Inspection on 02/08/05 for The Laurels

This inspection was carried out on 2nd August 2005.

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

The inspector 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

The Laurels 15/12/08

The Laurels 19/02/07

The Laurels 21/12/05

The Laurels 21/03/05

The Laurels 14/07/04

The Laurels 17/02/04

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Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 The Laurels 56 Lydia Road Walmer, Deal Kent CT14 9JY Lead Inspector Chris Randall Unannounced Inspection 2nd August 2005 : 09.05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Laurels Address 56 Lydia Road, Walmer, Deal, Kent, CT14 9JY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 364275 Mr M Beales Mr M Beales CRH 3 Category(ies) of LD (3) registration, with number of places The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st March 2005 Brief Description of the Service: The Laurels is a small, family type, home set in a quiet residential area of Walmer, Deal and provides care and support for 3 clients with learning disabilities. The accommodation in the home is set over 2 floors and consists of three client bedrooms and a sleep in bedroom/office, a lounge/dining room, a kitchen, a first floor bathroom with toilet and a downstairs shower room with toilet. At the rear there is a small lawned garden with sitting area for the clients and staff and a garden shed. A staff member said its like a normal home. Small shops and amenities are within easy reach of the home, the resort and town of Deal is about 20 minutes walk or a short drive from the home, Walmer Castle.is also just a short drive away. Further afield, but within easy driving distance lie the Port of Dover to the south west and the small town of Sandwich to the north. Currently all of the clients and staff are female, with the exception of the manager. Clients are supported in the enjoyment of a wide range of activities and outings of their choice, some within the home and the others in the local community. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over 8 hours, (4.5 hours in the home plus preparation time). The inspection consisted of a tour of the home; talking to all three clients, two members of staff, and the manager; and inspection of some records. The home was clean, well maintained, and pleasant smelling. The clients were happy, occupied and looked well cared for. A member of staff commented “I have complete satisfaction in the way The Laurels is run, if every home were run like this it would be a happier world”. What the service does well: What has improved since the last inspection? The home has been fitted with all new external doors and windows since the last inspection. Pictorial signs have been produced of daily events to aid clients with communication difficulties (day centre, sewing etc.), and quality assurance monitoring has been developed as recommended on the last report. Additional staff training has taken place and further training is booked and ongoing. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 6 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 Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, & 4 Trial visits, assessment of needs, and information provided ensure prospective clients can make an informed choice regarding admission to The Laurels. EVIDENCE: The manager has recently reviewed the statement of purpose and service user guide and at this stage no amendments were required. The admission process of the home is sound. A joint assessment is obtained from the care manager, and the home manager visits prospective clients to carry out a needs assessment. These two assessments form the basis of a comprehensive plan of care for the client. The formulation of the care plan takes into account the assessment of any restrictions that are needed to minimise risk to the client. The home consults and has a good working relationship with the appropriate specialist services for their clients. Staffs are properly trained to cope with the needs of the clients and to communicate appropriately with them. If the home feels that it cannot meet the needs of a client then this is addressed and a more appropriate placement sought. The admission process for The Laurels gives both the prospective client and the home ample opportunity to decide if this is the correct placement for the person, if their needs can be fully and properly met, and if they fit in with the existing clients. Prospective clients spend a day, an overnight, a week, and The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 9 then a month at the home prior to the statutory three-month settling in period before permanent admission is confirmed. Standard 5 with regard to the contract will be assessed at the next inspection. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9, & 10 Clients can be assured that they will be consulted and enabled to make decisions regarding their lives, and that any potential risks from their choices will be minimised. EVIDENCE: Each client has a comprehensive care plan, which includes personal details, visits to and from professionals (G.P. nurse chiropodist optician dentist etc.), needs assessment, care management reviews, risk assessments, day care activity plan, weight chart and various charts relating to specific needs of the client. The care plans are reviewed by the home at least six monthly or more frequently if needs of the client change. Reviews by care managers are often less frequent than the required 6 months, however this is due to failure on the part of the care management system and not the fault of the home. Clients are supported in making choices about all aspects of their daily lives, and are assisted to choose where and on what to spend their money. On the day of the inspection the 3 clients had all requested to go out to McDonalds for lunch and were becoming anxious for the inspector to complete the inspection and leave so they could all get in the car and go. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 11 The home supports both individual and joint decisions of its clients. As a group they choose what they will have for the meals of the day and where to go for group outings and holidays. Individually they choose such things as what to wear, what they want to do whilst in the home, what time they get up or go to bed etc. The home regularly consults the clients about all matters involving the home they also circulate user satisfaction questionnaires. The last questionnaires were completed in June 2005 and it is planned for these to be completed 6 monthly. Client comments included, “I choose what food I want, where we are going, and what to wear”, and “I chose these trousers and blouse to wear today”, and a member of staff commented, “the clients have choices all of time”. Risk assessment forms an important part of the care plans for the clients at The Laurels. Risks and the strategies to avoid them are agreed, clearly documented, and all staffs are made aware of any potential problems and the actions to be taken if they arise. The home has a confidentiality policy, a copy of which is on the notice board in the kitchen as a constant reminder to staff. Records are appropriately stored and any particularly sensitive information is stored in a locked filing cabinet in the office. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16, & 17 Clients at The Laurels lead full and interesting lives that meet their needs and wishes. EVIDENCE: Clients at The Laurels attend colleges, day centres, church groups and various other events within the local community and are supported by staff whenever needed. In addition to helping with chores around the home, activities in the home include jigsaws which all were seen to be enjoying, and an afternoon teaching session that normally involves craft, but occasionally includes simple lessons in English, or dealing with money. Client comments included, “I go to college sewing, I really enjoy it”, “I go to the day centre”, and “I sometimes go to the Disco and dance around”. The home has the use of a car for transporting clients to their chosen destinations. A trip to the fair was amongst recent outings undertaken, and trips to the sea, the nature reserve, bowling, swimming, and to the market or to town shopping are regular features of home life. The manager commented that the clients are well known in the locality. Client comments included “I The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 13 went to the fair and went on the bumper cars”, and “I am going to McDonalds soon”. Staff comments included “The ladies are very happy, they have a good social life”, and “I took them to the fair and went on the bumper cars with them”. All of the clients have chosen to go on a holiday to Tenerife this year; they are joining with 3 clients from another home. 4 staff members, 2 from each home, will support the total group. Holidays are not included in he contract price and this is made clear to clients in their contracts, however the home does pay all of the fees for the staff who go to support the clients. Client comments included “I am going to Tenerife”, “I like going in the aeroplane”, and “I like going to Tenerife, last year I went in the pool”. Staff comments included “I am going with the ladies to Tenerife this year”, and “I am not going this year but have been before, they go somewhere every year and have been to Malta, Greece, Spain, Euro Disney and Tunisia as well as Tenerife”. Clients are encouraged to maintain links with their families and friends, and sometimes go home for weekends and short holidays. Family photographs form an important part of the clients’ belongings in their rooms and they identified their family members from the photographs. Clients said, “that’s my mum and my sister”, and “he used to be my boyfriend”. Clients’ rights are respected. Staff knock on clients’ doors before entering, and use their preferred form of address. Interaction between staff and clients is relaxed, friendly and appropriate to family life. One client commented, “The staff knock on my door”, and staff comments included “it’s very friendly and caring here and we all get on well together”, and “this is the ladies’ home” The menu book demonstrates a good balance of foods. The clients choose daily what they will all eat from the food available in the larder, freezer or refrigerator, and sometimes choose to go out for a meal. If one client does not want the same as the others their wishes are respected and an alternative is provided. The clients help with some of the shopping, the rest being delivered by a local supermarket. Currently there is only one client with an allergy for a particular food and none on special diets, however these would be catered for if required. Weight charts are maintained for all clients and weights are monitored and recorded on a monthly basis. Client comments included “xxxx.gives us nice food”, and “zzzz makes us nice soup”, and staff comments included “meals are chosen by the ladies on a daily basis”. The manager commented “The staff and I all eat the same food as the ladies”. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, & 19 Clients can be assured that they will receive appropriate personal support and that their health care needs will be met. EVIDENCE: Clients are encouraged to do as much as possible for themselves in order to maintain their dignity, independence and control over their lives, however staffs are always on hand to help when needed and to give guidance where appropriate. Currently all three clients are female and the staffing of the home, with the exception of the manager, is also female. This enables personal care tasks to be carried out by a member of the same sex. Clients are able to exercise choice over what to wear, when to get up, etc. Client comments included “I chose to wear this today”, “the staff remind me to brush my teeth at night”, and “the staff come into the bathroom with me and I bath myself”, and a staff member commented, “the ladies are well looked after”. The health care needs of the clients are supported by doctors., district nurses and specialist nurses, Optician, Chiropodist, and Dentist and visits are organised on a regular basis and recorded in the care plans. The continence nurse is not currently involved in the home but will be contacted should the need arise. When the home has concerns about a client’s health needs they pursue the matter until it is resolved or a suitable outcome has been reached. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 15 Clients’ said “I see the Doctor when I need to”, and “I am going to the Dentist next week”. Standards 20 and 21 will be looked at during the next inspection The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, & 23 Clients’ views are listened to and they are protected from abuse. EVIDENCE: The home has a clear complaints procedure, a copy of which is displayed on the notice board. The documentation identifies complaints and the actions taken to resolve them will be recorded. The homes quality assurance questionnaires are also analysed to identify any possible concerns or complaints. There have been no complaints recorded since the last inspection. All staffs have been trained in adult protection. Potential staffs are checked against the POVA register. There has not been any cause for the home to make a referral to the POVA register. All client monies dealt with by staffs are properly and safely stored, all transactions are recorded and receipts are kept for all transactions. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, & 28 Service users at The Laurels live in a homely, comfortable and safe environment with bedrooms and communal facilities that meet their needs. EVIDENCE: The home is a two-storey domestic type property, situated in a quiet residential area of Walmer with easy access to local amenities. It is safe, comfortable, clean, odour free, and well maintained. Furnishings and fittings are domestic in character and are appropriate for the needs of the clients. A staff member commented, “I like it here, it’s like a normal home”. All clients have their own single bedrooms that are decorated, and personalised to their own taste. Two of the rooms are on the first floor and are reached via a staircase with handrails on either side; the third bedroom is on the ground floor. Service users commented, “I like staying here”, “I’ve got my pictures in my room”, “I’ve got a lot of soft animals”, and “I like my bedroom” There is a very pleasant lounge/dining room. The garden is laid to lawn and has an outdoor table and chairs, a garden shed used for storage, and a rotary washing line. There is also a clean, well-maintained kitchen with a cork type The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 18 notice board for important information. Toilets are provided in the upstairs bathroom and in the ground floor shower room. Standard 30 will be assessed at the next inspection. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, & 35 A well-trained and competent staff team supports clients, but some improvements need to be made with regard to recruitment practices. EVIDENCE: Staffs all have clear job descriptions, terms and conditions of employment, and are provided with copies of the GSCC code of conduct. The relationship and communication between staff and clients is good and this assists staff in meeting the individual needs of their clients. Clients commented, “I like the staff” and “the staff treat me properly”. All staff are encouraged to undertake NVQ training, one is currently studying for Level 2; 2 already hold level 2; 1 has completed level 3 and is waiting verification; and another has almost completed her Level 3. The home has 2 members of staff on duty during the day and 1 during the evening, and one staff member sleeps in overnight. There is a stable staff team employed in the home, one staff member commented, “I have been here for 10 years”. There are regular meetings held for staff at which client needs and changes are discussed. Staff members said, “we have regular staff meetings and can ask for extra ones if we need them”, and “they are lovely staff, a good team”. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 20 Recruitment procedures are fairly good but some improvements are needed to come up to date with the latest regulations. Although new staff are taken on under supervision prior to their Criminal Records Bureau check being received it is now a requirement that they should not be employed in the home at all until a satisfactory POVA check has been received, at this stage they can then work under supervision until a satisfactory CRB check is obtained. A requirement has been made to this effect. Staff files were all up to date in accordance with the old Schedule 2 and a recommendation has been made that these files are now updated to comply with the revised Schedule 2 of the Care Home Regulations. Staff at the home are well trained and in addition to the NVQ training already mentioned evidence was seen of training in moving and handling, first aid, infection control, basic food hygiene, fire safety, health and safety, NAPPI, epilepsy and the administration of rectal diazepam, and medication awareness. Although documentation was seen of annual appraisals Standard 36 will be fully assessed at the next inspection. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 38 The home has an open and transparent ethos and is run by an experienced and competent manager. EVIDENCE: The registered manager has been running the home for 10 years. Although he has not undertaken his NVQ level 4 and RMA he holds an HNC in Managing Health Care Services, an NVQ 3 in Care Management, is an NVQ assessor, and holds all of the general certificates that the rest of the staff hold (e.g. moving and handling, first aid etc.). He is now applying to do his NVQ 4 at South Kent College starting in April 2006. The manager communicates a clear sense of direction and leadership to the staff and the clients and there is an open and transparent ethos and management approach to the home A client commented “I like him (the Manager)”, and staff comments included “He is an excellent boss, you can talk to him”, “Michaels main concern is his The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 22 ladies, next his staff”, “he really cares”, “it’s a happy home”, and “he is a good boss, any problems, work or personal you can always talk to him”. Although the quality questionnaires that had been completed by clients have been looked at the remainder of this and the other standards in this section, including health and safety, will be fully addressed at the next inspection. The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Laurels Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 24 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. 1. Standard 34.3 Regulation 19 (4) (b) (i) & Schedule 2 Requirement No person shall be employed in the home, (even under supervision) until a satisfactory check of the POVA register has been confirmed. Timescale for action 31.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 34.1 Good Practice Recommendations Information on staff should be maintained in accordance with the Revised Schedule 2 of the Care Home Regulations The Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Laurels H56-H05 S23126 The Laurels V234595 020805 stage 4.doc Version 1.40 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. 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