Inspection on 25/07/06 for The Cottage

This inspection was carried out on 25th July 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Oldhill Cottage The Cottage Old Hill Longhope Glos GL17 0PF Lead Inspector Mr Nicholas Jones Key Unannounced Inspection 25 July and 16th November 2006 1:00 th Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 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 Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oldhill Cottage Address The Cottage Old Hill Longhope Glos GL17 0PF 01452 830373 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) The Brandon Trust To be Appointed Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th September 2005 Brief Description of the Service: The Cottage is a detached house in the village of Longhope. It is registered to provide care and accommodation for four learning disabled adults. The home is staffed at all times. In addition to providing personal care and other support as required, the home aims to offer a range of activities both on site and in the community. There is a sensory room and large split-level garden. A new,sensory garden is being built on the lower level garden. The Registered Provider of the home is now the Brandon Trust as of the 1st April 2006. They are a social care organisation based in Bristol and were chosen by the Gloucestershire Partnership Trust in the re-provision of the MEND/Mayfield Trust homes in Gloucestershire. The home has a Statement of Purpose and Service Users Guide that is available to a prospective service user. The monthly fees charged by the home are £1359.15 Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Key Inspection and was completed during one afternoon and a day three months following the first day of the site visit. The delay in completing the inspection was due to unexpected leave being taken by the inspector. Staff, including the Manager, on duty were seen and spoken to. All of the service users were met and whilst their ability to offer comment was limited it was evident that they were happy in the home and had a positive relationship with the staff. All staff were helpful and well informed during the inspection. Before the visit a pre-inspection questionnaire was returned, and several comment cards were received from people involved with service users’ care. During the inspection various documents were checked including examples of care plans, Essential Lifestyle Plans, risk assessments, medication reviews and records, training summaries, daily notes and staffing files. A tour of the home and garden was completed. The home was seen as comfortable and stimulating environment where staff are totally committed to meet the varied and complex needs and wishes of the service users. The home has maintained the continuity of service during the change over to the new Registered Provider, The Brandon Trust. What the service does well: The home is good at providing a flexible service by identifying the needs and wishes of the individual service users. Staff were seen as approachable, attentive and competent. Good systems are in place for planning care and for assessing and managing risks. People living in the home are enabled to take part in a range of different activities that reflect their needs and interests. And are supported to stay in touch with friends and family. A varied diet, which takes into account people’s preferences, is served. It provides imaginative solutions to meet the varied and complex needs of service users that enables them to maintain choice and a safe environment. The support staff have provided to service users to access healthcare is to be commended. The manager has a sound understanding of requirements around recruitment and selection, thereby helping to protect service users. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 6 The home is well run. 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. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 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 the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s Statement of Purpose and Service User Guide provide most of the required information for prospective users of the service. Comprehensive assessments provide detailed information about the needs of service users. EVIDENCE: The home has not had a new admission for over two years. The manager has recently updated the Statement of Purpose and Service User Guide, which included providing information about the Brandon Trust. Risk assessments for current service users indicate the kitchen is not a safe environment to be able to access. This has been detailed in the Statement of Purpose but should also be described in the Service User Guide. Service user files viewed contained detailed assessments of the needs of each individual. There was also evidence of involvement of NHS CLDT (Community Learning Disability Team) clinicians in assessing the needs of service users. The assessments have taken into consideration the views of family carers and professionals with knowledge of the needs of the individual service user. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A good care planning system operates in the home, helping to promote the quality and consistency of support. People’s choices are ascertained and respected as far as possible, helping to empower service users to take control of their lives. Arrangements are in place to assess and manage risks, helping to keep service users safe with any restrictions or limitations being clearly recorded. EVIDENCE: Care plans of service users were viewed, two in more detail. They contained detailed and well-written plans that described how staff should support service users in various aspects of their lives. These have more recently been recorded using the ‘Essential Lifestyle Plans’ format. This included needs such as daytime activities, communication, mealtimes, personal care, emotional Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 10 support and travelling in vehicles. Files also included a summary ‘Person Profile’. A picture file of staff duty rotas with photos of staff has been made available to service users to assist them in knowing which staff will be working on any given day. The care plans show staff are supported to understand particular needs of service users such as autism. The plans have been devised with as much involvement as possible of service users, family carers and other health and social care professionals. There was evidence that the plans are appropriately reviewed. Discussions with staff and observations of staff interactions with service users over the two days demonstrated that staff have a detailed understanding of the support and communication needs of service users. A letter from a CLDT clinician stated a service user has ‘clearly experienced a better quality of life since moving to the home.’ Viewing care plans and risk assessments and spending time with service users demonstrated they are imaginatively supported to make choices and decisions in their day-to-day lives. Any limitations to choice are documented as to why it is in the best interests of the service user. There was evidence that CLDT clinicians have been involved in the decision making process. Service users were observed to be able to choose where they wished to spend time in the house or garden, other than in the kitchen. The staff team are to be commended in their support of the complex and varied needs of the service users. A wider range of activities outside of the home have been offered to service users since the previous inspection with appropriate risk assessments having been undertaken for new activities. The assessments have been reviewed appropriately. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate support is provided for people to take part in activities which reflect their needs and interests both in the home and community. Service users are also supported to maintain and develop contact with important people in their lives. Service users are respected and valued as individuals, promoting their selfesteem and sense of autonomy. A varied and balanced diet is provided, enhancing service users’ health and quality of life. EVIDENCE: People living at the home have access to a range of social and leisure activities. During the week they have the opportunity to access a range of community activities such as swimming, shopping, bowling, places of worship, pub lunches, picnics and walks. Some service users access a music session Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 12 held at another nearby Brandon Trust home. Some people choose to spend time at home on some days, rather than a planned activity. This is arranged flexibly for some who have anxieties about daily routines. Another service user can become very upset if a planned activity cannot take place, and the team therefore try to offer activities more spontaneously to reduce their anxiety. Discussions with staff and viewing daily notes showed the frequency and range of activities being offered to service users have increased since the previous inspection. One service user went on holiday to a holiday home recently and another has been on day trips, which they prefer to being away from home for a week. Staff were observed treating people living at the home respectfully, knocking on bedroom doors and spending time with them. There is a small table available next to the lounge to play games or puzzles. Service users are supported to maintain contact with families. Cards were viewed from family members thanking the home for support they offer to their relative. Menus showed that service users are offered a varied and balanced diet. Staff said that they use fresh ingredients as much as possible and that they offer fresh fruit to service users. Staff provide discreet supervision and support during mealtimes, balancing some service users’ apparent preference to be left alone with other people’s preference for company, also taking into account identified risks such as choking. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have access to a range of healthcare professionals making it possible to meet their physical and emotional health needs. Systems for the administration and control of medication ensure that people living at the home are not put at risk. EVIDENCE: Service users’ personal care needs are written in care plans. These include reference to establishing and respecting choices where possible. Staff spoken to have a good understanding of these needs. The team aims for people of the same gender to provide personal care if possible. Health and social care workers’ feedback via comment cards was very positive about the support provided to service users. Healthcare records appeared to be up to date including weight charts, which were completed every month. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 14 Staff have supported a service user to have their eyes tested and to try out wearing them some of the time. A written protocol has been written to ensure a consistent approach by staff. Discussions with staff and viewing service user files showed the home is committed to supporting people with complex needs to access health checks such as dental, eye and blood tests. Visits by health professionals to the home are arranged for service users who are assessed to prefer this. Some service user files contained health action plans and an annual health check. It is recommended that work on health action planning for each service user be progressed in conjunction with others involved in their care. Medication storage and administration appeared to be in order. Service user files contained letters from their GP confirming homely remedies that could be administered. All service users have had a recent medication review involving appropriate health professionals. A draft protocol has been developed for one service user in how staff should support them with their epilepsy. None of the service users are assessed as able to administer their own medication. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place for managing complaints that ensure the views of service users and their relatives are listened to and acted on. Systems are in place which help to protect service users from harm and abuse. EVIDENCE: Discussions with staff and viewing service user files showed that staff work to understand the views and preferences of service users as much as is possible. A range of CLDT clinicians support the staff team in devising ways to make this possible for service users. The manager stated that the families of service users are encouraged to be involved in the lives of their relatives and that their views are sought. The home has received a written complaint in October 2006. A written response to this complaint was viewed and showed that the views of the complainant were being taken seriously and that they were being offered the opportunity to meet to discuss the issues raised. Staff receive training in the protection of vulnerable adults and is addressed during NVQ study with the ‘No secrets’ element. Staff also attend ’Positive Response’ training, which is specific to the needs of service users living at the home. The finances of two service users were checked. They were recorded and managed appropriately with personal spending recorded for items such as food and drink on trips out and clothes. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, clean, hygienic and safe environment, which meets the needs of service users. EVIDENCE: All areas of the home were viewed including all bedrooms. Décor and furnishings are of a good quality with bedrooms personalised to the tastes and preferences of service users. Fixtures and fittings were well maintained and appropriate to the needs of service users. Recent on-going improvements to the environment included re-decoration of the kitchen and hallways, new flooring for the lounge and first floor bathroom, a new gas boiler and various new white goods. Staff described how service users enjoy using the separate sensory room for one to one time, particularly music sessions. The sensory garden was undergoing further building work including the development of a pond. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 17 The home was clean and bright on the days of the inspection. Disposable aprons, gloves and disposable red laundry bags are available. Bathrooms and toilets have sanitising wipes and anti-bacterial soaps. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by committed staff who demonstrate care and interest in providing appropriate support. The home has a staff team with sufficient numbers and suitable qualities to meet the needs of service users. A suitable recruitment process supports and safeguards service users. The training, development and supervision of staff, in the main, ensure the staff team meets service user’s needs. EVIDENCE: Staff were observed providing skilled, individualised support throughout the inspection, treating service users with respect. The people living in the home in turn appeared comfortable and relaxed with the staff. Staff appeared able to communicate effectively with service users and to understand what was being conveyed to them, in accordance with communication guidance on file for each person. Service user files and feedback from health professionals in comment cards returned to the Commission showed the home has excellent working Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 19 relationships with a range of health and social care professionals who support the staff team in a variety of ways to improve the quality of life of service users. Discussions with staff and viewing of meeting minutes showed staff team meetings discuss a range of issues and that staff are able to raise any ideas or concerns. The staff team made use of detailed handover sheets for shift changes with a space for a record of any discussions about the needs of service users. A third of the staff team have achieved an NVQ 2 or above in health and social care. Six staff were in the process of completing their LDAF inductions. These were started after all staff received a comprehensive ‘in-house’ induction. Four staff at the time of the inspection were undertaking their NVQ level 3 and further staff are booked to commence this qualification. The manager was undertaking an NVQ assessor’s course. Staff duty rotas and the daily notes of two service users were viewed in detail. They showed that there were sufficient numbers of staff working at the home to meet the needs of service users. The range and frequency of activities, on the whole, have increased since the previous inspection. Discussions with the manager and staff confirmed that the home does have some full-time vacancies but that they are being covered by regular bank staff. Recruitment of permanent staff was being undertaken. Three staff files were viewed and found to contain all the details as required under Schedule 2. The manager described the steps that she takes when recruiting staff, demonstrating a sound awareness of the relevant National Minimum Standards and Care Homes Regulations. Discussions with staff and the manager, and viewing staff files and training records showed staff are, in the main, provided with a comprehensive induction and on-going training package. The Brandon Trust provide staff with a corporate induction, which includes the staff completing the Learning Disability Awards Framework (LDAF) induction. Staff training records showed staff receive training in areas such as Food Hygiene, Fire Safety, Moving and Handling, Safe handling of medicines, and Basic life support. Food Hygiene, Fire Safety and First Aid training and refreshers should be updated/provided for some staff. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run, promoting positive outcomes for service users. Systems are in place which help to monitor and improve the quality of the service provided. Health and safety in the home is promoted which safeguard people’s wellbeing. EVIDENCE: The manager has completed an NVQ level 4 in management and has commenced the Registered manager’s Award (RMA). A Registered Managers application has been forwarded to the Central Registration Team of the Commission. She has promoted an inclusive style of management that has enabled the staff team to develop in their roles and develop a service user focused approach. Staff felt that the manager was approachable and supportive. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 21 The home conducted a survey of the views of various family members of service users in April 2006. There was evidence that the home had taken into consideration some of the views expressed. The Trust has devised some quality standards and home managers were asked to complete a self-audit which would in turn be checked by their line manager. Quality standards are being reviewed by the Trust. Health and safety aspects of service provision are being maintained and monitored. Records viewed included fire safety checks, water temperatures and servicing of equipment. A fire safety risk assessment was undertaken and written in March 2006. The last recorded fire drill took place on 2nd May 2006. The Fire Safety trainer used by the Trust has made some suggestions around fire safety and fire drills. Service users have experienced the noise and disruption of a fire drill as a traumatic experience. The possibility of ‘silent’ drills or staff-only fire drills were discussed. Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X X 3 X Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 23 No 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. Standard Regulation Requirement Timescale for action 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 YA1 YA19 Good Practice Recommendations Any limitations of access for service users to parts of the building should be detailed in the Service User Guide. Health action plans should be completed for all service users. The draft protocol to be completed for how to support a service user with their epilepsy. To continue to support staff to complete their NVQs to ensure at least 50 of the staff team have an N VQ 2 or above. Mandatory training to be updated for all staff. Alternative ways of completing fire drills should be explored that reduce the stress experienced by service users. 3 4 5 YA32 YA35 YA42 Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Oldhill Cottage DS0000067014.V291702.R01.S.doc Version 5.1 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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