives were also spoken with. What the service does well: Residents spoken with indicated that they feel safe residing in the home and that they are well taken care of. The fixtures and fittings are maintained to a very high standard creating a homely environment. A number of resident choices are evident in pastimes, hobbies and meals, which are varied and well presented; most comments about meals were positive. All residents spoken with indicated that they are satisfied with the overall care given in the home. St Wilford’s Walk, the new area for residents with dementia is providing a pleasant environment to a high standard where residents with dementia can receive good quality care from staff who have received appropriate training. Residents spoken with in this area were positive about their environment and the care they received. Springwater Lodge Care Home DS0000040348.V288122.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. Springwater Lodge Care Home DS0000040348.V288122.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 Springwater Lodge Care Home DS0000040348.V288122.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): 3 and 6 The quality in this outcome area is good. Residents are assured that they will have their needs assessed and met prior to moving to the home. EVIDENCE: This home does not provide intermediate care. Care plans viewed showed that residents were assessed prior to moving to the home and residents and relatives spoken with confirmed that they were assessed prior to moving to the home. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 9 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 and 10 The quality in this outcome area is good. Residents’ personal and health care needs are set out in a plan but lack individualism. Residents’ health needs are fully met; medication is handled well following procedures, a few minor shortcomings need to be addressed. Residents are treated with dignity and respect and their right to privacy is upheld. EVIDENCE: Plans showed that residents are assessed in a variety of areas including nutrition, pressure care and falls. The plan covers aspects of daily living and gives some information how staff are to support the resident. However they lack an individual identity and could refer to any resident. It is recommended that the Registered Person create plans that are individual to each resident to reflect their personal needs. There was some evidence that residents and/or relatives are involved in creating and reviewing the plan, residents spoken with knew they had a plan but could not remember if they were bale to see it. It is recommended that the Registered Person remind residents at regular intervals that they are able to see their care plans. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 10 Service users are supported to access health services as required and there was evidence within plans to demonstrate this. Appropriate services are liaised with to ensure service users have the required equipment and aids in place. Staff spoken with said that there was a link nurse who had responsibility for liaising with the Tissue Viability nurse to ensure residents had good skin care. Staff spoken with also understood the importance of maintaining good skin health and how to prevent or minimise the risk of sores in the first place. Each plan inspected showed that a risk assessment had taken place identifying whether a resident was able to self medicate or not. The medicines were stored in locked trolleys in a locked treatment room, staff spoken with regarding medication understood administration procedures and what to do in the event of an error. Medication viewed tallied with numbers in stock and the manager and staff said that an audit of medication takes place every Sunday. However it was noticed that for one identified resident the blister pack contained an extra tablet. The staff explained why this was the case but it was not recorded on the back of the Medication Administration Record sheet to ensure a clear audit trail. The Registered Person must ensure that all medication can be accounted for. The thermometer in the fridge no longer worked and was providing misleading temperatures and so the Registered Person must replace this. Staff spoken with understood the importance of maintaining residents privacy and dignity, residents and relatives spoken with confirmed that staff were polite and knocked on their door before coming in. During the tour of the building residents were observed to be clean, with their hair tidy and their clothes clean this shows that staff are ensuring residents dignity by maintaining their appearance. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 11 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 and 15 The quality in this outcome area is adequate. Residents find the lifestyle in the home mostly meets their preferences and mostly satisfies their social, cultural and recreational interests. Residents are able to maintain contact with their family and friends as well as exercise control over their lives. Residents’ meals are provided in adequate surroundings in the main building but are significantly better in St Wilford’s Walk. EVIDENCE: Residents spoken with said that they were able to make a choice regarding food but not necessarily around meal times, as breakfast was a set time from information received from the Pre-Inspection Questionnaire (PIQ) breakfast is from 8.00am. It is recommended that the Registered Person remind residents that there is some flexibility at meal times to accommodate their preference. Care plans showed where residents had a religious belief and diary notes showed where residents were supported to attend a service or other activity. Most residents spoken with said that they could choose how they spent their day and staff were observed in both St Wilford’s Walk and the main building encouraging residents to take part in a variety of activities, such as sewing or dominoes. Residents spoken with said that they were able to have visitors whenever they wanted and relatives spoken with confirmed that they were Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 12 welcomed at any reasonable time. A menu was provided in the PIQ which showed a choice was provided at every meal and residents spoken with confirmed this and said that food was ‘generally ok’. Staff spoken with said that they felt meals were ‘all right’ but obviously provided on a budget and so the quality varied a great deal. There was an adequate supply of food in the kitchen however the fresh vegetables were very limited and there appeared from the amount of food in the freezer a heavy reliance on frozen vegetables. There was very little fresh fruit available. The manager said that fresh fruit and vegetables were delivered every Friday. The inspection was held on a Tuesday and there was very little in evidence. The Registered Person must ensure that sufficient fresh fruit is available for residents. The staff also said that they recently had a ‘fish and chip’ supper evening, which residents ‘really enjoyed’. The dining area in St Wilford’s Walk was pleasant and clean with crockery and table decorations. The dining area in the main unit was less congenial as it did not have any of the same place settings as in St Wilford’s Walk. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 13 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 and 18 The quality in this outcome area is good. Residents and relatives feel able to complain and are confident they will be listened to. Residents are protected from abuse. EVIDENCE: The Commission has received no complaints since the last inspection. The home has received three and from evidence seen these have been dealt with according to the policy and procedures with satisfactory outcomes. The Commission has no concerns in this area. Residents spoken with all said that they felt comfortable to complain to a member any member of staff and it would be dealt with. Staff spoken with had a clear understanding of what to do if someone complained to them. Staff spoken with had received Abuse Awareness training and understood what constituted abuse and what to do if they witnessed or suspected it. Residents spoken with said they felt safe and staff were kind and spoke to them with respect. Relatives spoken with said they felt their loved one was cared for very well and did not have worries about leaving them at the end of a visit. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 14 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 and 26 The quality in this outcome area is adequate. Areas of the home are well maintained and improvements are planned for other areas. The home is clean and hygienic. EVIDENCE: The home is accessible and suitable for its stated purpose. It is mostly comfortable if somewhat institutionalised in it set up in the open plan dining room and lounge in the Older Person area. St Wilford’s Walk is pleasant and more homely in the way the furniture is laid out and staff use the space. There is evidence of routine maintenance with bedrooms being decorated. The garden is a pleasant space for residents to wander into and sit. Evidence from the Pre-inspection Questionnaire shows that the home complies with fire regulations. Plans were seen for the laundry area to be completely refurbished this would improve the capacity and facilities. The washing machines meet the regulatory standards. The home was clean and hygienic. Staff spoken with had a good Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 15 understanding of infection control and how to maintain residents safety from infection. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 16 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, 28, 29 and 30 The quality in this outcome area is good. It is not clear that there are sufficient staff to meet residents’ needs. Residents’ benefit from a trained and experienced staff group, residents are supported and protected by the homes recruitment policy and practice. Staff are trained and competent to do their job. EVIDENCE: A copy of the staffing rota was provided with the PIQ and identified how many staff on duty and in what role. Residents said that staff were very busy but usually came fairly promptly when you asked for help, staff said that staffing was difficult as occasionally staff did not turn in for a shift, but the manager worked hard to get cover, however they felt that sometimes there were not enough staff to meet the needs of the more dependent residents. There are currently seven residents who are confined to their bed and need regular care to minimise risks to their skin. This takes staff away from being with other residents. The manager reported that she has recently recruited some more staff and is awaiting Criminal Records Bureau clearance and references before they start. Relatives spoken with also felt that some of the problems their relative had experienced such as laundry going missing or sometimes not having clean clothes on stemmed from too few staff. The Registered Person must ensure that staff numbers are sufficient to meet the needs of the residents. Staff training files showed that there are 50 of care staff with NVQ or over, this ensures that residents benefit from well trained staff. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 17 Recruitment files were viewed and evidenced that thorough recruitment practices were taking place, with two references and Criminal Records Bureau checks taking place. Where staff were from oversees appropriate Home Office clearance was also obtained. Evidence was seen of staff induction and mandatory training staff confirmed that they are able to access training easily and where their First Aid or Food Hygiene training needs renewing they are able to renew the training. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 18 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, 35 and 38 The quality in this outcome area is good. Residents’ benefit from a well run home. The home is run in the best interests of the residents and the health, safety and welfare of residents and staff are protected and promoted. EVIDENCE: There is new manager in post and she has applied to be registered as manager with the Commission. From information supplied in the Statement of Purpose she has 20 years of experience in the care of the elderly and has recently completed her NVQ 4 manager’s award. The home is part of the Southern Cross group of homes and therefore part of the their quality control system. During the inspection there managers from other homes visiting to carry out a quality audit on the care plans. Evidence was seen of Residents meetings and residents spoken with said that they feel listened too if they want to change something. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 19 Evidence from the PIQ showed that policies and procedures are reviewed regularly. Support plans show that relatives act as Power of Attorney and no staff from the home have this role. Money is kept securely with two staff signing for all transactions. Health and safety is closely monitored in the home with regular Health and Safety meetings being held. Staff receive appropriate training to ensure they are able to maintain not only their own safety but that of the residents. Water temperatures are monitored and PAT is carried out. There are window restrainers fitted to all windows ensuring residents are safe from falling out of the windows or someone climbing in. Accidents and incidents are recorded and passed to the Commission for information, so care can be monitored. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 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 3 Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 21 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 OP9 Regulation 13(2) Requirement The Registered Person shall make arrangements for the recording, handling, safekeeping and safe administration of medication in the care home. Where medication has been given from another source leaving the blister pack with excess this must be clearly recorded. The Registered Person shall make arrangements for the recording, handling, safekeeping and safe administration of medication in the care home. A new thermometer must be obtained for the fridge. The Registered Person must provide, in adequate quantities, suitable, wholesome and nutritious food, which is varied and properly prepared and available at such time as may reasonably be required by service users. The Registered Person shall, having regard to the size of the care home, the statement of DS0000040348.V288122.R01.S.doc Timescale for action 01/09/06 2 OP9 13(2) 01/09/06 3 OP15 16(2)(i) 01/09/06 4 OP27 18(1)(a) 01/09/06 Springwater Lodge Care Home Version 5.2 Page 22 purpose and the number and needs of service users ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. It must be established there are sufficient staff on duty at all times to meet the needs of the residents. 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 OP7 OP12 OP15 OP19 Good Practice Recommendations That the Registered Person makes the care plans individual to the residents personal needs. The Registered Person remind residents at regular intervals that they are entitled to see their care plans. The Registered Person should ensure that residents know that there is some flexibility in meal times. The Registered Person should make fresh fruit available at all times for residents. The Registered Person should improve the use of the communal space to encourage residents to interact more with each other and staff. Springwater Lodge Care Home DS0000040348.V288122.R01.S.doc Version 5.2 Page 23 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 Springwater Lodge Care Home DS0000040348.V288122.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!