Inspection on 08/07/05 for Stocksbridge Neuro-Rehabilitation Centre

This inspection was carried out on 8th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stocksbridge... 12/08/08

Stocksbridge... 31/07/07

Stocksbridge... 02/08/06

Stocksbridge... 02/02/06

Stocksbridge... 11/01/05

Stocksbridge... 29/06/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

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

CARE HOME ADULTS 18-65 Stocksbridge Neuro-Rehabilitation Centre 2a Haywood Lane Stocksbridge Sheffield S36 2QE Lead Inspector Sue Stephens Unannounced 08 July 2005 09:15am - 18:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stocksbridge Neuro-Rehabilitation Centre Address 2a Haywood Lane Stocksbridge Sheffield S36 2QE 0114 283 7200 0114 288 7736 None Active Care Partnerships Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kathryn Sandra Oakley N - Care home with nursing 24 Category(ies) of PD - Physical Disability (24) registration, with number of places Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is for service users who require neurological care. The minimum numbers of staff on duty must comply with the staffing notice dated 6/3/00 and attached (referring to previous name of home; Holly Lodge). Date of last inspection 11 January 2005 Brief Description of the Service: Stocksbridge Neuro-Rehabilitation centre is a purpose built residence for people requiring neurologcal care. The building has therapy rooms, an independent living skills kitchen, lounges for relaxation and paved access to the gardens. The centre overlooks Stocksbridge and is near to a bus route and some shops; and is within easy reach of Sheffield and the motorway network. The building has two levels, with a passenger lift providing access to both levels; there is level access is to the gardens. Rooms and corridors are designed to accommodate wheelchairs. Nurses, psychologist, physiotherapist, occupational therapist, speech and language therapist, carers and assistants are employed to form a multidisciplinary care team. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 9¼ hours, between 09:15am and 18:30 pm. Areas of the premises were checked, clients, staff and managers were consulted, and samples of records, including health and safety records were checked. Six clients were consulted, either individually or in small groups; and observations were made of the client’s daily routines, and their relationship with staff and the managers. Staff were observed carrying out their duties. The service manager assisted in the inspection in addition to the registered manager. Both managers said the centre refer to service users as clients because the focus was on developing individuals and moving them on; however some people were living at the centre long term and regarded it as their home. The clients, staff and manager are thanked for the welcome they gave to the inspector and their assistance during this inspection. What the service does well: Good, physiotherapy, occupational therapy, speech and language, social and leisure opportunities were provided. Clients also received psychological support within the centre. The professional teams were focused and worked well together. Staff were positive motivated and understood their roles well. Clients had been involved with some day-to-day running of the home and had been able to express their opinions freely about some areas they were not satisfied with. Medication was stored safely and complaints had been responded to effectively. Clients were satisfied with the environment and said they were comfortable. Some areas were being refurbished, for example the activity room, to benefit the clients. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 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. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These areas were not assessed on this occasion. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 8 Clients were able to participate in the daily routines of the home and express their opinions about life at the home. EVIDENCE: Staff and members of the management team showed an understanding of client’s abilities to be involved in the day to day running of the home; for example, where a client would not benefit from involvement this was recognised; however an individual’s idea about a garden plan had been supported and encouraged as part of that person’s rehabilitation. Clients had also been involved in planning, decorating and providing art for the bathrooms. Meetings had been set up where viewpoints about the home could be raised; clients said they had used the last meeting to express their views about the quality of meals. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 and 17. There were good opportunities for personal development, this enabled clients to achieve a more independent and healthy life style. Families were welcomed and offered support; this helped to promote an understanding of their relative’s condition and abilities. Meal choices need to be improved to suit clients preferences and choices. EVIDENCE: The homes aims and values focused very much on personal development, staff spoke about how they understood this and how all the multidisciplinary team worked together with the individual. Staff consulted spoke very positively and enthusiastically about achievements clients had made. Members of the management team spoke clearly about the centre being a place for rehabilitation with the goal to improve the individual’s needs and for them to develop and move on. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 11 Clients received physiotherapy, occupational therapy, speech therapy and psychological support as part of their rehabilitation programme. Examples of activities include structured visits to the community, one-to-one support, art, exercises, swimming and independent living skills and cooking. One client consulted was very positive about the therapy programmes. Clients were relaxing in the atrium, T.V. lounge and gardens and books and games were available. The service manager said T.V may be limited for some client’s (for example not provided in the bedroom); this was based on assessment of the client’s wellbeing and coping abilities. One client consulted and said this had been explained to them. The service manger said family links were supported and encouraged, and he expressed an awareness that some clients had come from different counties where families needed to travel distances for visiting and meetings. The physiotherapist explained how families were given support and guidance in caring and supporting their relative ready for when they move on. Clients consulted said they were satisfied with their daily routines; one client said these had improved considerably and praised staff for their hard work. However, some clients said the centre could be noisy at night and some night staff spoke in a loud voice, which disturbed the clients rest. The registered manager said she was aware of this and was consulting with night staff. Staff were seen talking with clients with respect and friendliness. One staff said if a client chose to opt out of an activity the client would be very much encouraged to participate; the registered manager confirmed this and said where a client declined the activity, this would be recorded and discussed at the clients review meeting. Clients consulted expressed their dissatisfaction about meals, in particular the vegetables and potatoes. Clients also said the choice was limited and unexciting. The standard of meals was a concern to most the clients consulted, they said they had raised this with the registered manager; some said they were not sure if improvements would be made. The cook said she was aware of the issues; the registered manager said she had arranged a meeting with a nutritionalist to look at the menu, and this had been fed back to clients. Puddings had been limited to fruit or yoghurts only, the cook said this was to manage calorific intake. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 In the main, medication systems were safe; however some medication records need to be improved to maintain client’s safety and rights. EVIDENCE: Medication storage was clean and orderly, records in the main were well maintained; one medication record checked had not been signed, on more than one date, to indicate whether the client had received the medication or not. Client’s consent to medication had not been obtained and recorded, or where the client was unable to consent this had not been identified and recorded. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The complaints procedure was suitable and had been used effectively, enabling complaints and concerns to be resolved. Because robust adult protection systems were not in place, this could not fully safeguard client’s safety and welfare. EVIDENCE: A complaints policy was on display; and a recent complaint raised had been followed up, actioned and resolved within the homes policy guidelines. Clients consulted said they knew how to raise a complaint and staff were aware of the procedures. Staff had not received suitable adult protection training and were not made aware of the relevant policies and procedures. Policies and procedures were not easily retrievable and available to staff. Adult protection contact numbers of out of authority placements were not available. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,28, 29 and 30. The clean and well-maintained environment promoted clients’ safety, wellbeing and comfort. Investment in improving areas was also beneficial to the client’s recovery and development. The centre was proactive in identifying structural and maintenance needs, however the subsidence around patio areas continues to be a hazard. EVIDENCE: In the main, the building was well maintained and clean; maintenance work being carried out included: adding a work surface in the dining area to encourage clients and visitors to make drinks, refurbishing two bedrooms, replacing lighting, adding kitchen units and sink to an activity room and tidying the gardens. The service manager said areas in need of maintenance and structural work, for example the external patio areas and dwarf walls were identified and suitable contractors were being sought (the main problem area had been cordoned off for safety). Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 15 Where there were offensive odours action was being taken to eliminate these. Clients said they were comfortable and satisfied with the environment. Clients had participated in creating art for the dining room and bathroom walls; the artwork was colourful and pleasing to look at and created a homely environment. There was good space for wheelchairs and equipment in the rooms where clients relaxed and dined. Fittings, adaptations and equipment were assessed and monitored by the physio and occupational therapy departments. Equipment that was unsuitable or in need of repair, for example the shower bath had been identified and action taken for removal or repairs. The therapy rooms were being updated to better suit clients needs. A domestic size kitchen was provided; this was used to assist some clients in preparing their own meals and drinks. Suitable laundry facilities were provided and this was also used to assist some clients to wash their own laundry as part of their personal development. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35 and 36. The positive and confident manner of the staff and the effective team approach promoted the client’s health, wellbeing and progress; completion of 50 of staff holding an NVQ qualification would further promote this. Further improvements are needed to bring supervisions in line with National Minimum Standard targets; this will help to benefit clients by maintaining a well-supervised and supported staff team. EVIDENCE: Staff consulted were very clear about their roles and understood the aims and values of what they were doing, they were positive and motivated. One staff member said, “this is a lovely place and the team works well”. Support staff worked on a rotational basis in each of the departments, this enabled them to have a good understanding of all roles. Staff spoke to clients in a friendly professional way and encouraged conversation. Clients said staff were friendly and approachable and named individual staff who they enjoyed being with. Clients said there were sufficient staff and past rotas reflected this. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 17 All staff consulted had good knowledge of clients disabilities and were confident in how to approach and care for individuals with specific or complex needs. National Vocational Qualification targets had not been reached, with only two staff having almost completed level 2. The registered manager said they were consulting with an NVQ provider for training. Staff said they had had good training; the moving and handling and brain injury training was particularly helpful because it was very specific to the needs of the clients. Staff consulted had attended a disability awareness course, and induction training. Supervisions were carried out; the registered manager was in the process of increasing these to meet National Minimum Standard targets. Clinical professionals, for example the physiotherapist, arranged clinical supervisions with appropriate professionals outside of the organisation. The registered manager was advised to consider, in addition, a system that would provide staff employed at the centre with supervision carried out within the organisation and focused on the centres and organisation aims and objectives. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 41, and 42. The home was well run; this contributed to the residents well being and good recovery progress, however safe working practices need to be improved to continue safeguarding clients welfare. EVIDENCE: suitably experienced; she had kept updated with relevant knowledge and skills and was in the process of completing a National Vocational Qualification in management. The registered manager was supported by her line manager, the service manager; both were based at the centre and involved in the day-to-day running of the home. The and had find service manager and registered manager had been working on improving updating records; some records, for example health and safety records not been archived, this made current information confusing and difficult to and understand. J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 19 Stocksbridge Neuro-Rehabilitation Centre Staff confirmed they had received safe working practice training and understood the policies and procedures. Some training, for example food hygiene, had not been provided; the manager had arranged training dates for these. Infection control was covered on induction and staff were given information to read to keep them updated. Six staff had been trained in first aid, the manager said she planned to have all staff trained to ensure a first aid person is on duty at all times. A fire drill was carried out and all staff acted promptly. Fire drills had not been carried out at alternative times of the day (including nights), using blocked exits and different escape routes; this would identify whether various staffing levels and routines could cope in the event of a fire. Some drill records did not include the time of day it was carried out; and all records did not include the name of the person carrying out the drill. The recording system was difficult to identify if staff had received a drill twice yearly. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 2 2 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stocksbridge Neuro-Rehabilitation Centre Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 2 x J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 16 Regulation 12 Requirement Action must be taken to reduce the noise levels at night and clients must be consulted regularly about whether the situation has improved. Menus must be reviewed and improved and take into account clients comments. Clients individual likes and dislikes must be considered for all meals. Clients must be consulted about the changes to menus and available choices. All medication must be signed 08.07.05 for at the point of administration. Consent to medication must be identified and recorded. All staff must receive training on the protection of vulnerable adults. The governments guidelines No secrets, the Local Authorities adult protection procedures and the organisations procedures must be kept available in an accessible place at all times. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 22 Timescale for action 30.08.05 2. 17 16 30.08.05 3. 20 13 4. 23 13,18 30.08.05 5. 24 13,23 All staff must be made aware of the relevent adult protection procedures and where to find them. The external patio areas and dwarf walls must be repaired to enable safe client access. (previous requirement action date 01.12.05) Records must be maintained in line with The Care Home Regulations 2001, and include archiving system. Fire Drills must be carried out in accordance with Local Fire Authority Guidelines and include drills carried out at various times of the night and day. (previous requirement action date 01.03.05) The fire risk assessment must be kept updated. A qualified first aider must be rostered to work at all times. (previous requirement action date 01.06.05) 30.09.05 6. 41 15 30.08.05 7. 42 13,23 30.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 17 32 36 Good Practice Recommendations Varied healthy puddings in addition to youghurt and fruit should be available on the menu Preparations should be made to ensure that 50 of staff are trained to NVQ level 2 or equivalent by 2005. Supervisions should continue to be increased to match National Minimum Standard targets. J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 23 Stocksbridge Neuro-Rehabilitation Centre 4. 37 All staff should receive supervision within the organisation in addition to their own professional supervision. The registered manager should aim to a level 4 NVQ qualification in management or equivalent by 2005. Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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 Stocksbridge Neuro-Rehabilitation Centre J55 S48612 Stocksbridge NRC V234113 08.07.05 UI Stage 4.doc Version 1.30 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. 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