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Inspection on 01/06/05 for Sycamore Court Nursing And Residential Care Home

Also see our care home review for Sycamore Court Nursing And Residential Care Home for more information

This inspection was carried out on 1st June 2005.

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

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

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

What the care home does well

All residents spoken with stated that the home was clean and comfortable, that the ` staff are lovely, so kind` and that they were allowed choices in their lifestyles. They also stated that they were able to participate in outings and activities and that people came in to entertain them. Visitors stated that the staff were wonderful and that they were always made to feel welcome. That staff were always willing to help and kept them informed about any changes to the home or their relatives. The home does not have a big staff turnover and the success of keeping staff may be due to the approachability of the various management staff, residents stated that it was `nice that staff do not change much- lets you get to know them`. Generally the home invests a lot of time in training staff, and although they have not yet got any staff who are NVQ 2 qualified, have 12 undertaking this course. The home also has registered nurses on duty twenty four hours a day and these nurses do undertake further training so that they can ensure that the best care is given to residents. The home is very good at providing suitable activities and taking residents out, and consults residents on the type of activities they would like. Catering is of a very high standard, there are always choices of meals available and a sweet trolley is always available at lunchtime. The kitchen is very clean and the cook is knowledgeable about the resident`s likes and dislikes.

What has improved since the last inspection?

The home is generally good and there has maintained its already high standard rather than any improvements being made. The manager has only been in post for a few months and has been intent on maintaining the standards already in the home, but is voicing several ideas for the future.

What the care home could do better:

Cares staff need to complete the NVQ2 qualification in order to ensure that all grades of staff are confident in the care that they give and to enable the home to maintain the standard of care already in place. A member of catering staff identified particular interests that she would like to follow. Some method of ensuring that residents can have their room doors open and still be assured of safety in case of fire is being considered and this needs to be put in place soon. People that wish to keep their own medication do have to be assessed in order to make sure that they are able to do this safely. And this needs to be looked at frequently in order to confirm that they are taking the right amount, and can remember what they are supposed to be having.

CARE HOMES FOR OLDER PEOPLE Sycamore Court Nursing and Residential Care Home Bear Road Bevendean Brighton East Sussex BN2 4DD Lead Inspector Elizabeth Dudley Unannounced 1 June 2005 10:00 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 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. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sycamore Court Nursing and Residential Care Home Bear Road Bevendean Brighton East Sussex BN2 4DD 01273 697331 01273 621163 Address 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) Anchor Trust Suzan Frances Green Care Home with nursing 40 Category(ies) of Old age, not falling within any other category registration, with number (OP), 40 of places Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service can provide up to forty (40) nursing places and five (5) personal care places. 2. The maximum number of service users to be accommodated is forty (40). 3. That one named service user can be admitted aged fifty-eight (58) years. Date of last inspection 5 November 2004 Brief Description of the Service: Sycamore Court is a purpose built home owned and run by Anchor Trust, it is registered to offer both nursing and residential care to people over 65 years of age. The home is situated in a residential area on the outskirts of Brighton within approximately five minutes walk of local transport services. The home can also offer parking for around 14 cars. Spannning three floors, all of which are served by a shaft lift, the home has a alrge lounge/ dining area on the first floor and small lounge areas on each of the other floors. The small lounges have tea and coffee making facilities for relatives and friends of residents. There is also a small well maintained garden which is accessible to all from the ground floor. There are five assisted bathrooms and all residents rooms have an ensuite facility consisting fo shower, washbasin and w.c. The home is staffed by registered nurses twenty four hours a day. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 1st June 2005 over a period of 7 hours and forms part of the yearly inspection programme for this home. During the course of the inspection 30 residents, 5 visitors and 10 members of staff were spoken with. Although the home is large, it is prevented from feeling impersonal as it split into small units, each having its own lounge and staff. What the service does well: All residents spoken with stated that the home was clean and comfortable, that the ‘ staff are lovely, so kind’ and that they were allowed choices in their lifestyles. They also stated that they were able to participate in outings and activities and that people came in to entertain them. Visitors stated that the staff were wonderful and that they were always made to feel welcome. That staff were always willing to help and kept them informed about any changes to the home or their relatives. The home does not have a big staff turnover and the success of keeping staff may be due to the approachability of the various management staff, residents stated that it was ‘nice that staff do not change much- lets you get to know them’. Generally the home invests a lot of time in training staff, and although they have not yet got any staff who are NVQ 2 qualified, have 12 undertaking this course. The home also has registered nurses on duty twenty four hours a day and these nurses do undertake further training so that they can ensure that the best care is given to residents. The home is very good at providing suitable activities and taking residents out, and consults residents on the type of activities they would like. Catering is of a very high standard, there are always choices of meals available and a sweet trolley is always available at lunchtime. The kitchen is very clean and the cook is knowledgeable about the resident’s likes and dislikes. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 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. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,5. There is sufficient information available for prospective residents to judge whether they wish to live at Sycamore Court and whether the staff are able to meet their needs. The manager also assesses all prospective residents to ensure that no-one is admitted to the home if there is any doubt that the their needs will be unable to be met, or that they will not be able to integrate well into the home. EVIDENCE: Sycamore Court provides a comprehensive statement of purpose and service users guide. The manager believes that all residents have a copy of the service users guide and has agreed to check to ensure that this is so. The manager must also ensure that the service users guide and statement of purpose are reviewed regularly to reflect any changes within the home. All residents receive a statement of terms and conditions on their admission to the home. Prior to admission all prospective residents are assessed by the manager or her deputy to determine whether the home can meet their needs. Prospective residents and their families or friends can also visit the home and meet the other residents and staff. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 9 All staff have on-going training to ensure that they have the knowledge to enable them to meet the standards of care required by residents. The manager is advised to reassess two residents who have been at the home for several years and whose needs are specialised, and to assess whether the staff require further training to meet the requirements of these specialities. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11Care within the home appears to be good with care plans for residents addressing residents assessed needs, these are reviewed on a regular basis. Some issues around medication administration and assessment of residents ability to self medicate give reason for concern, and staff must ensure that residents safety in this area is paramount. EVIDENCE: Care plans show that there is sufficient documentation to address the physical, psychological and social needs of the residents, all care plans have been reviewed monthly, but some care plans need to be signed by the resident or their representative. Two residents need to be reassessed in order for the home to ascertain whether the staff will require specialist training to meet their needs, which are different to those residents normally admitted to the home. A physiotherapist and a dentist visit the home and residents can keep their own GP if within the visiting area. The wound care nurse visits the home as required. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 11 The majority of medications had been signed on administration. Registered nurses are reminded of their accountability in this area and the implications for resident safety if this is omitted. Risk assessments for residents who self medicate require to be in depth and to be reviewed monthly or more frequently, these should include the nurses opinion on whether the resident is still capable of self medication and evidence that the resident is taking the medication and is aware of the need to store medication safely. Residents were seen to be treated with respect for their dignity. Catheter bags were discreet and there was no evidence of continence products stored in rooms. Staff and residents interacted well. There were no very ill residents at this time, but staff have attended courses on the care of the dying resident and there was evidence that the manager is able to contact advocates and Macmillan nurses. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15. The home provides a good quality of life for those residents living there. EVIDENCE: Sycamore court endeavours to provide a full life for those living there, it provides various activities including painting therapy, reminiscence therapy and entertainers coming into the home. Residents are taken out in the community bus or by taxi. Residents meetings take place and suggestions for future activities are discussed at these. All residents can make choices about their times of rising and retiring and who they wish to visit them, the home welcoming visitors at most times of day. Visitors spoken with stated that they were happy with the care given to their relatives and that staff made them feel very welcome. They stated that the home was ‘excellent’ and ‘the staff are so nice’. The home offers a high standard of catering, with a sweet trolley available at lunch each day. The meal of the day was Roast Pork, roast potatoes, mashed potatoes, green beans and sprouts. The home offers a choice of meals and it is recommended that this choice is displayed in the dining room. All cakes and puddings are made within the home, and the cook makes birthday cakes for resident’s birthdays. Liquidised meals have their various Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 13 components displayed separately and staff were seen to be feeding those residents that required it, in a dignified manner. The assistant cook expressed interest in learning more about various medical diets and it is recommended that the manager accesses courses from the community dietician. The kitchen was clean and all fridge and freezer temperatures are done regularly, and hot and cold foods are heat probed prior to training. All catering personnel have relevant courses. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 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 standard(s) 16,18 Residents are protected by both the complaints procedure and the staff knowledge of adult protection. EVIDENCE: A complaints policy is provided which meets the standard and is given to all residents in the service users guide. The home has had very few complaints and these have been seen to be dealt with seriously and fairly. All staff have attended adult protection training and are aware of their responsibilities towards the residents, however not all were aware of the whistle blowing policy and the responsibility they have regarding this. The manager is asked to reassess the staff knowledge of this. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25,26 Sycamore Court provides a well maintained safe home for residents. Although quite large, division into separate units ensures that it remains a homely environment. EVIDENCE: The home is well maintained and pleasantly decorated. Attention is paid to minor maintenance issues. Recently the home has had a new extractor unit and fly screens installed in the kitchen and staff stated that this had improved working conditions. There is a large dining room and lounge area available on the ground floor and small lounges on each floor with tea and coffee making facilities. The ground floor lounge accesses the garden area. The home has five assisted bathrooms and residents rooms have ensuite facilities with assisted showers. There is a range of equipment which includes variable height beds, full body hoists and the home has been assessed by a qualified occupational therapist to ensure that it has sufficient equipment, grab rails and other aids for those who are disabled. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 16 Residents rooms have radiator guards and window restrictors in place, and water temperatures are tested regularly with the majority falling within recommended parameters, some however need adjusting to ensure that all water is delivered around 43C. All residents rooms are fully furnished but residents can bring in furniture following discussion with the manager, and are encouraged to bring in their own possessions to personalise their rooms. It was seen that four rooms do not appear to have a lockable drawer and the manager must ensure that these are put in place. Infection control measures are in place, this includes staff wearing aprons and gloves for care and protective clothing when entering the kitchen. All bathrooms and toilets were in a clean condition, as were the sluices, and all soiled washing is put in red alginate bags. It was noted that one of the communal bathrooms had block soap for use, this must be replaced with a soap dispenser, the other bathrooms and toilets seen have liquid soap and disposable towels in place. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,30 Staff receive in house and other training relevant to the care needs of the residents. To ensure well informed and skilled care is given to residents, care staff must be encouraged to gain the NVQ qualification. EVIDENCE: Off duty rotas showed that there are enough staff on duty at any given time to meet the needs of the residents and there are registered nurses on duty twenty four hours a day. Staff spoken with stated that they felt the workload was manageable and that the manager increases the number of staff should the needs of the residents make this necessary. All members of staff undertake an induction course which meets NTO specifications. There are no members of care staff who have NVQ 2 at present although there are 12 members of staff that are undertaking study for this. It is important that NVQ training becomes a priority. Staff at all levels receive ongoing training on matters relevant to the needs of the residents, and the assistant cook has further identified that she would be interested in attending training sessions in medical diets. Previous inspections have identified that the homes recruitment policies are sufficiently rigorous to ensure that the safety of residents is not compromised and these will be examined at the next inspection. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38 Residents positive comments show that they benefit from the good ethos and atmosphere within the home. The present banking arrangements for residents monies can put some residents at a disadvantage. EVIDENCE: The manager, Suzan Green, has been in post since October 2004 and prior to this was the deputy manager for twelve years. She is an RGN and holds the NVQ4 ( managers certificate) and the NVQ D32 /33 assessors award. The home holds regular staff meetings and staff supervision is taking place at those timescales specified within this standard. Residents, staff and visitors spoke highly of the ethos within the home, feeling that the manager makes herself available at all times, offering support and help. The atmosphere in the home is unhurried and friendly and people within the home feel able to speak openly. Comment cards received from residents and visitors verify this. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 19 Residents described the staff as ‘lovely’, ‘helpful’ and ‘patient’ and felt that staff do everything possible to make their lives as pleasant as possible. Regular visits by the registered person take place and reports are received by the CSCI. All records are kept secure. A quality monitoring programme is in place in the form of ‘SAMS’ whereby the home is assessed and monitored by managers from other homes within the trust. Questionnaires are given to residents and visitors and now should be extended to include other professionals. It was agreed that Anchor Trust could keep residents’ money in an interest bearing residents account, which is not in individual names, and the interest put into a residents fund. This was due to the unavailability of banks being able to offer a service that would allow service users to be named in one account and individual residents interest to be calculated. However some national banks are now providing this service and Anchor Trust is recommended to look into this service in order that individual residents can benefit from interest on their money, Likewise monies given in for residents for safe keeping is pooled instead of being kept individually, although good records are kept of which money belongs to individual residents. In order to meet this standard residents money should be kept separately. All certificates relating to regular servicing of utilities and equipment were seen and in date. Keypads have now been put on doors to prevent access to laundry and staff rooms. Magnetic door closures are now in place on all doors accessing residents private accommodation. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 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 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 1 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 4 3 3 1 3 3 3 Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 21 yes 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 OP1 Regulation Reg 5 Requirement That the manager ensures that all service users are in possession of a service users guide. That all medications are signed for following administration. ( This was a previous requirement on three past inspections- last date 5th November 2005) That risk assessments for service users who self medicate are reviewed. That bar soaps are not left in bathrooms. That training on the use of the whistleblowing policy is updated Timescale for action Aug 1st 2005 Immediate 2. OP9 Reg 13(2) 3. 4. 5. 6. 7. OP9 OP26 OP18 Reg 13(2) Reg 13(3) Reg 13(6) Immediate Immediate August 1st 2005 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 OP23 Good Practice Recommendations Service users money handed in for safe keeping should be kept in individual amounts, not pooled together. H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 22 Sycamore Court Nursing and Residential Care Home 2. OP35 That service users monies are transferred to interest bearing accounts in the names of the individual service users. Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Sycamore Court Nursing and Residential Care Home H59-H10 S14065 Sycamore Court V222722 010605 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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