Inspection on 24/05/06 for The Grange Rest Home

This inspection was carried out on 24th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Grange Rest Home 04/10/07

The Grange Rest Home 15/09/05

The Grange Rest Home 21/04/05

The Grange Rest Home 19/10/04

The Grange Rest Home 22/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Grange Rest Home 11 Sackville Gardens Hove East Sussex BN3 4GJ Lead Inspector Linda Boereboom Key Unannounced Inspection 24th May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Grange Rest Home DS0000014251.V290523.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 Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Grange Rest Home Address 11 Sackville Gardens Hove East Sussex BN3 4GJ 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) 01273 298746 The Grange Rest Home Limited Mrs Suzanne Leahy Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents to be accommodated is 25 The residents will be aged 65 years or over on admission Date of last inspection 15th September 2005 Brief Description of the Service: The Grange Rest home is situated in a residential road close to Hove seafront. It is registered for twenty-five residents who are older people aged over sixtyfive years. Since 1989 the home has been privately owned. The building is Victorian and has been extended. There is a small garden at the rear that has a conservatory and paved area for residents and their visitors to use. Internally the building is spread over three floors with a passenger lift servicing each level. The first floor is split levelled with a few steps linking the residents’ accommodation. There are twenty -five single bedrooms, eleven of which have full en suite facilities. On the ground floor is a shared dining room close to the kitchen, and two sitting rooms. The front of the home is paved to enable visitors to park, however there is onstreet parking and meter parking on the seafront. The pavements are suitable for residents who require a wheelchair. The home is close to the shopping area of Hove and all amenities including Hove Museum that has a teashop, the local library and Sussex County Cricket Ground. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was facilitated by the Registered Manager Mrs Sue Leahy. It took place between 10am and 4pm; during this time the Inspector was able to look at the home’s administration processes, tour the premises and speak with residents and staff. Prior to the inspection the Inspector contacted relatives and friends of residents by telephone to ask their views on the care received in the home. Resident, relatives and staff surveys were sent out by the Commission for Social Care Inspection prior to the inspection. Fees for residency in the home varied between £361-£410 with additional charges for hairdressing, chiropody, newspapers and magazines, and personal toiletries. The Inspector would like to thank Mrs Leahy, staff, and the residents for helping to make the inspection a pleasant and positive one. What the service does well: What has improved since the last inspection? The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 6 Requirements made in the last inspection report have been addressed and were discussed in full between the Inspector and Registered Manager; in addition some rooms have been redecorated to a good standard. A new fridge has been purchased for the storage of medication. 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. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that residents are assessed prior to moving in to the home and offers the opportunity if they are able, to visit for a day enabling them to make an informed decision. EVIDENCE: The Inspector looked at pre-admission assessments undertaken by the Registered Manager and found them to hold relevant and comprehensive information. The Registered Manager confirmed that she visited prospective residents who had been referred either from Social Services or as a recommendation, in hospital or their place of residence. Prospective residents are encouraged, if possible, to visit the home and spend time having a meal and meeting with the other residents to help them make an informed choice. The home has both private and funded residents with fees ranging from £361£410 per week. The Inspector spoke with relatives prior to the inspection who confirmed that someone from the home had made an initial assessment prior to a place being offered in the home. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 9 The home is not registered for intermediate care therefore this standard is not applicable. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has improved its care planning and reviews and provides a good standard of care to the residents using links with all healthcare professionals. Residents are protected by the homes medication procedures and are treated with kindness and respect. EVIDENCE: The home has addressed requirements made in the last inspection report and the Inspector looked at care plans finding they had been reviewed, signed and dated. All residents had been risk assessed. Relatives confirmed that the home makes contact with them if a change occurs to the health of a resident. Records showed that any involvement by a GP or District Nurse had been recorded. Residents with pressure area soreness had been supplied with pressure relieving equipment to make them more comfortable. The home has access to all services within the NHS Framework including an optician, dentist, chiropodist and dietician. The requirement from the last inspection report has been addressed and the home now has a fridge for the storage of some medication. Medication records looked at by the Inspector were up to date with photographs available of each The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 11 individual resident for easy identification. All individual records showed a clear explanation and instruction of PRN (as required) or preferred medication. Residents who self medicated had been risk assessed to do so. In the medication cabinet there was no evidence of stockpiling or shared lotions and creams. Records are in place for returned medication and controlled medication. The Registered Manager told the Inspector that a new blind is being purchased for the window to prevent the room becoming too hot. Relatives and residents confirmed that staff treat everyone with kindness and respect preserving resident’s dignity. The Inspector observed that staff knocked on doors and called residents by their preferred name. The Registered Manager confirmed that residents are seen in their own rooms by visiting healthcare professionals. The Registered Manager and Inspector discussed the home’s policies for death and dying and the Registered Manager confirmed that residents are able to stay in the home, in their own room, as long as the home is able to fully meet their needs, this often includes the involvement of the district nursing teams. Relatives and friends are able to be a part of the process and are encouraged to spend as much time with the resident as they wish, sharing the homes facilities. The Grange Rest Home DS0000014251.V290523.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): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is pro-active in ensuring that residents are able to maintain links with their families and friends and given the opportunity to join in a choice of activities in the home. Meals are good and presented well with residents having choice if they do not like what is on offer. EVIDENCE: When the Inspector spoke with residents in the home they all said that they have the opportunity to join in activities. Activities spoken about included bingo, reminiscence therapy, arts and crafts, singing, listening to live music and trips out of the home for walks or to the theatre. On the day of inspection eleven residents were seen enjoying a musical afternoon with a singer playing the organ. The home does have its own organ in the dining room but at the time of inspection no one could play. All relatives and friends spoken to prior to the inspection said they are always made very welcome in the home and offered a drink on arrival. During lunch one resident told the Inspector that a friend of hers visited each week and stayed the day having lunch in the dining room with all the other residents. Conversations with residents, relatives and staff all confirmed that the home has a warm and friendly approach encouraging residents to maintain their social lives if they wish. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 13 The Inspector visited residents in their rooms and those who chose not to join in activities said they are able to undertake arts and crafts, listen to the radio or watch the television in their own room if they wish. Staff frequently visit residents who are unwell for a chat to prevent them feeling isolated. Throughout the home the Inspector observed evidence of very good communication. Everyone spoken to confirmed that the food is good and that there is choice with plentiful portions. The Inspector observed sixteen residents having lunch together in the very pleasant dining area. There is a rolling programme of menus with a menu board displaying what is on the menu for the day Residents’ said that the new chef consults them on their likes and dislikes and that their dietary needs are catered for. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents and staff are protected by the home’s attitude to complaints and the protection of vulnerable adults. EVIDENCE: The home has policies in place for complaints and the protection of vulnerable adults. There have been no complaints since the last inspection and any minor concerns raised by residents are reported in their care plans. During the inspection the Inspector observed a resident raising a concern with the Registered Manager, this was dealt with in an empathetic way and a conclusion reached. Both relatives spoken with prior to the inspection and residents confirmed they felt comfortable in approaching staff in the home with any worries they may have. All staff receive training in the protection of vulnerable adults and new staff are automatically POVA first checked and supervised until their Criminal Records Bureau check comes through. The Registered Manager has a sound knowledge of adult protection procedures and to ensure staff have quick reference an adult protection flowchart is on view in the staff room. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is good with residents having pleasant bedrooms and communal areas in which to live. The home is pro-active in improving facilities making them homely and bright however hot water pipes above floor level in some rooms need addressing as a priority. EVIDENCE: Requirements from the last report have been addressed with the exception of fitting blinds in the conservatory, adjoining the dining room. The Registered Manager explained this is due to future renovation and extension of the dining room resulting in the conservatory being taken down. It was agreed that on sunny days when residents use the conservatory, staff would ensure that they have extra drink available and are monitored to prevent them getting too hot. The conservatory faces east and has the effect of the sun until midday during the summer months. During a tour of the premises the Inspector noted that some pipes above the floor in residents rooms had not been covered when the rooms were redecorated. It was agreed that this would be addressed as a matter of urgency giving priority to rooms 7 and 9 then rooms 5,11,12 and 20. In The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 16 addition to this, on the first landing a radiator has been removed leaving the water fittings in place. The Registered Manager and Inspector discussed the hazard this presented and it was agreed that it would be removed as soon as possible. Improvements have been made to the toilet and bathing facilities in the home with the refurbishment downstairs of two existing toilets; one now has an additional shower facility. The home has adequate bathroom facilities throughout with one new bathroom being equipped with an electric bath hoist. The Registered Manager said that the home had not been specifically assessed by an occupational therapist although any resident requiring aids or adaptations would be referred for OT support. The home does have grab rails and equipment in place to assist residents with poor mobility. There is a small passenger lift servicing all three floors. It was a greed that for good practice a recommendation will be made in this report suggesting an OT assessment is sought. Residents’ rooms visited by the Inspector were found to be inviting and homely with each resident having personalised his/her individual accommodation. Residents with electric kettles have been risk assessed to use them. Residents and relatives spoken with all said they found the home very homely and that it was always kept clean and tidy. On the day of inspection there were no offensive odours and everywhere looked very clean and well organised. The laundry area in the home is situated outside with access through the kitchen area. The Registered Manager is aware of the importance of ensuring that laundry from the home is securely sealed before being taken to the laundry. The laundry itself has hand washing facilities and industrial machines. Staff have protective clothing for dealing with human waste and the Registered Manager said there are plans to provide a sluice for this purpose. Liquid soap and paper towels are used in communal toilets and hand washing areas. For good practice the Inspector recommended some control of infection posters be on view as a reminder to staff of the importance of health and safety and control of infection procedures. The side entrance to the home is kept locked for the security of the residents; all visitors have access through the front door which has an entry system in place. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures residents are protected by its recruitment and training procedures. EVIDENCE: The requirement from the last inspection report has been addressed and the Registered Manager reported that staff have received training in visual impairment. The Inspector looked at staff records and found them to have information required to support thorough recruitment i.e. staff have been Criminal Records Bureau checked and two references received prior to employment. The Registered Manager said that most staff have been with the home for a long time and that on the whole staffing is not a problem however occasional agency staff are used from an agency who always sends staff familiar with the home and its routines. The Registered Manager takes responsibility for all recruitment in the home. Rotas convey that the home has sufficient staff on duty at all times of the day including two waking staff at night who in addition to their caring role undertake some light household duties. In addition to care staff the home has a cook, two domestic staff and a maintenance person. Staff training is good; all staff have individual training records and certificates on file. The Deputy Manager takes responsibility for induction training, supervision and staff files. A recommendation will be made in this report that files relating to staff are reviewed and reorganised to make reference easier. The Grange Rest Home DS0000014251.V290523.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): 31,32,33,35,36,37 and 38. 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 and the outcome for residents is good. There is clear communication throughout the home that supports an ethos promoting that residents have a homely and secure place in which to live. EVIDENCE: The Registered Manager has been working in the home for nine years, five of which have been as the manager. She has taken a break from undertaking NVQ4 in care but is planning to resume it again. The Deputy Manager supports the Registered Manager and takes responsibility for care planning, training and staff supervision. She is also studying for NVQ4. Staff are trained in moving and handling, fire safety, health and safety, food hygiene and first aid and control of infection. The Registered Manager has been the Appointed First Aid person in the home but as her certificate has run out is considering delegating the position to another member of staff. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 19 The Registered Manager and Inspector discussed staff meetings and resident/relatives meetings. Although efforts have been made in the past to hold staff meetings the Registered Manager said that attendance was poor. Discussion took place about making sure that staff did attend; the Inspector and two members of staff later discussed this. The Inspector is aware through conversations with relatives, residents and staff, and through observation that communication in the home is very good and agreed with the Registered Manager that a recommendation will be made in this report that meetings are resumed to promote good practice. Staff in the home do not manage the financial affairs of the residents and do not act as appointee or have power of attorney. The Registered Manager does hold small amounts of personal allowances that are banked by relatives when the amount becomes excessive. Receipt books are used for all financial transactions relating to personal allowances. Staff records showed that supervision does take place approximately every eight weeks and the Registered Manager and Inspector discussed the need for a more suitable format. A requirement will be made in this report that the Deputy Manager receives appropriate supervision to support her role in the home. Staff receive fire safety training and fire drills take place every two months. The Registered Manager said that the home has a ‘stay put policy’ and residents are not automatically evacuated from the home in the event of a fire. This has been discussed with the fire safety officer for the home. The Inspector requested this be written into the homes fire safety policy and will be supported by a requirement in this report. All other equipment in the home is tested for efficiency on a regular basis including the call alarm system, emergency lighting, and fire fighting equipment. The maintenance person takes responsibility for testing the water temperatures throughout the home and makes visual wiring checks to support the pat tests (portable appliance tests). At the time of inspection one resident required the use of an oxygen cylinder and staff had ensured that appropriate signage was in place. Recording in the home is generally good however the Inspector and Registered Manager discussed a suitable format for a maintenance book covering a record of all maintenance work planned and all work undertaken. The Grange Rest Home DS0000014251.V290523.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 The Grange Rest Home DS0000014251.V290523.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. 1 Standard OP12 Regulation 16(2)m Requirement The home to have an activities notice board on view highlighting all activities on offer for residents. Until the renovation of the dining area and conservatory is complete, residents using the conservatory to be monitored for over – heating. Above floor hot water pipes in residents rooms to be covered giving priority to those in rooms 7 and 9, followed by rooms 5,11,12 and 20. The existing fittings from the radiator that was removed from the first landing to be removed as these present a hazard should a resident fall against them. The Deputy Manager to receive regular supervision to support her role in the home. The home to prepare a ‘stay put’ policy, made available to staff and residents in case of the event of a fire in the home. Timescale for action 30/06/06 2 OP19 13(4) 23(2)ap 25/05/06 2 OP25 13(4)abc 15/06/06 3 OP25 13(4)abc 15/06/06 3 4 OP36 OP38 18(2) 23(4)ciii 30/06/06 15/06/06 The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP22 OP26 OP37 Good Practice Recommendations The home obtains an Occupational Therapist report on the home to ensure sufficient aids and adaptations are in place. The home obtains some health and safety and control of infection posters for the home as a reminder to staff to promote good practice. Staff files to be revisited and re-addressed to make them more user-friendly. The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East Sussex Area Office 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 . The Grange Rest Home DS0000014251.V290523.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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