CARE HOMES FOR OLDER PEOPLE
The Firs Residential Home 9 Stevens Lane Breaston Derby Derbyshire DE72 3BU Lead Inspector
Steve Smith Unannounced Inspection 7th February 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Firs Residential Home DS0000063245.V282297.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 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. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service The Firs Residential Home Address 9 Stevens Lane Breaston Derby Derbyshire DE72 3BU 01332 872535 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 Firs Care Home Ltd Yvonne Marie Pelosi Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Mrs Yvonne Pelosi must obtain a qualification of NVQ level 4 in Management and Care by May 2007. 22nd June 2005 Date of last inspection Brief Description of the Service: The Firs Residential Care Home provides accommodation for 20 Older People. The building was originally a large Victorian family home that has been extended to its current size. The Home is situated in the village of Breaston, located almost midway between Derby and Nottingham. All bedrooms meet the National Minimum Standard for size, as does the communal space. Two stair lifts, and three staircases, provide access to the first floor. The Home has two lounges, and a seating area in the large reception area of the Home. There is a front conservatory that exits into a patio and garden area, which Residents regularly use. There is a call system, which operates in all areas of the Home. Relatives and visitors can call to visit Residents at any time. The Home is run by the two Registered Providers, one of which is also the Manager. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place in just under 5 hours. Discussion took place with both Registered Providers and records were looked at. All public areas of the Home were also examined. What the service does well: What has improved since the last inspection?
Information provided in Residents files had greatly improved. For example, initial assessments of needed were completed, as were risk assessments on each Resident, and regular reviews of care were documented within each file, etc. The recording of the administration of medication had improved. Residents had been spoken to about their funeral needs shortly after they arrived at the Home. In the toilets in Residents bedrooms, and elsewhere in the Home, towels were no longer left to dry on Residents handrails. The appropriate number of seats was provided within Residents bedrooms. However, where bedrooms would not comfortably allow the required number of
The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 6 seats to be provided, the Registered Providers had provided seating in corridors that could be taken to the bedrooms as Residents and their visitors wish. Hot water was supplied to the hot taps in all of the Home’s bathrooms at 430 centigrade, plus of minus 20 centigrade. The Registered Providers had ensured the Home had copies of all necessary legislation relating to the operation of the Home. At least fifty percent of all care staff were trained to at least the NVQ level 2 qualification in Care. The Registered Provider/Manager was under going her own qualification of NVQ level 4 in Management and Care. What they could do better:
The Registered Providers needed to ensure that the statement of purpose was completed, at least in line with Schedule 1 of the Care Homes Regulations, including the physical environmental standards. They also needed to inform Residents, in the statement of terms and conditions or contract for living at the Home, information on the rights and obligations of the Residents and Registered Providers and who would be liable if there were a breach of contract. The Residents Guide also should contain information from Residents on the quality of care provided by the Home. New Residents had not been formally informed, by the Registered Providers, of the fact that the Home would be able to meet their needs in respect to their health and welfare. The Registered Providers also needed to improve their recording of complaints, ensuring that all complaints, whether verbally given or provided in writing were acted upon. A number of improvements within Residents’ bedrooms and in the Home in general needed to be addressed. The Registered Providers needed to ensure that when appointing new staff to the Home that they obtained all necessary information. They also needed to provide all necessary training to new staff, within 6 months of beginning to work in the Home. The Registered Provider, not the Registered Provider/Manager, needed to inspect the Home at least once every month, ensuring that he also interview a number of Residents and staff. Quality Assurance issues had not been addressed in the Home. A number of staff required training.
The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 7 Finally, the Registered Provider/Manager needed to complete risk assessments on all practice issues undertaken by care staff, catering staff and domestic staff. The Registered Provider/Manager was also recommended to provide a written statement of the policy, organisation and arrangements for maintaining safe working practices in the Home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1 & 2. The statement of purpose and Residents Guide did not provide Residents with clear information on the provision of services in the Home. EVIDENCE: Standard 1 was not examined during this inspection of the Home. However, while reviewing the Requirements and Recommendations of the last inspection report it became apparent that the Registered Providers had not provided all of the details required legally in the statement of purpose. Details relating to the physical environment standards were also not completed and nor were they summarised in the Residents Guide to the Home. These issues were outstanding from the inspection report dated June 2005. It was also found that the Registered Providers had not provided all of the details require in the Residents contract/terms and conditions of residency, as they did not include a section detailing the rights and obligations of the Resident and Registered Providers, and who would be liable if there were a The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 10 breach of contract. This was also outstanding from the inspection report dated June 2005. Standard 6 does not apply to this Home. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 7 & 10. The care provided to Residents was of a good quality, and ensured that the required records were maintained for all Residents and potential Residents. EVIDENCE: Standard 7 was not examined during this inspection of the Home. However, while reviewing the Requirements of the last inspection the Registered Provider/Manager was able to say that all new Residents moving to the Home were provided with a letter confirming that the Home would be able to meet their needs in respect of their health and welfare. Since taking over the Home the Registered Providers had employed an Activities Coordinator who worked across two days of the week providing entertainment and activities for Residents. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These Standards were not examined during this inspection of the Home. EVIDENCE: The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16. The Registered Providers needed to ensure that all complaints, whether written or verbally presented received appropriate attention and recording. This would ensure that Residents needs were always appropriately addressed. EVIDENCE: Standard 16, Complaints, was not fully examined on this visit to the Home. However, the Registered Providers said that they did not maintain a full record of all complaints. Their system would have recorded written complaints, of which there were none, but they did not record verbal complaints. Most complaints would be made verbally to the Registered Provider/Manager, so this is a significant omission in the Registered Providers complaints recording system. A record of verbal complaints needs to be kept. This issue was first identified during the inspection of June 2005. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 19, 22, 24 & 25. Generally, the Home was well maintained throughout, however, improvements were needed to ensure all Residents lived in a well-maintained environment. EVIDENCE: None of these Standards was formally examined on this visit to the Home. However, on reviewing the Requirements and Recommendations of the previous year the following items were found not to have been addressed: It was found that two double sockets in single bedrooms and four double sockets in double bedroom had not been provided. This issue was outstanding from June 2005. Residents’ bedrooms had not been fitted with locks to allow the Residents to choose whether or not to lock their bedroom doors, whether they were in or out of their bedrooms. This issue was also outstanding from June 2005.
The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 15 The Registered Providers had started to provide covers on radiators throughout the Home. The task had almost been completed, although some radiators were still awaiting covers. This issue is also outstanding from June 2005. The Registered Provider/Manager commented that at the date of this inspection 5 bedrooms had been completely redecorated and carpeted. She said that it was their intension to shortly redecorate all bedrooms within the Home. The first floor corridor carpet was still found to be very badly worn. The Registered Providers said that it was their intension to replace the carpet once the decorating of Residents bedrooms was complete. Two bedrooms on the first floor had high windows openings on to the corridor. During the night, light from the corridor entered the bedrooms. It is understood that the current Residents were pleased to have this light entering their bedrooms at night. However, the Registered Providers needed to provide curtaining that could be closed should these or future Residents wish to have the bedroom darkened at night. Since the last inspection the new Registered Providers had provided a new floor covering in the dining room. They had also provided a hoist, for use on the ground floor, belts and other moving equipment. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 27, 28, 29 & 30. More than sufficient care staffing was provided within the Home to meet Residents needs. EVIDENCE: Staffing provided in the Home was compared with the details provided by the Residential Forum. This showed that during the three weeks beginning 2 to the 16 January 2006, the Home was providing between 14 and 22.5 hours of care a week more than the minimum amount required for 20 Residents, when allowing for 10 Residents at the Low Dependency level and 10 Residents at the Medium Dependency level. These figures were calculated without the Registered Provider/Manager’s working time included, as recommended by the Residential Forum. Since the last inspection, in June 2005, the Registered Providers have ensured that all but two care staff had begun their training in either NVQ 2 or 3 in Care. This meant that the Home would shortly meet and surpassed the requirement that at least 50 of staff hold a qualification of NVQ 2 in Care. The staffing records of two staff employed since April 2002 were examined. These showed that the Registered Provider/Manager had obtained some of the Requirements necessary, although a number were missing. CRB checks and relevant qualifications had been obtained. Two references for one member of staff, but only one reference for the second had been obtained. The record for
The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 17 neither member of staff showed that the Registered Provider/Manager had obtained a photograph, a full history of employment prior to working at the Home, or details of the person’s mental and physical fitness for the job. All these items need to be provided to meet the Requirements. The Registered Provider/Manager said that new staff completed induction training when starting work in the Home. She also said that foundation training was provided, although this was found not to be, as yet, be up to date. However, she said that all care staff were provided with at least three days paid training a year. All staff also had an individual training and development assessment and profile. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38. The Registered Provider/Manager needed to obtain an NVQ in Management and Care to ensure Residents needs were appropriately met. The second Registered Provider needed to conduct unannounced ‘inspections’ of the Home, again to ensure that Residents needs were appropriately met. EVIDENCE: The Registered Provider/Manager started her training to obtain an NVQ level 4 in Management and Care shortly after the purchase of the home. She hopes to have finished the qualification by the end of 2006. The second Registered Provider said that checks were made on the operation of the Home at regular intervals, but these check were not recorded. However, he was reminded that during these checks he needed to interview Residents and staff and provide documentary evidence of his review (‘inspection’) of the workings of the Home. This issue was first raised with the Registered Providers in June 2005. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 19 The Registered Providers were asked about the Quality Assurance measures they had put in place within the Home. However, it transpired that this work had not yet been addressed by the new Registered Providers. A small amount of Residents money was kept in the Home for everyday expenditure. The record of these was examined. Money was appropriately stored and securely held. Records were kept, and a sample of these was examined, and found to be satisfactory. The training provided for staff was examined. This showed that the Registered Providers had ensured that all but one member of staff had received the three yearly training in Moving and Handling. Fire Safety training was also examined and this showed that all members of staff would need this training by the end of February 2006. Night care staff had not received Fire Safety training twice each year. All care staff also needed First Aid training, and all senior staff needed First Aider training to ensure that at least one First Aider would be on duty at all times, both day and night. All catering staff and care staff were qualified in Food Hygiene, although one member of the care staff needed to obtain this qualification. Lastly, it was found that all but 5 members of staff had a current qualification in Infection Control. All Residents have been risk assessed to determine their vulnerability and measures had been put in place to provide protection where necessary. The Home had complied with all necessary legislation, such as the Health and Safety at Work Act 1974, and the Manual Handling legislation of 1992. The Registered Provider/Manager said that risk assessments had not been carried out to ensure safe working practices in the Home that related to the care staff, catering staff or domestic staff tasks. This issue was first identified during the inspection of June 2005. The Registered Provider/Manager also said that she had not provided a written statement of the policy, organisation and arrangements for maintaining those safe working practices. The Registered Provider/Manager ensured that all accidents, injuries and incidents of illness or communicable disease were recorded and reported to the relevant government bodies. She also had ensured that fire safety notices were posted in relevant places around the Home. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 2 X X 3 X 2 2 X STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 2 The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 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. Standard Regulation Requirement The Registered Providers must ensure that the statement of purpose contains all of the issues listed in Schedule 1 of the Care Homes Regulations, including the physical environment standards listed in Standard 1. (This issue should have been addressed from the inspection report dated 22 June 2005) The Registered Providers must include in the statement of terms and conditions/contract for living in the Home, information on the rights and obligations of the Residents and Registered Providers and who would be liable if there were a breach of contract. (This issue should have been addressed from the inspection report dated 22 June 2005) The Registered Providers must ensure that all complaints, both written and verbal complaints, are recorded and positively acted upon. The outcome, following the complaint, must also being recorded. (This issue should
DS0000063245.V282297.R01.S.doc Timescale for action 1 OP1 4 04/04/06 2 OP2 5 04/04/06 3 OP16 22 04/04/06 The Firs Residential Home Version 5.1 Page 22 4 OP19 12 & 23 5 OP19 16 & 23 6 OP24 16 7 OP24 12 8 OP25 13 have been addressed from the inspection report dated 22 June 2005) The Registered Providers must provide curtaining across the two windows that open on to the first floor corridor from two Residents bedrooms. The curtaining could then be drawn in the evening when each Resident moves into their bedroom. The Registered Providers must replace the first floor corridor carpet, as it is badly worn in a number of places. The Registered Providers must provide two double electric sockets in single bedrooms and four in double bedrooms. (This Standard should have been addressed from the inspection report of 22 June 2005) All bedroom doors must be fitted with a lock that can be operated from both the inside and outside of the room by the Resident. Each Resident must be provided with a key to their bedroom. Risk assessments must be carried out and recorded in the Resident’s file where it is considered by the Registered Providers that the Resident is not able to hold the key to their bedroom. (This Standard should have been addressed from the inspection report of 22 June 2005) The Registered Provider must ensure that all radiators and pipework in Residents’ bedrooms are provided with covers to safeguard Residents. (This Standard should have been addressed from the inspection report of 22 June 2005)
DS0000063245.V282297.R01.S.doc 30/06/06 31/08/06 30/06/06 30/06/06 05/05/06 The Firs Residential Home Version 5.1 Page 23 9 OP29 19 10 OP30 18 11 OP31 9 12 OP31 26 13 OP33 24 14 OP38 13 & 18 15 OP38 18 & 23 16 17 OP38 OP38 13 & 18 18 The Registered Provider/Manager must check, and hold documentary evidence, that all staff employed in the Home, since April 2002, have satisfied the requirements listed in Regulation 19 and Schedule 2 of the Care Homes Regulations 2001, as amended during 2004. The Registered Provider/Manager must ensure that all care staff receive foundation training within the first six months of employment at the Home. The Registered Provider/Manager must obtain a qualification in Management and Care at NVQ level 4 by 31 May 2007. The Registered Provider must ensure that he inspects the Home, on an unannounced basis, at least once each month in line with the requirements listed in Regulation 26. (This Standard should have been addressed from the inspection report of 22 June 2005) An effective quality assurance and quality monitoring system must be introduced. (This Standard should have been addressed from the inspection report of 22 June 2005) The member of staff, identified during the inspection, must receive training in Moving and Handling. The Registered Providers must provide the annual Fire Safety training immediately for all staff. They must also ensure that all night staff receive training twice each calendar year. All care staff must receive training in First Aid. The one member of care staff, identified during the inspection,
DS0000063245.V282297.R01.S.doc 04/04/06 04/04/06 31/05/07 04/04/06 31/05/06 30/06/06 04/04/06 30/06/06 30/06/06
Page 24 The Firs Residential Home Version 5.1 18 OP38 18 must receive training in Food Hygiene. The Registered Provider/Manager must provide risk assessments on all working practice issues undertaken by care staff, catering staff and domestic staff. (This Standard should have been addressed from the inspection report of 22 June 2005) 04/04/06 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 4 5 Refer to Standard OP1 OP24 OP38 OP38 OP38 Good Practice Recommendations The Registered Providers should include in the Residents Guide information from Residents on their views of staying in the Home. All care staff and domestic staff should be provided with master keys to Residents bedrooms. Sufficient senior members of staff should be trained as First Aiders to ensure that at least one First Aider can be on duty, on each shift, both day and night. The 5 members of staff identified during the inspection, should receive training in Infection Control. The Registered Provider/Manager should provide a written statement of the policy, organisation and arrangements for maintaining safe working practices in the Home. The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 The Firs Residential Home DS0000063245.V282297.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
