Inspection on 01/08/06 for The Saplings

This inspection was carried out on 1st 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Saplings 24/06/08

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 The Saplings Wilton Orchard Fons George Taunton Somerset TA1 3JS Lead Inspector Judith Roper Key Unannounced Inspection 1st August 2006 09:00 The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 Saplings DS0000065161.V306440.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Saplings Address Wilton Orchard Fons George Taunton Somerset TA1 3JS 01823 324832 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) Somerset County Council (LD Services) Mrs Elizabeth Mary Sweeting Care Home 7 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for one named person over the age of 65 years, as stated in the application letter to vary registration dated 22 November 2005. This is the home’s first inspection since registration in March 2006 Date of last inspection Brief Description of the Service: The Saplings is registered with the Commission for Social Care Inspection to accommodate up to seven people with a learning disability and a physical disability. At the time of the inspection there were seven people living at the home and therefore the home has no vacancies. The registered provider is Somerset County Council (Learning Disabilities Services). The registered manager is Mrs. Liz Sweeting. Mrs. Sweeting has been the manager at the home since it opened in 1992. The home reregistered in March 2006 when the county council (Community Directorate for Learning Disabilities) became the registered provider. The Community Directorate had provided management and staffing at the home since the home originally opened in 1992. The responsible person for the home is Mr. David Dick. The Saplings is a purpose built care home with accommodation on the ground floor. It is situated in a quiet residential area, close to Vivary Park. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out by one inspector and took place over one day between the hours of 09.00 am – 12.00 pm. Seven residents were at the home on the day of the inspection. Six of the current residents have lived together at the home for a considerable amount of time and one person moved into the home in March 2006 when a seventh bedroom was registered with the Commission. There are no vacancies at the home. All current residents are described as white/British. There is a mix of male and female residents. The inspector was able to see and interact with all residents. There were no visitors to the home during the inspection visit. Prior to the inspection the CSCI received two comment cards from relatives and two comment cards from the visiting community health professionals associated with the home. The home also completed and submitted a detailed pre-inspection questionnaire about the service, as requested by the CSCI. Staff on duty were able to give time to speak with the inspector. The registered manager Mrs. Sweeting was not scheduled on duty. Her deputy team leader Mr. Elan Govan was on duty an available throughout the inspection. The inspector would like to thank the staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and friendly. Staff carried out their duties in an attentive and supportive manner. The aim of this inspection visit was to inspect key National Minimum Standards as part of the Commission’s ‘Inspecting for Better Lives’ strategy. Inspectors focus on outcomes for service users and measure the quality of the service under four general headings. These are - excellent, good, adequate and poor. The judgement descriptors for the seven chapter outcome groups are given in this report. What the service does well: Most residents who live at The Saplings have known one another for a number of years, several having been sharing residential care accommodation before The Saplings opened in 1992. The registered manager has also been in post since 1992. This means that there is continuity for the residents and stability at the home. Behavioural patterns and interactions of residents are known, planned and promoted positively by the staff team who benefit from the management that has worked alongside the residents over the years. New admissions are planned over several weeks to try to ensure that placements are appropriate and the mix of residents is harmonious. The staff team has a The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 6 low level of turnover and staff seem to know their roles and responsibilities well. The standard of personal care given to residents is good and independence is promoted to the individual’s level of ability. The home is purpose built with good disabled facilities. The recent addition of more communal space further improves the environmental Standard of the home. 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 Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. The overall outcome for these assessed Standards is good. Information provided for prospective new residents is clear, available in Somerset Total Communication (STC) as well as written English, and is regularly reviewed and updated. This provides an accurate description of services at the home. The home meets the needs of the residents and the established staff team has worked alongside the vast majority of residents for many years. Any new admission is assessed as a suitable placement at the home, taking into account current residents’ needs, invited for day visits, meals and then a trial period of a month to ensure that the placement is suitable for both parties. EVIDENCE: The home has produced a revised Statement of Purpose and Service User’s Guide following the change in provider in March 2006. The information provided for new residents is therefore current. These documents are also available in a format other than written English such as Somerset Total Communication (STC) and video/DVD. There has been one recent admission who was assessed for suitability of placement and the Commission was approached to consider an application for The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 9 variation on age grounds. This was granted by the Commission. The new resident had several trial days at the home prior to moving in. All residents are in the process of changing contracts from the previous to the current provider. The staff team is stable with no current vacancies available. The staff team know the needs of residents very well and care to be given is documented clearly in individual care and support plans. The environment at The Saplings is adapted to meet the residents’ physical care needs. Although the home is not a registered nursing home, some nurses are employed as part of the care team and this gives the team additional clinical knowledge and experience. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 the following standard(s): 6, 7, 9, 10. The overall outcome for these assessed Standards is good. Care and support plans are detailed and person centred allowing staff to provide care that meet’s resident’s assessed needs. Risk assessments are completed for activities and clinical tasks for individual residents in order to promote independence but to promote safety too. Residents are consulted with and encouraged to make decisions affecting the day to day running of the home to the level of their individual ability in order to ensure that residents’ self- esteem and mutual respect between resident and staff is maintained. EVIDENCE: The care and support plan for the recently admitted service user was inspected. ‘My-Day’ plans for day-to-day social and leisure activities for other residents were discussed in detail with senior staff. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 11 Risk assessments are in place for activities and clinical needs. Care and support plans are cross referenced to the National Minimum Standards for Care Homes. Residents are supported and encouraged to make informed decision and staff assist this by using pictures and STC to communicate if a resident’s ability for speech is impaired, meal books, risk assessments and detailed care plans reflecting and recording personal choices in daily routines. Residents also use visual diaries, using photographs and pictures to aid daily decision making and choice promotion. Residents are consulted in choosing colour schemes and soft furnishings for their bedrooms. The home uses bedrails and listening devices for some residents for personal safety reasons. Relevant community healthcare professionals, next-of-kin or care managers have been consulted in the use of such devices. The home checks bedrail fitting for safety weekly and this is recorded. The use of baby monitors as nighttime listening devices was discussed. It is recommended that the use of baby monitors as health surveillance devices be reviewed for individual service users on a monthly basis and that the parameters for using the devises in terms of privacy be clearly recorded in the individual’s care and support plan. Records regarding service users are stored in a manner that respects confidentiality. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 the following standard(s): 11, 12, 13, 15, 16, 17. The overall outcome for these assessed Standards is good. The home supports residents to access community facilities for shopping, leisure or education. Residents’ friends and family relationships are supported and encouraged by the staff team. The daily routines at the home are centred on individual need and routine. This focuses on maximising independence and choice for the individual, within a risk assessment framework. Meal choice and health eating is promoted. EVIDENCE: Each resident has a ‘communication passport’. This gives a brief description of care needs and enables people involved in resident’s care a consistency in approach to communication and care provision. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 13 Presently no residents have the capacity to undertake paid work or voluntary experience roles. A nearby day centre is accessed by two residents, enabling them to practice daily living skills in a group setting. This also provides residents with social interaction with people other than those whom they live with at The Saplings. There is 1:1 key worker time allocated in the staffing roster for personal attention and outside trips. Community access volunteers also assist with days out. One resident regularly has a home day with their family. Residents have day trips rather than an annual holiday and this decision is based on emotional and physical risk assessments. Families are encouraged to visit and one resident has maintained a friendship formed prior to admission, which includes a day out together most weeks. Two comment cards about the service were received from relatives prior to the inspection. These cards were overall positive. Both feedback cards indicated that the home communicates well with families about the health/social needs of their relative at the home. Bedrooms are lockable and residents can choose to hold a key as well as to the front door, although presently nobody chooses to and/or is able to do so. Alternative types of locking devises were discussed previously with the home’s manager and are being considered. Care plans state where the resident is unable to open their mail and there is not an independent person able to do this on behalf of them. In such cases staff open the resident’s mail. During the inspection residents appeared comfortable and relaxed with staff and staff encouraged residents to make decisions for themselves. The home has a recently upgraded kitchen. Part of the work surface has been lowered to enable wheelchair users to have better access to meal preparation. At the inspection the kitchen was seen to be clean, with a written cleaning schedule displayed. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 the following standard(s): 18, 19, 20. The overall outcome for these assessed Standards is good. Physical and emotional care and support is documented in regularly reviewed detailed care and support plans. Staff know resident’s clinical needs well and have formed emotional bonds with the residents over the years. Residents are receiving the health care they require. Medication is generally managed in a satisfactory manner but in order to provide a safe system of medication administration staff must record when a prescribed medicine has or has not been given. EVIDENCE: The Saplings does not provide nursing care as part of its registration although there is nursing experience within the current staffing team. Residents access the support of the Community nursing teams as required. Each resident has a key worker. Staff are encouraged to be patient with residents allowing time for resident’s to convey their meaning of what they want to express. The Intensive Interaction care model is used in the home where indicated in a person’s care and support plan. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 15 Prior to the inspection the CSCI received a positive feedback comment card from the GP surgery that all current residents are registered with. One care manager commented on the home via a feedback card, this was followed up with the care manager who was generally satisfied with the level of communication by the home. The physical dependency at the home is high and the home is equipped with appropriate equipment for managing moving and handling and pressure area care. There are no residents with pressure sores at the home. Medicine management was inspected. Some gaps were identified in MAR charts. Advice was also given to staff regarding securing cold storage of medicines in the home. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 the following standard(s): 22, 23. The overall outcome for these assessed Standards is good. The home has not received any formal complaints and has available for consultation appropriate polices for the protection of vulnerable adults. EVIDENCE: The home has not received any complaints. The home’s complaints procedure is kept with their Statement of Purpose, and is available in STC. The deputy team leader arranged for the complaint’s procedure to be displayed during the inspection. Service users able to express their view confirmed staff as approachable and responsive to concerns. The home has policies and procedures relating to vulnerable adults and Whistle Blowing. There is a ‘raising concerns at work’ leaflet promoted in the home for staff stating the employer’s channels for staff to report concerns to. The home utilises one volunteer who has had a satisfactory CRB check. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 the following standard(s): 24, 25, 26, 27, 28, 29, 30. The overall outcome for these assessed Standards is good. The Saplings has a relaxed, calming atmosphere and the environment is decorated and furnished in a homely way. The open plan of the design of the bungalow provides a light and airy environment. Part of the communal space is for a quiet sensory area for residents who will benefit from this kind of environment. The home is clean and welcoming with good quality furnishings and is adapted to meet the physical needs of disabled residents. EVIDENCE: The Saplings is a purpose built building adapted for the physical and sensory needs of the current residents. The garden is landscaped and accessible for wheelchair users. The Saplings is situated within a short distance of the town centre and local amenities. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 18 Five of the seven single bedrooms have access to en-suite facilities. Two bedrooms do not have a wash hand basin in the room and the management should give this consideration should a new person move into the rooms in the future that may benefit from this facility. All bedrooms are personalised and are decorated to reflect individual tastes of the residents. Each resident’s bedroom has a picture board displaying photographs of the staff on duty for that day and any activities that the resident will be participating in. Five of the seven bedrooms have overhead tracking. It was reported that there are plans to provide overhead tracking in the other two bedrooms. The home also has a mobile patient hoist. The home has sufficiently equipped numbers of bathrooms; four in total, and all are adapted for disabled use. There is a large, light lounge and a tropical fish tank in the lounge. There is also a smaller quiet lounge with sensory equipment off the main lounge. Adequate and suitable seating for residents is provided at the home. The dining room has a large wooden table and residents sit together at the table for their meals. Residents using wheelchairs have chairs built to suit their body profile. Laundry equipment is sufficient. Washing machines and dryers are industrial in design and the home has a macerator for incontinence waste and a sluicing facility. Chemicals used in the home were observed to be stored locked away securely out of resident reach. The home was clean and smelled fresh. The home is centrally heated and radiators are guarded with low surface temperature covers. Liquid soap, paper hand towels and flip top bins are provided in appropriate areas for staff hand washing in order to manager cross contamination in the home. There are suitable gloves/aprons available for staff providing personal care tasks. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 35, 36. The overall outcome for these assessed Standards is good. Staffing levels at the home are set to meet the needs of current residents. Staff are supervised in their work and are supported to perform to meet their conditions of employment in providing good resident care. Staff recruitment practices are robust protecting vulnerable adults. EVIDENCE: There is a structured and formal system of staff supervision established at the home, wherein job roles and responsibilities are discussed and reviewed. There is a key worker system at the home with staff having individual responsibilities for maintaining care and support plans and for monitoring the needs of individual residents. The home has an annual training plan; this includes statutory training, NVQ awards and training relevant to the current service user group. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 20 The staffing levels ensure a minimum of 3 staff during the day and one waking and one sleeping-in staff member at night. Four weeks current staffing rosters were submitted to the CSCI by the home for scrutiny as part of the preinspection questionnaire. Two recently appointed staff were on duty and their employment processes and inductions were discussed with the inspector. The Community Directorate has a week long initial induction process that is worked through over six months with the newly appointed staff member. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 40, 41, 42. The overall outcome for these assessed Standards is good. There are both informal and formal methods of quality assurance at the home and within the Community Directorate to actively seek feedback from stakeholders about the service in order to continuously critically evaluate the standard of service provision. Health and safety is managed well to protect residents, staff and visitors. The home has appropriate policies and procedures and records examined were generally well maintained. EVIDENCE: The home is visited by a network manager on behalf of the Community Directorate a minimum of once a month. These visits are a mixture of planned and unannounced. The network manager completes a report (Regulation 26 The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 22 report) on her findings of her visits to the home. Feedback questionnaires about the service are produced. The home has policies and procedures for quality assurance. Health and safety was inspected via touring the premises and discussing the pre-inspection questionnaire information given regarding equipment servicing. There is a low rate of accidents and incidents in the home. One incident has been notified to the Commission under the Regulation 37 reporting requirement since March 2006. Fire records were inspected and were maintained appropriately. The Saplings DS0000065161.V306440.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 4 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X X X 3 3 3 3 X The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 24 N/A 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 YA20 Regulation 13 (2) Requirement When a medication is not administered, staff must ensure that a definition is recorded to confirm why this has not taken place. Timescale for action 12/09/06 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 Refer to Standard YA6 Good Practice Recommendations It is recommended the use of baby monitors as health surveillance devices be reviewed for individual service users on a monthly basis and that the parameters for using the devises in terms of privacy be clearly recorded in the individual’s care and support plan. The Saplings DS0000065161.V306440.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Saplings DS0000065161.V306440.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. 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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