Inspection on 13/09/05 for St Catharines Residential Home

This inspection was carried out on 13th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

St Catharines Residential Home 23/07/09

St Catharines Residential Home 28/07/08

St Catharines Residential Home 10/08/06

St Catharines Residential Home 19/12/05

St Catharines Residential Home 15/10/04

St Catharines Residential Home 29/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE St Catharines Residential Home 24 St Catharines Road Broxbourne Hertfordshire EN10 7LE Lead Inspector Mrs Jan Sheppard Unannounced Inspection 13th September 2005 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 St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 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. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Catharines Residential Home Address 24 St Catharines Road Broxbourne Hertfordshire EN10 7LE 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) 01992 462224 01992 442 632 janice.pittom4@btinternet.com B & M Investments Limited (Trading as B & M Care) Vacant Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th October 2004 Brief Description of the Service: St Catharines is a large detached property situated in a quiet residential area of Broxbourne. It was first registered as a residential home under the Registered Homes Act in 1983 when it was converted to provide accommodation on three floors all of which are accessible by a lift. There are 19 single bedrooms, 6 of which have en-suite facilities and 4 double bedrooms of which 2 have en-suite facilities. On the ground floor there are two lounges, a separate dining room, a conservatory, the kitchen and a small office. The home has very attractive landscaped gardens with pathways and a patio area. The home is easily accessible for the local shops and there is a range of bus and rail links nearby. The home, which is owned by B&M Care Ltd, provides a warm, secure and caring environment for its elderly residents in a very homely setting. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of this inspection year and took place over one day when residents and staff were spoken with, records examined and a tour of the building undertaken. Since the last inspection the registered manager has left to take up a post in another home owned by the company, the deputy manager has been promoted to the Managers role and a former senior carer has been appointed to the deputy’s post. These changes, which offer continuity of care to the residents, appear to have gone smoothly and have been well accepted by both staff and residents. The residents appeared to be relaxed and happy and care was seen to be being delivered in a kindly, calm and sensitive manner by the staff who showed good awareness of potential problems that could arise for individual residents who were exercising their choice to move independently around the home and its gardens. The home has carried out a number of improvements since the last inspection in line with requirements and good practice recommendations made so that the National Minimum Standards are met. Five requirements and one recommendation are made following this inspection. What the service does well: This well established home continues to provide a warm secure and homely environment for its residents with personal care being delivered by an experienced and trained staff team. Staff demonstrate a good awareness of the individual care needs of the residents and appreciation of this individual knowledge and attention was expressed to the inspector by several of the residents. Other residents were complimentary about the homely appearance and atmosphere prevailing through out the building and the manner in which they were assisted in personalizing their own rooms. One said, “ the staff helped me to get my room just as I wanted it. I have all my things around me, it feels just like home and I can relax here in my room”. The home continues to offer a very full and varied activities and entertainments programme for the residents who were seen to be able to choose whether or not to participate in the three various activities held during the day of this inspection. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 6 The home is surrounded by attractive and accessible gardens, which are maintained to a very high standard and were again this summer awarded first prize in the Broxbourne Gardens in Bloom competition. 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. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 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 St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 and 6 Information available to prospective residents and their families is comprehensive and informative enabling a decision about admission. The atmosphere in the home is relaxed offering a welcoming environment to prospective service users. EVIDENCE: The home has a comprehensive pre admission assessment procedure that is well documented. All prospective residents are visited by a manager either in their own home or other setting for a full needs assessment before being invited to visit St. Catharines themselves. Recently admitted residents spoken with during this inspection all confirmed that the process of their admission to the home had been handled sensitively by the staff and that they had been given sufficient time to make their own decision about admission. The pre admission information includes the Service Users Guide, a Statement of Terms and Conditions, information about the fees and the Complaints procedure. Copies of the latest inspection report were seen in the homes entrance hallway alongside other information relating to the homes activities. The Statement of Purpose was seen to have been recently updated so that it accurately reflects the current position in the home. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 9 One resident confirmed that she understood her admission was initially on a trial basis and that a review would be held before she had to finally decide whether or not to stay permanently. She was very positive about the home saying that the staff were very kind and did everything they could to make her initial days as easy as possible. She said that she was happy with the care and appreciated the way that choices about activities and where she liked to spend her time, either in the lounge or staying in her room, were given to her to make and that in this respect the homes routine was not regimented. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Personal care and assistance offered to service users is of a high standard, thus meeting their individual needs whilst retaining dignity and respect. Care staff are unobtrusive and sensitive in their approach. Care plans are comprehensive and are reviewed regularly this ensuring that changes to health and social care needs are recognised and met. EVIDENCE: A number of care plans were examined, these were seen to contain good detail and to be maintained up to date. Each has a major annual review involving relatives and with medical and other professional input, as well as having smaller monthly reviews carried out by the residents key worker and closely involving the resident. Where possible residents read and sign their care plans. Risk assessments were seen well documented with reviews and the planned date for the next review also noted. Enjoyed leisure activities were also noted. The visits made by the District Nurses were found to be well recorded as were the notes made by the careworker’s to the nurses although none of these notes from the careworker’s had been signed or dated. The new manager is currently part way through an exercise to reorganise the arrangement of these files into one more comprehensive document so that all the residents information is kept together and is more easily accessible to staff. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 11 Service users seen to be requiring help with meals were observed to be receiving this discretely with staff encouraging them to eat as independently as possible offering assistance where needed in a sensitive manner that promoted and protected their dignity. There have been no changes in the arrangements for medication storage and administration since the last inspection. The recently acquired medication fridge was seen to be being well used with regular checks of temperatures maintained. The records on the MAR sheets were seen to be accurately maintained, the manager makes regular checks on these and the supplying pharmacist continues to make regular audits of the homes medication arrangements. The process of administering one residents medication was seen to be carried out by the carer in an unobtrusive and caring way. The manager stated that the home continues to have very good working relations with its Doctor and community nursing teams who visit promptly and where required refer residents quickly for hospital assessment and treatment. Residents were seen to have equipment appropriate to meet their needs this being provided following an OT assessment. The manager stated that residents were encouraged to live their lives as they would in their own home and on the day of this inspection two residents were seen to be taken our by their relatives whilst another was taken by a friend to attend a local day centre this being a weekly activity that she enjoys. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 A wide and varied activities programme is offered and this tries to accommodate everyone’s individual preferences. Feedback and suggestions are sought on all aspects, this promoting autonomy and choice. Visitors are always welcome in the home and several visiting on the day of this inspection were seen to take their relatives out into the community. A number of residents complained about the recent changes to the quality and choice of food provided. EVIDENCE: A number of activity co-ordinators are employed within the home who organise a variety of activities and entertainments on a sessional basis. Three different activities took place on the day of this inspection with varying numbers of residents attending each session. The residents who spoke with the inspector confirmed that they are free to attend what ever they like or not to attend as they wish, they are not co-erced in any way. Most said that they really enjoyed the stimulation that this range of activities afforded them and expressed pleasure at the good ideas for time related activities that are thought up by the staff. A Halloween night was being planned with various craftwork being undertaken. In one lounge a group of ladies meet regularly as a knitting circle and their work making blanket squares has recently need sent to earthquake St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 13 victims, photos of this were shown to the inspector. One resident who spoke to the inspector as she returned from attending a local day centre held in a local church hall, said, “ I’m an independent type, I have been here for two years now and am very happy and very well cared for. I thought it would be difficult settling into residential life but they (referring to the manager and deputy) made it easy for me. I can make my own decisions as to what and when I do things they never stop me going about even though I am sometimes a bit wobbly”. The manager confirmed that risk assessments are in place for all residents but the home aims to help all to be as independent as possible with known risks being evaluated involving if necessary the GP and the residents relatives. A number of residents told the inspector of a recent decline in the quality of meals provided. One complained about the poor quality of the pastry and another that the variety of the meals had lessoned. Several residents were aware that a new cook is about to take up her duties she having previously been the homes occasional weekend cook who was highly thought of. The manager discussed with the inspector plans that she has to give the residents more involvement with the choice of menu and also to involve further residents who have particular catering/cooking skills. Fresh meat and vegetables are purchased by the home several times each week and fresh fruit was seen to be available. The staff explained that as during the recent hot weather fruit left in bowls in the lounges and in some residents rooms quickly deteriorated but so to avoid waste the cook had been making individual fruit salads for residents to take during the day as a snack. Residents confirmed to the inspector that there was always plenty of food available and that staff would always accommodate any requests for changes to the set menus. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 A robust complaints procedure is in place. The Adult Protection procedures as set out in the Hertfordshire joint agency guidelines are followed. EVIDENCE: A copy of the complaints procedure is available to prospective and current service users. Reference is made to the Commission for Social Care Inspection. Residents spoken to said that they had never had to make a complaint but felt that they would first speak to a member or staff or to the manager and expressed their confidence that their concerns would be dealt with promptly. One said, “ the manager is very approachable I am sure that she would soon sort things out”. One complaint has been received since the last inspection and this was dealt with by the company head office. Staff confirmed that they had received training on adult abuse and they were aware of the literature concerning the Hertfordshire Adult Protection Procedures, which is displayed both in the main office and in the staff room. The homes training records demonstrated that training on protection and Whistle Blowing is undertaken by all staff on an ongoing basis. Literature in the homes entrance hallway relating to financial advice concerning fee payment and details concerning the Power of Attorney arrangements demonstrate the homes attempts to protect the service users legal rights. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 The home and its surroundings offer a pleasant, comfortable safe and homely environment of its service users. The home is kept very clean is well maintained and the bedrooms are personalised offering a homely, lived in feel. The home generally meets the space and environmental requirements for this standard except for one double bedroom, which does not meet the size requirement. EVIDENCE: All the residents, except one, who were spoken with said that they were happy with their rooms and appreciated the help that staff had given them in personalising them so that they felt them to be homely and to reflect their taste. One resident showed the inspector the samples of paint, paper and soft furnishings that she was choosing as her room is about to be refurbished. Another newly admitted resident explained how the handyman had helped him to hang his plates and pictures and said that now these were up he felt his room to be much more homelike. Various rooms were seen to contain mobility and other equipment provided to meet the residents needs following an O.T. assessment. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 16 One resident who occupies a shared room explained to the inspector that she was not happy with this arrangement, “ I’ve tried to help them (the management) out “, she said “but I have had so many changes (of residents to share with) I really can’t stand it any more”, and she asked the manager if she could move into a single room as soon as possible. The home, which was originally, a large old priory house has been very well refurbished into a care home and provides a comfortable and homely environment. All floors are accessible by the lift but some short flights of steps still have to be negotiated to access some rooms some of the corridors are long and quite narrow making movement with mobility frames difficult. The number of bathrooms and toilets are adequate to meet the needs of the current residents. One ground floor bedroom, which has been used as a double room with the same occupants who wished to share together, for some considerable time, falls short of the required space for double occupation. At present one of these residents is in hospital. It is a requirement that this room does not continue to be used for double occupation for any new resident. Staff spoken with demonstrated a good awareness of hygiene and infection controls and confirmed that gloves and aprons are always readily available. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 The staff team appear to be enthusiastic about their work, to take great pride in the service and in the home and to work well together as a team and in a competent manner. Robust Recruitment procedures are in place, which ensures the safety of the residents. EVIDENCE: The provider is fortunate in being able to retain a stable core group of workers many who have been employed at the home for many years and are experienced carers. Interviews had recently taken place for the one vacant post and the necessary CRB checks were awaited before the appointed person could take up her duties. The manager commented that on this occasion the home received a good response to its advertisement with applications from several experienced and qualified staff. All new staff are recruited with the expectation that following their induction training they will commence on the NVQ level 2 qualification course. The home now has approximately 45 of its care staff holding an NVQ 2 or 3 qualification. Three other staff who have achieved this qualification have recently moved from St. Catharines to another of the companies homes which has reduced this percentage. With one or two exceptions staff spoken with had a positive attitude towards training. The records showed that all staff now receive supervision at least six times a year and that annual appraisals are planned to be conducted over the coming months by the new manager and deputy. Both these managers require to attend training as to the carrying out of supervision duties and appraisals so that they are fully equipped with the appropriate skills for staff management. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 18 St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 and 38 The home has an excellent reputation and the company directors, who have good involvement, appear to be dedicated to providing a first class service thus enhancing quality assurance and ensuring that the home is run in the best interests of its service users. The home is well run by experienced and well qualified staff who work well together as a team and are dedicated to enhancing the services provided. Close consideration to the health, safety and welfare needs of the residents is given and this results in a warm caring environment where the service users seemed relaxed and happy. EVIDENCE: Staff said that they understood the procedures that were in place for all aspects of their work and if something was not clear to them a senior worker was always on hand for consultation. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 20 The recently appointed manager and deputy manager have both worked at the home (and have worked together) for many years there by giving a continuity of service to the residents none of whom asked considered that the recent staff changes had adversely affected them. One said, “ this is a beautiful home and the staff work hard and take pride to keep it really nice” The new manager said that she is taking a fresh look at various aspects of the manner in which care is delivered, she is consulting with the staff at their staff meetings and intends to use customer questionnaires to further consult with the residents. The records kept of the various formal and informal residents meetings were found to be recorded if at all with insufficient detail, a requirement is made. The manager already holds the NVQ level 3 qualification and both the newly appointed managers are registered to commence management of care training courses in the autumn. In addition it is a requirement that the manager, so as to be able to fully discharge her management duties within the home, attends a course on dealing with staff disciplinary issues. Records relating to Health and Safety, Fire precautions and Accidents and Incidents were seen to be being properly maintained. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 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 3 3 3 3 3 3 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 2 3 3 3 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 2 x 3 x x x x 2 St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP23 Regulation 23(2)(f) Requirement The undersized bedroom, (number 1), is not used for double occupancy for any new resident. The new manager must attend training on dealing with staff disciplinary matters. The homes managers must attend training on conducting staff supervision and appraisals. Adequate records must be kept of all residents meetings both formal and informal. Timescale for action 20/09/05 2 3 4 OP31 OP31 OP37 18(c)(i) 18(1)(c) (i) 24(3) 01/01/06 01/01/06 30/09/05 St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 23 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 Refer to Standard OP15 OP37OP17 Good Practice Recommendations Menus should be revised to better meet the requirements of the residents. It is recommended as good practice that staff date and sign all communication messages made in the homes various communication books. St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 St Catharines Residential Home DS0000019536.V265901.R01.S.doc Version 5.0 Page 25 - 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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