Inspection on 26/10/06 for St Brannocks

This inspection was carried out on 26th October 2006.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Brannocks 16/10/08

St Brannocks 18/10/07

St Brannocks 03/11/05

St Brannocks 12/05/05

St Brannocks 25/11/04

St Brannocks 12/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 St Brannocks 7 Cromer Road Mundesley Norwich Norfolk NR11 8BE Lead Inspector Mrs Judith Huggins Unannounced Inspection 26th October 2006 04:55 St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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 St Brannocks DS0000027524.V317784.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 Adults 18-65. 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. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Brannocks Address 7 Cromer Road Mundesley Norwich Norfolk NR11 8BE 01263 722469 01692 650330 janithhomes.com@btinternet.com www.janithhomes.org Janith Homes Limited 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) Manager unregistered Care Home 7 Category(ies) of Learning disability (7) registration, with number of places St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: St Brannocks is a care home providing personal care and accommodation to 7 adults with a learning disability. A company operates the service and service users attend day services at the companies main home The Rookery. St Brannocks stands in the Norfolk seaside village of Mundesley and is easily accessible to all community facilities and to bus links to the city of Norwich. The home has its own transport. The home is located in an Edwardian house and all users have their own bedroom. The home has enclosed rear gardens, with a patio, lawns, flowerbeds and a greenhouse and vegetable garden. Inspection reports are available but would need to be explained to residents. The company’s website (www.janithhomes.org) says that inspection reports are available on request. Charges are from £2720 to £4612 per month depending on need. There are additional charges for transport to requested activities (but not for health care appointments), hairdressing, dry cleaning and personal spending. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The staff at the home were told the inspector would be coming, just before she visited. This is so she could be sure there would be someone at home, and that the manager would be there to help with some of the information. The visit to the home lasted just over three and a quarter hours. The manager was on duty by himself so the inspector needed to try and make sure he could spend time with the residents as well as helping her. Six of the people living at the home spoke with the inspector. The inspector looked at the things that were written down about four of those people. All of the people living there sent forms in to say what they thought about the home. The inspector also looked at five of the bedrooms, the lounge and dining room, kitchen and laundry, as well as some of the bathrooms. This was to see if the home was in good condition. The inspector also needed to visit the headquarters of the home, based at Bacton. This was so the records for staff working at the home could be checked. What the service does well: People living at the home say that they like it, that they get on well with the staff, and that they have lots of things to do. The other things the inspector saw or read help to show that people can do lots of different things, inside and outside the home. These include things like going to classes, going to church, attending the “art barn”, shopping, going out for holidays, meals or drinks. Residents also help to do things around the house, like keeping their rooms tidy and doing the shopping as well as helping to keep the kitchen, living room and dining room clean. People say that they discuss things that are good and things they would like to change. The staff or manager write down some of the things that they suggest and try very hard to make sure they happen. The things that are written down, about what people want to do and how they are to be supported, are reviewed regularly and residents sign their plans to show they have been involved. People living at the home are supported by staff to see people who can help them stay well, like the doctor and dentist. All these things mean that people have a good lifestyle and are well supported. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 6 St Brannocks is homely, clean and comfortable and people have their own bedrooms arranged as they like. 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. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents could be confident that their individual needs and aspirations would be assessed. EVIDENCE: The company has developed a new assessment form for prospective residents, collecting a good range of relevant information. If fully and thoroughly completed it would provide useful information from which to devise a care plan. There are currently no vacancies and there have been no admissions since 2000. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know their changing needs and goals are reflected in their care plans, they are supported to make decisions and risks are addressed but would benefit from improved documentation. EVIDENCE: Care plan files show that the needs and goals of each person are reflected in their care plan. All of those spoken to say they have care plans and that these are reviewed. Records show regular/monthly reviews of progress towards the recorded goals. Residents signed files. There are risk assessments in place. Residents are able to express their views and to discuss and make decisions. People are encouraged to take risks, for example in pursuit of hobbies (one person using a cordless electric drill for example, and another going out unaccompanied after dark to the local shop). The drill is cordless in order to minimise risks, and people going out after dark are encouraged to wear high visibility jackets in the interests of road safety. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 10 Underpinning documentation is not present in all cases, although discussion with the manager shows that staff do follow routine precautions, and discussion with residents shows that they are also aware of issues. See also medication standard. A recommendation has been made. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have opportunities for appropriate activities in and outside the home, can maintain relationships, and have their rights and responsibilities recognised. EVIDENCE: Two residents spoken to say they attend college courses from time to time and certificates from the National Open College Network were seen. They participate in activities during the day time, including artwork – some of which is displayed around the home - and keep fit programmes, based on discussion with residents and the manager. Records and residents confirm that they use the local shops, church, village hall or other amenities such as the hairdresser. There is a daily record in which these things are recorded. These confirm what the manager and residents said about trips to local attractions such as a zoo, and Blickling Hall for a picnic. One person confirmed planning a 1:1 holiday with their St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 12 keyworker, due in November. Residents confirm that they have the opportunity to go out regularly and that they have lots of things to do. Residents say their families are able to visit. One person was out with a relative during the fieldwork visit and another took a telephone call in private on the cordless handset. The sexuality of residents is respected and support offered as appropriate based on discussions with a resident and the manager. Residents say that staff knock on their doors before going into their rooms. Those spoken to all had keys for their rooms, although one person said it was bent and they were not able to use it. A recommendation has been made. Responsibility for household chores in shared areas is set out in a roster. One person gave an account of their week and the things they were responsible for. During the visit people assisted with tasks such as washing or drying up, cleaning work surfaces and washing the floor. One person vacuumed their room and two confirmed that they helped to keep their rooms clean and tidy and changed bedding. All of the residents completing comment cards say that they choose their food and go shopping for it. Some help is given with choosing healthy options and one person had a certificate showing that they had been on a course to learn about eating healthily. Residents take their meals in a large dining room and say that they enjoy sitting and talking together with the staff member on duty. None of the residents need assistance with eating. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and health care needs are met as they require and they are protected by the practices and policies for administering medication. EVIDENCE: Personal care needs are set out clearly in care plans which show the level of support or prompting needed. Residents say that times for getting up are flexible, dependent on daytime activities during the week. The manager says that residents have recently been involved in a keyworker review following one person expressing the desire to change. Records show that people are referred for advice from specialists as necessary. Residents confirm in comment cards that they see their dentist and doctor and one person spoken to confirmed visit to the opticians. Records support this and show screening appointments are encouraged. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 14 Medication storage is tidy and which would help avoid errors. The manager was responsible for administering medication during the fieldwork visit and the observed practice showed appropriate checks. (As all residents came to the office in quick succession there were distractions.) As an additional check residents have their own record book to sign to say they have had their tablets. The organisation is arranging for employees throughout its homes to attend up to date training from the UEA. There are no residents who administer their own medication but no supporting risk assessments to say why they are not capable of doing so. The manager agreed there might be one or two who could manage part of the process. A recommendation has been made. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be sure their concerns will be listened to and that they are protected from abuse. EVIDENCE: Residents spoken to know who to talk to if they have concerns about their care – identifying staff. They say that they were happy at the home. Everyone completing comment cards said they felt safe at the home and all of those spoken to said that they had no concerns or worries and got on well with the staff. There is a complaints record book at the home available for recording complaints should any be made. The training profiles for staff supplied do not show that all have had training in basic awareness of abuse, although the line manager for the home (on 1st November when staffing issues followed up) says that courses are booked to cover this area. A recommendation has been made. There is policy guidance for staff to follow. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, homely and safe environment that is clean. EVIDENCE: All communal areas, kitchen and laundry facilities were seen, as were five of the seven bedrooms. The sitting room has been redecorated and has new furniture and carpets. Residents are pleased with this they say. Furnishings and fittings elsewhere were domestic in nature and of reasonable quality. Residents benefit from a large separate dining room in which to eat their meals or use the computer. There has been a recent fire inspection where, the manager says, some concerns were expressed about the state of one person’s room (their personal preference based on discussion with the resident – who suggested there should be a competition for the untidiest room). The manager says that this has been discussed with the resident by both the keyworker and himself. No concerns have been expressed to the Commission regarding this. All service users are mobile and can get round the home without difficulty. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 17 Work is in progress towards in a bathroom and an extension is being built with a view to increasing the registration by one person. The area is cordoned off so that residents are safe. Areas of the home seen were clean. Based on discussion, assessments seen, and the pre-inspection questionnaire there are no issues with continence. This would present problems as the laundry is accessed through the kitchen. The manager says that there are plans to create a laundry on the first floor so that this problem would be avoided should the needs of residents change. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents feel they are well cared for by staff, although there is room for improvement in training and supervision. There is unacceptable practice in employing staff in a full range of duties before full checks are received, and a lack of evidence of formal supervision. EVIDENCE: One of the three care staff has NVQ level 2 and 3. Other staff do not. The minimum standard for 50 of staff to be qualified to this level is not met. A recommendation made at the last inspection has not improved the situation to reflect compliance with the standard. A requirement has been made. However, it is noted that the registered providers generally make good investment in staff training. Residents say they feel well treated by staff and staff are good. The manager says he has revised the duty rosters so that these can be more responsive to the individual wishes of residents. One person says that they will be going on holiday with 1:1 support from their keyworker, as they prefer this to going in a group. This is commended. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 19 Two care staff and the manager are shown as starting work before their full enhanced Criminal Records Bureau (CRB) checks were received although each has a POVA First disclosure (showing preliminary checks against the register for the protection of vulnerable adults). Department of Health and Commission guidance is that staff must not work unsupervised and do not escort residents on trips out of the home unless supervised by named staff who have been fully checked. Rosters show that there were occasions when staff did work unsupervised and carried out sleep in duties alone before CRB disclosures were received. This does not represent a robust approach to recruitment – although ultimately disclosures were clear. A requirement has been made. The manager has the workbook for managers covering the Common Induction Standards. If adequately and appropriately completed this would provide for proper induction to each worker. The one person completing these as the manager says, did not have a workbook on the premises against which to evaluate progress. However, the line manager for the home says that the person had already completed the former induction programme and was continuing with the new standards (these replace the induction and foundation programme). A recommendation has been made. The manager is unable to confirm that supervision takes place with the nature and frequency set out in standards. He says that staff are spoken to on a regular basis and individual difficulties will be taken up as they arise but not necessarily recorded. A requirement has been made. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has been generally well run, but the manager has not completed the registration process with the Commission and is now leaving the home. There is room for improvement in showing that self-monitoring, review and development of the service takes place regularly – possibly because the incoming manager was not aware of what had previously happened. The health, safety and welfare of residents is promoted. Outcomes would be good in this area with recruitment, retention and registration of an appropriately qualified and experienced manager. EVIDENCE: A manager was recruited and took up his post in August and has a nursing qualification and experience of work with people with learning disabilities. He has not completed the registration process with the Commission and has now resigned his post. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 21 The last survey of stakeholders associated with service quality and available on the premises was dated 2004, the manager being unable to locate anything more up to date. However, residents say that they do have meetings to talk about what’s good and what could be changed. Residents’ meeting notes reflect that they are asked for their opinions and ideas, and there are comments to show that these are actioned. This is good practice. The organisation has a generally good record in this area but needs to ensure the process in all homes is ongoing and up to date. A requirement has been made. There are monitoring visits on behalf of the providers. A summary of these report findings has been supplied to the Commission although a review of the Commission’s files shows that the last time complete reports were received for all of the homes including St Brannocks, these showed visits carried out in quick succession at a number of locations. A requirement is made that these are now supplied in full. A sample of records associated with health and safety were checked. These show that attention is paid to maintaining the service as safe, with maintenance and testing of equipment and services. St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 3 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 2 x x 3 x St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 23 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 YA32 Regulation 18.1.c Requirement The registered persons must ensure that staff start NVQ training to achieve the 50 ratio set out in standards. The registered persons must ensure that staff recruited after POVA first checks and full references etc, but pending receipt of enhanced CRB’s, are supervised at all times by a named and properly checked staff member until induction and checks are complete. (See amendments to care homes regulations.) The registered persons must ensure that there is evidence that supervision is carried out with the nature and frequency set out in standards. The registered persons must review and evaluate the quality of the service regularly, taking into account the views of service users. The registered persons must supply full reports compiled on behalf of the registered providers. These need to include the nature of discussions with DS0000027524.V317784.R01.S.doc Timescale for action 31/01/07 2. YA34 18.2.b & 19.11 31/12/06 3. YA36 18.2.a 31/12/06 4. YA39 24.1 31/03/07 5. YA39 26 26.5.a 31/12/06 St Brannocks Version 5.2 Page 24 residents and staff and should reflect that adequate time is spent in each home to assess service quality. 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 YA9 Good Practice Recommendations The registered persons should make sure that they set down identified risks in care plan files and how staff are to support residents to keep these to a minimum and acceptable level. The registered persons should ensure that the bent room key is replaced so the resident concerned can once again have a useable key for the bedroom. The registered persons should carry out risk assessments to see if any residents could manage their own medication (completely or in part), and make any arrangements for support that are necessary. The registered persons should ensure that all care staff complete basic training in the awareness of abuse. The registered persons should ensure that workbooks for staff working towards induction and without certificates for completion are retained on the premises as evidence of satisfactory and timely progress. 2. 3. YA16 YA20 4. 5. YA23 YA35 St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 St Brannocks DS0000027524.V317784.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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