Inspection on 31/08/06 for The Laurels

This inspection was carried out on 31st August 2006.

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

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

Other inspections for this house

The Laurels 27/05/08

The Laurels 08/05/07

The Laurels 07/12/05

The Laurels 01/08/05

The Laurels 27/10/04

The Laurels 16/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Laurels Bull Lane South Kirkby West Yorks WF9 3QD Lead Inspector Elizabeth Hendry Unannounced Inspection 31st August 2006 08:40 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 Laurels DS0000006194.V302070.R01.S.doc Version 5.2 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 Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Laurels Address Bull Lane South Kirkby West Yorks WF9 3QD 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) 01977 640721 01977 640721 Superior Care Homes Limited Mrs Jessie Stringer Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: The Laurels is a care home providing personal care and accommodation for 28 older people. It is owned by Superior Care Homes Ltd a privately owned limited company. The home is situated close to the centre of South Kirkby, a small former mining community. The premises a former vicarage that has been adapted and extended. Service user accommodation is arranged on two floors and there is a passenger lift. There are twenty bedrooms for single occupancy of which one has en-suite facilities. There are four bedrooms designed for shared occupancy of no more that 2 people. The home, which is close to local amenities, has a car park to the front and gardens and a patio area to the rear. As of the 31st August 2006 fees at the home were £359 in line with Wakefield Metropolitan District Council. The home has a service user guide that provides information about their service for current and prospective residents. A copy of this guide is provided to all prospective service users by the management of the home along with a copy of the most recent inspection report. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s annual inspection, the visit took place on an unannounced basis between 08.40 am and 1.30 pm. As part of this key inspection, CSCI have had contact with the following people. Residents, their relatives, the service provider, staff members, social workers and GPs. During the visit records, a tour of the home was undertaken, along with observations and discussions with both residents and staff. Ten resident questionnaires were sent out. At the time of writing this report all had been returned. In writing this report, information and evidence was not only obtained by way of visiting the home, but information and evidence was obtained from monthly provider visit reports and notifications sent to the CSCI since the last key inspection in December 2005, questionnaires, and the last inspection report. The inspection has concluded that residents’ needs, both personal and recreational, are met. Residents live in a relaxed and informal homely environment. The inspector would like to thank the residents, deputy manager and staff for their hospitality and patient co-operation throughout the inspection. What the service does well: Of those residents spoken with, all spoke highly of all members of staff commenting that nothing is ever too much trouble. Staff spoken with had a sound understanding of each resident’s personal needs and abilities, and were able to communicate effectively with those in their care. Individual care plans and resident records sampled are kept in good order. Support systems in place within the home ensure that both residents and members of staff have access to either a member of the care team or management to discuss any concerns as they may arise. Residents live in a welcoming, relaxed and homely environment, which is well maintained and furnished to a good standard. The Management of the home are committed to staff development and actively promote National Vocational Qualifications. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 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 Laurels DS0000006194.V302070.R01.S.doc Version 5.2 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 is based on evidence gathered both during and before the visit to this service. Service users are only admitted into the home once it has been established that their needs can be fullly met and the home meets their personal requirements. EVIDENCE: The home’s terms and conditions of residence and resident contract identify what is and what is not included in the weekly bed fee. Information regarding the trial period, notice of termination of contract and services available within the home is also included within the contract and service user guide. Care plans viewed identified the personal care needs and abilities of each resident, and the methods in which care staff can meet these needs. The Registered Manager confirmed that residents’ care plans are developed based on the pre-admission assessment, which is undertaken by a senior member of staff. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 9 The home’s pre-admission assessment for residents determine the level of need in the following areas: personal care, mobility, communication, family involvement, medication and medical treatment, social and recreational interests. Reference to care management assessments were present within some residents’ files. The home also provides respite accommodation, the registered manager confirmed that temporary residents are only admitted if their needs can be fully met and if it would not compromise the care permanent residents receive. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 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 and 10 Quality in this outcome area is adequate. This judgement is based on evidence gathered both during and before the visit to this service. Detailed information of residents’ health, personal and social care needs are set out in an individual plan of care. Residents are protected by the home’s medication policies and procedures, no administration errors were identified. Records viewed identified that residents’ health care needs are met. Residents are always cared for in a manner that maintains their dignity and affords respect. EVIDENCE: Four individual care plans were inspected on a sample basis. The plans contained relevant information on the care required to meet the residents’ health and personal care needs. In addition to this, individual life histories, family dates, hobbies and interests were also recorded to provide a holistic The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 11 approach to each resident’s care. Of the four care plans examined, two had not been reviewed on a regular basis, the registered manager confirmed that this had occurred due to staff sickness and that new key workers had been appointed to ensure that these care plans receive monthly reviews. Risk assessments contained an adequate level of information for staff to follow to prevent residents being placed at unnecessary risk. Service user and staff signatures were absent from many of the care plans evidenced, dates were also infrequently noted within service user records. Individual care plans held records of healthcare appointments with detailed information of their outcomes being documented. Staff spoken with during the visit confirmed that any health or welfare problems identified are quickly addressed. Residents spoke positively about their personal care needs being met. Resident questionnaires returned to CSCI following the visit indicated that residents either always receive the care and support required. Of the three relative questionnaires returned and four general practitioner and health professional questionnaires returned, all were satisfied with the overall level of care provided. Daily records contain sufficient information and are consistently completed detailing the individual’s activities for the day and staff observations. The recording, administration and storage of medication was inspected on a sample basis. Records kept of the medication being received into and leaving the home are accurately recorded. Appropriate arrangements are in place for the disposal of the medication. Medication administration records are completed at the time of administration. The Registered Manager confirmed that only members of staff who have received training in the safe handling of medication are involved in the management of residents’ medication. The manager spoke of residents receiving regular medication reviews with their chosen GP, and that frequent pharmacy audits are made by the local chemist. All of the residents spoken to at the visit complimented the dedication of the care staff, commenting that “nothing is ever too much trouble for them”, one resident added that “they always have time to listen and they take a genuine interest in how I am”. Resident questionnaires returned to CSCI following the visit indicated that residents they always receive the care and support required. Throughout the site visit, staff were observed communicating and interacting well with residents and, at all times, maintaining the dignity and respect of each individual. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 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 is based on evidence gathered both during and before the visit to this service. Discussions with residents and relatives described how, the lifestyle they experienced within the home met their expectations and preferences and satisfied their social and religious interests and needs. Residents maintain contact with family and friends and members of the local community as they wish. Residents are encouraged and supported to exercise choice and control over their lives. Residents receive a varied and nutritious diet, within a pleasant dining environment. EVIDENCE: Activities available within the home offer variety and choice to the majority of residents, with adequate provisions being made for those residents who are less able to participate. The Registered Manager spoke of staff assisting residents to participate in a weekly programme of activities. Evidence of The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 13 residents’ personal preferences being sought in relation to activities and interests were clearly documented within each individual care plan and, of those residents spoken with, all were very pleased with what was available. Within those care plans sampled, individual interests had been clearly recorded, within daily records reference had been made to what activities had been undertaken. On the day of the site visit, residents were enjoying reading, watching films and chatting to one another. An activity newsletter was viewed on display within the entrance detailing forthcoming events such as coffee mornings, barbecues, and trips out into the local and wider community and art and crafts. The registered manager explained that wherever possible new games are introduced into the home to enable residents to experience new things. Of the six resident questionnaires returned, all stated that there were usually activities arranged in the home that they can participate in. Photographs from a recent day trip to Bridlington were viewed by the inspector and illustrated an enjoyable day out for both residents and staff. Many residents were sitting within the communal lounges chatting to one another. Staff members were very busy on the day of the site visit, however they were observed being very responsive to residents when anything was asked of them. Throughout the visit, residents’ family and friends were visiting. Three relative surveys were returned to CSCI following the site visit, all indicated that they were made to feel very welcome at the home whenever they visited. Discussions with residents were very complimentary about the food, confirming a wide range of choice, with all meals being tasty and of a good quality. Staff confirmed that snacks and drinks are available throughout the day. Menus showed careful planning, while no choices were illustrated on menus for the main meal, staff spoken to said that should a resident request an alternative meal this would be provided. Of the ten questionnaires returned, residents identified meals were always or usually to their taste. The presentation of the dining room was of a good standard with fixtures and fittings being domestic in nature. Dining tables had been arranged in a layout that encourages small groups of residents to converse during mealtimes. The Registered Manager said that, for those residents who do not wish to eat within the dining room, a tray is provided in their bedroom or lounge area. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 14 It was observed that those residents requiring a greater level of care or who had speech difficulties were offered the same choices as those more able, for example regarding what clothes to wear, where they would prefer to sit and what they would like to eat. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 15 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 is based on evidence gathered both during and before the visit to this service. Residents and relatives could be confident their complaints would be listened to and acted upon. Systems in place for the protection of service users from possible abuse is good. EVIDENCE: Of the ten resident questionnaires and three relative questionnaires returned, all but one relative indicated that they were aware of how to complain and who to speak to if they weren’t happy. There was a detailed record of complaints held within the home, with sufficient information regarding the nature of the complaint, timescale and the action taken. Letters of appreciation and compliments were viewed, highlighting the quality of the service provided. A copy of the Wakefield adult protection policies and procedures was available within the staff office. The registered manager explained that all staff under go in house adult protection training as part of the induction process. No The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 16 outstanding adult protection alerts were in place at the time of compiling this report. Enhanced Criminal Records Bureau checks and POVA First checks were absent for one of the four care staff files sampled. Records viewed did not indicate that these had been applied for, however a previous criminal record check was held on file from the staff members past employer. The registered manager confirmed that a new check would be undertaken immediately, and that this member of staff would not work unsupervised within the home until the new check had been returned. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. The standard of the environment within the home is good providing service users with an attractive and homely place to live. Infection control measures are in place, which promotes the wellbeing and health of service users and staff. EVIDENCE: A tour of the home was undertaken, a good standard of decoration and furnishing was found throughout the home. The majority of fixtures and fittings were domestic in nature. To the rear and front of the property there are large garden areas, which is laid mainly to lawn, this provides additional seating and living space for residents during the summer months. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 18 The Registered Manager spoke of an ongoing programme of redecoration and refurbishment to ensure a pleasing environment for all residents. All residents spoken to said that their bedrooms were comfortable and that they had everything they needed. One resident spoken to said that they find the home perfect for their needs. Feedback from ten questionnaires identified the home as being “always” fresh and clean. On the day of the inspection, the home was found to be clean and tidy and no offensive odours were present. Staff training records sampled indicated that all staff receive infection control training on commencement of employment as part of the induction process. Protective equipment was present within bedrooms, bathrooms and food preparation areas. The registered manager spoke of allocating a dedicated laundry worker out of the care staff on shift each day to ensure that no other carers undertake this role and risk spreading infections or bacteria. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement is based on evidence gathered both during and before the visit to this service. Residents’ needs are sufficiently met by the numbers and skill mix of staff. Some staff have achieved, and more are to begin, NVQ Qualifications thus ensuring that residents receive care from staff who have undertaken training relevant to their role. Residents are not fully protected by the home’s recruitment policy and practices. Staff are sufficiently trained and competent to do their jobs. EVIDENCE: Two of the relative surveys returned to CSCI indicated that they felt that there were times when there was not enough staff on duty. However, on the day of the inspection despite staff sickness, residents’ care needs had been met and the home appeared to be running well. Despite questionnaires indicating that there is not enough staff on duty, the staff rota confirmed that usually there are sufficient numbers of staff on duty to meet all of the needs of each resident Resident’s spoken with were very complimentary about all members of staff. Staff were observed interacting well with all residents and, despite being very The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 20 busy, were seen to take a proactive role with regards to meeting residents’ requests. The Deputy Manager spoke of the home’s recruitment procedure and induction process. Records viewed confirmed that these policies are not always adhered to. Four staff files were inspected on a sample basis. Enhanced Criminal Records Bureau checks and where applicable POVA First checks were in place for three members of staff. One member of staff was found to be working within the home without a current enhanced Criminal Record Check or POVA first check. When questioned about this, the registered manager acknowledged that one had not been applied for as a previous record was held on file from their last employer. The inspector confirmed that these checks are not transferable and that a new application should be made immediately. Second written references were absent from three staff files reviewed. Information received prior to the site visit indicates that 80 of all care staff hold an NVQ level 2 in Care or above. At the time of the site visit, a number of staff were about to commence the award. During the visit, the registered manager provided the inspector with historical training records. These records indicate that the majority of staff have received mandatory induction training in key areas such as manual handling, infection control, fire safety, first aid and health and safety. The registered manager also confirmed that staff were awaiting certification for recent training in food hygiene. Staff were observed approaching residents in a respectful manner and respecting individual preferences. Staff spoken to said that they receive informal supervision and support from their colleagues and formal supervision on a regular basis from the Registered Manager. Supervision records viewed during the site visit supported this. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 21 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): 31,33,35 and 38 Quality in this outcome area is good. This judgement is based on evidence gathered both during and before the visit to this service. Quality assurance procedures within the home ensure the home runs in the best interests of the service users. The management of the home is good and records are well managed. The manager is supported well by the owner in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The health, safety and welfare of service users and staff are promoted and protected. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 22 EVIDENCE: The home places a high priority on ensuring quality care for all residents. In addition to the annual inspection from CSCI, the home undertakes regular quality audits, frequent resident meetings and annual visitor questionnaires. The Registered Manager said that the findings are then used to help improve the overall service residents receive. The Registered Manager has a clear understanding as to the goings on within the home, residents spoke of the manager undertaking care and domestic duties when needed and providing an open door to discuss personal issues and worries. Staff confirmed that the manager and owner are approachable and understanding and actively encourages their personal development. Records are generally well maintained, accurate and regularly reviewed. No financial records relating to both the home and the residents’ finances were inspected on this occasion, however no incidents surrounding the management of residents’ monies has been reported to CSCI. The Registered Manager provided details of the management of residents’ monies prior to the site visit. This confirmed that residents receive their full personal allowance to dispose of as they wish and that records are kept within the home of any transactions involving residents’ finances. The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 23 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no 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 OP18 OP29 Regulation 19 (1,b) schedule 2 Requirement The Registered Manager must ensure that all staff working within the home hold a current enhanced criminal records bureau check specific to the home. Timescale for action 01/12/06 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. Refer to Standard OP7 OP7 Good Practice Recommendations All care plans should be reviewed on a monthly basis All care plans should be dated and contain staff and service user signatures The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Laurels DS0000006194.V302070.R01.S.doc Version 5.2 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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