CARE HOMES FOR OLDER PEOPLE
Townsend House Court Farm Lane Mitcheldean Glos GL17 0BD Lead Inspector
Mrs Ruth Wilcox Unannounced Inspection 09:00 6 March 2006
th 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 Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Townsend House Address Court Farm Lane Mitcheldean Glos GL17 0BD 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) 01594 542611 01594 541449 The Orders of St John Care Trust Mrs Dorothy Jayne Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One bed in the rehabilitation unit can be used to provide respite care for service users over the age of 55 years. 22nd August 2005 Date of last inspection Brief Description of the Service: Townsend House is situated in the centre of Mitcheldean, and is in close proximity to the local shops and amenities. The home is managed by The Orders of St John Care Trust. The home is purpose built, and is registered to provide both nursing and personal care for 40 older people over the age of 65 years. Four of the registered places are used to provide rehabilitation care, with one of these four places registered for the use of a rehabilitation resident under the age of 65 years if necessary. The home is able to provide respite care if there is a vacancy. A day centre, which serves the local community is also integral to the home. The home provides forty single rooms, six of which have en suite facilities. A passenger lift has been installed to provide easy access to the first floor. Communal areas consist of a main lounge and dining space incorporating a conservatory, a second lounge and dining room, and a separate lounge and kitchen/dining area for rehabilitation care. Adapted bathing facilities are provided. The home is surrounded by well-maintained gardens with inner courtyards of flowerbeds. A number of rooms overlook the gardens and courtyard. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection over six hours on one day in March 2006. The Registered Manager was present, providing information and assistance as requested, and remained entirely open and cooperative with the inspection process. Care records were inspected, with the care of four residents closely looked at in particular. There was direct contact with one visitor and a large number of residents, with twelve being spoken to directly to gauge their views regarding the standards of service and care at the home. The arrangements for visitors, and for residents to make and pursue personal choices in respect of their daily lives and social activity were considered. The management arrangements, and the systems for monitoring and ensuring quality of the service, and for addressing any complaints and concerns were looked at. The arrangements for ensuring safeguards for those choosing to place money or valuables with the home for safekeeping was inspected. A tour of the premises took place, with particular attention to the standard of maintenance and cleanliness. The provision of staff and the way in which they are supervised was inspected. Staff were observed at various times throughout the day, whilst going about their duties and interacting with the residents. As well as the manager, the rehabilitation coordinator and six other staff were spoken to directly. What the service does well:
Townsend House provides a safe, well maintained, clean and comfortable home for the residents. There are plans for some environmental improvements, with some maintenance work in certain areas of the home, and with the provision of an improved bathing facility on the ground floor; it has been recommended that attention be given to the deteriorating condition of the smokers’ lounge carpet. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 6 Residents are admitted here on the basis of an assessment of their personal and health needs, although it has been recommended that assessment forms are completed with the maximum of detail in all cases. A number of residents were spoken to during this visit, the vast majority of whom were in the main part of the home, and also a small number who were accommodated in the rehabilitation unit. Residents in each area were satisfied with the standards of care and attention they receive from the staff, with just one or two isolated minor exceptions in the main home. Each seemed happy to confirm that in the main the staff are very helpful, kind and caring. Staff were observed at various times, and on each occasion were courteous and attentive, and were mindful of individuals’ choices and level of independence. Visitors are welcomed into the life of the home, and residents are well supported to maintain their close contacts with family and friends. A visitor was very complimentary about all aspects of the home. The home works jointly with the PCT with regards to ensuring the most appropriate care and dignified ‘end of life’ for residents, when the time comes and this is needed. There are good systems for monitoring the quality of the service provided at Townsend House, with residents and their families having opportunities to give feedback on their views and ideas; however The Orders of St John Care Trust is now required to provide an individual quality report based on a survey of residents and their families for the home to address. The home has established a safe and transparent system to allow residents to place money or valuables in the main safe, keeping good clear records. What has improved since the last inspection?
Since the last inspection the manager has endeavoured to improve communication in the home, and has taken steps to make herself appear more accessible and approachable to people; given the positive comments received during this inspection it can be said that she has been successful in this regard. An improved system for dealing with concerns and complaints has been introduced into the home, and there is a more evident intention to fully address any matters that arise. A more organised staff supervision programme has now been introduced in order that all staff receive a more appropriate level of formal supervision and guidance.
Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 7 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. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The home’s admission procedure ensures that all residents are admitted on the basis of an assessment of their needs, so that they can receive the care that they require. EVIDENCE: Residents are admitted to the home on the basis of a documented assessment of their health and personal needs, which can be performed in hospital or in the person’s own home, as appropriate; the assessment tool used for those residents forming part of the case tracking exercise was seen. Some aspects of these pre-admission assessment forms were completed to the bare minimum, and could have been done a lot more comprehensively. Copies of RNCC assessments and Social Services assessments were seen where applicable. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 10 Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 10 & 11. The care planning systems in place do not adequately provide staff with the information they need to satisfactorily meet residents’ needs. In the main, care and support is offered in such a way as to promote the privacy and dignity of the residents. They receive attentive and sensitive care when they reach the final days of their lives. EVIDENCE: Each resident has a personal plan of care, which in the main is regularly reviewed. Three care plans from the main part of the home, and one from the rehabilitation unit were selected as part of a case tracking exercise. In most cases the assessments had clearly informed the care planning process. However there were omissions noted, which included the following; In one case a pressure sore risk assessment showed that the resident was at risk of developing pressure sores; there was no documented plan of care to address this. Also an assessment showed that the resident suffered from confusion, and was at risk of falling. Despite recorded evidence of appropriate medical interventions regarding their mental state, there was no care plan to
Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 12 address this, and despite the identified risk of falling the risk assessment had not been reviewed for over one year, and there was no clearly documented care plan to demonstrate how risks should be reduced. This person had fallen, and had sustained a serious injury. In another case the assessment showed that this person was also at risk of developing pressure sores and suffered from confusion; there were no care plans to address these issues. Despite this person having specific nutritional needs their weight was not being monitored. Many different care plan documents were filed together in one section of the person’s designated care plan folder, and were not laid out in an accessible format. This made it difficult for any reader to utilise the care plan efficiently, and ensure that it was a dynamic document for the resident. The rehabilitation care records contained a lot of very useful information and detail. However, the care plan was not fully reflective of the resident’s assessed needs. Staff were observed interacting with residents throughout this visit, and appeared consistently mindful of residents’ privacy and dignity. Attitudes from the staff were sensitive, kind and encouraging towards residents, and evidence was also seen and heard of respect for their level of independence. In one case it was observed that, despite a safe and gentle manual handling procedure with a frail and vulnerable resident, the staff concerned did not speak to the resident at all. Residents themselves confirmed their satisfaction with their care, and that generally staff were very kind, caring, helpful and respectful towards them. Some said the staff were ‘excellent’. Two said that ‘one or two’ staff members can be a ‘bit brusque or abrupt on occasions’. A visitor commented on how ‘brilliant’ Townsend House is, and how ‘excellent’ the staff are. A rehabilitation resident indicated his very high levels of satisfaction with all aspects of the rehabilitation unit. The home is currently working in conjunction with the ‘End of Life Gold Standards’ and the Primary Care Trust regarding the care of those who are dying. This involves planning for all in terms of the end of their life, including ensuring the choice of where to die, and providing help and support to families as well. Care pathways are used, and issues such as planning pain relief if required are addressed with the relevant doctor. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 13 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. Consideration and respect is shown towards residents exercising control and choice in their daily lives, with visiting arrangements ensuring that they can keep close contact with their families and friends. However, the limited social opportunities for residents have resulted in a lack of stimulation for some. EVIDENCE: Notices are displayed, which advertise some planned group social activities; an entertainer was visiting the residents on the same day as this inspection. Many residents were sitting quietly and unattended in the communal areas with very little going on around them. Some were reading, watching television or listening to the radio in their rooms. Residents themselves, and one visitor, said that there is very little going on socially to stimulate and interest them. One gentleman said that he occupied himself very well, but that he often saw others just ‘sitting about with nothing to do’. Some residents had evidently formed friendships, and staff themselves displayed friendly attitudes. One resident said that he remained very active socially outside the home, and that he often went out into the local town.
Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 14 The home provides a relaxed environment for visitors, and does not place any restrictions on them. Some of the residents themselves confirmed their close contact with their relatives and friends. One visitor said that she was always made to feel very welcome, and was very enthusiastic and complimentary about all aspects of the home. Some residents were seen moving freely around the home in accordance with their wishes. It was clear that they could choose how and where they spent their time. Residents, without exception, indicated that staff fully respect their choices with comments heard such as, ‘I’m my own boss’, ‘we’re never made to do anything we don’t want’, ‘they respect my choice to keep my own company’. Residents are offered choices at mealtimes, and although some rooms do not appear particularly personalised, it was clear from some, that residents are free to introduce personal items and treasures in order to individualise and personalise their room as they wish. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 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. The home manager has made the necessary improvements to provide a more robust complaints system, and there is now evidence of residents and visitors feeling that any concerns they may have are listened to and acted upon. EVIDENCE: There is a copy of the written complaints procedure in the entrance hall for anyone wishing to use it. The manager has set up a designated complaints folder, where records of any concerns or complaints received and addressed are kept. However, there were none to inspect on this occasion, as none have been received. A number of residents and a visitor indicated confidence in the manager and staff to listen and respond to their concerns. The visitor said that the manager and staff were very approachable, and would respond very quickly to any issues. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 16 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 & 26. The standard of the environment within this home is satisfactory in the main, providing residents with a comfortable and clean place to live; very isolated instances of poor staff practice could ultimately pose a certain degree of risk to residents however. EVIDENCE: Townsend House is purpose built, and provides safe, clean and well maintained accommodation. A maintenance person is employed, and there is a rolling programme of redecoration, and a cyclical programme of maintenance work. The smoking lounge carpet is badly marked, and should ideally be replaced. Six armchairs have recently been disposed of, which have yet to be replaced. There is work planned in the rehabilitation bathroom, to include the provision of a new sink unit and some re-tiling to the walls. The grounds are well maintained, and some tree surgery work is due. The installation of a variable height bath is planned in a ground floor bathroom, and there are plans for some maintenance work to the conservatory windows, all of which is fairly imminent.
Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 17 The home was very clean and fresh, with no unpleasant odours anywhere, apart from a faint, unidentifiable but persistent odour in the zone 2 lounge. A cleaner was spoken to, who was clearly doing a very good cleaning job, and was taking pride in her work. One of the chemicals in use had been decanted into a smaller spray bottle; this bottle was unmarked, and did not have any sort of product label at all. The first floor sluice room is not currently being used for its stated purpose, and is cluttered with a variety of stored items. The ground floor sluice contained a stored commode and shower chair, both of which were blocking access to the sink; the manager said this was not usual, and resolved to get the items removed. The laundry room provides appropriate facilities for the sluicing and disinfection of any foul or infected laundry. The laundry assistant was conversant in the appropriate infection control procedures. Gloves and aprons, liquid soap and paper towels are provided throughout the home. The home has a contract for the correct management of clinical waste. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 18 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. Staffing provision is only just adequate to meet the needs of the residents currently accommodated. EVIDENCE: Staff rotas demonstrate the provision of nursing, care and ancillary staff. In the main part of the home, it is the routine for there to be one nurse on duty at all times, with six carers in the morning, four carers during the afternoon and evening, and two overnight. In the rehabilitation unit there is one carer at all times between 07.30 and 21.00; the three already rostered to be on duty in the main home provide the night cover in here. Deployment in the main home in the morning means that staff are divided among the different zones in the house, as follows: • Two care staff caring for sixteen residents divided between two floors • One caring for ten residents, with the occasional help of a ‘floating carer’ • One caring for ten residents, divided between two floors, occasionally assisted by the already mentioned ‘floating carer’. This leaves the sixth carer to manage the dining room and the provision of hot drinks to residents around the home later in the morning. These levels drop during the increased evening activity, with only four care staff to help 36 residents. Although there were no complaints about staff from residents at all, it is vital that these current staffing levels remain under continual review, as they are at the most basic level of provision.
Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 19 The manager confirmed that, although they do, staff are ‘stretched’ to meet residents’ needs appropriately, and that the work is ‘heavy and demanding’. She and others also said that staffing provision was adversely impacting on their ability to offer a more stimulating and regular social activity programme. All the residents said that the staff are very helpful, kind and caring. One person said that he could always enjoy a ‘good joke with them’. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 36. Adjustments to the way in which this home is being managed have ensured better safeguards for the interests, health and safety of the residents. EVIDENCE: The home manager is a first level registered nurse, who has achieved the Registered Manager’s Award, and who is registered with the CSCI for her role. Residents and relatives meetings are conducted, with the aim of providing support to them, and of providing an opportunity for them to discuss any issues they wish. Staff confirmed that meetings have been held for them also, and that communication had improved in the home recently, with the manager becoming more accessible. Comments and Suggestions forms are available in the entrance hall, for anyone choosing to offer feedback on the home in this way.
Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 21 A quality survey was conducted last year, with the results analysed afterwards for all homes within The Orders of St John Care Trust group; individual statistics have still not yet been provided for Townsend House to act upon however. Meal monitoring forms have been introduced on a random but regular basis, in order that residents’ views about the quality of the food can be obtained. Some residents have placed personal money with the home for safekeeping. Clear and transparent records for each person, which include transaction details, running totals, and receipts, are kept. Random audits on individual accounts proved to be accurate. Residents or their representative sign to acknowledge some transactions, but where this is not possible in the majority of cases, two staff members sign the record to witness on behalf of the resident. The manager has now introduced measures to ensure that staff are more adequately supervised, with a monitoring matrix devised to plan and implement the programme. Some staff spoken to confirmed that they received regular supervision. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 22 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 1 8 X 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X X Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement The Registered Manager must ensure that staff document fully and appropriately detailed plans of care for residents who are at risk of developing pressure sores, at risk of falling, and who have identified mental health needs. (previous timescale of 30/09/05 not met) Staff must ensure that all assessments are kept under review, and revised as appropriate. Staff must ensure that residents’ weights are monitored and recorded, particularly when there are specific nutritional needs. Staff in the rehabilitation unit must prepare written care plans as to how rehabilitation residents needs in terms of their health and welfare are to be met. (previous timescale of 31/10/05 not met in full) The Registered Manager must make arrangements for all residents to engage in a
DS0000064611.V277345.R01.S.doc Timescale for action 31/03/06 2. OP7 14(2) 30/04/06 3. OP7 12(1.a) 30/04/06 4. OP7 15(1) 31/03/06 5. OP12 16(2.n) 31/05/06 Townsend House Version 5.1 Page 24 6. OP26 13(4.c) 7. OP26 23(2.l). 13(3) 18(1.a) 8. OP27 9. OP33 24(2) programme of social activities to suit their varying abilities and needs. The Registered Manager must ensure that all chemicals in use around the home are clearly labelled. The Registered Manager must ensure that furniture-style pieces of equipment are not stored in sluice rooms. The Registered Persons must keep the provision and deployment of staff under review, so as to ensure that they are provided in such numbers as are appropriate for the health and welfare of the residents. The Registered Provider must provide a quality improvement report for the home. 30/04/06 31/03/06 31/03/06 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP3 OP7 OP7 OP19 OP26 Good Practice Recommendations The Registered Manager should document pre-admission assessments in fuller detail. Staff should review all elements of care plans at least monthly. Staff should ensure that each individual record in a care plan is filed in such a way that it remains accessible for ease of use. The carpet in the smoking lounge should be replaced. Staff should continue trying to trace the source of the faint odour in the zone 2 lounge. Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 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 Townsend House DS0000064611.V277345.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
