Inspection on 17/05/06 for West Bank Care Home

This inspection was carried out on 17th May 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

West Bank Care Home 06/11/09

West Bank Care Home 15/10/08

West Bank Care Home 16/10/07

West Bank Care Home 23/01/07

West Bank Care Home 16/01/06

West Bank Care Home 11/05/05

West Bank Care Home 08/11/04

West Bank Care Home 26/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

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

CARE HOME ADULTS 18-65 West Bank Care Home 21 Crow Tree Lane Bradford West Yorkshire BD8 0AN Lead Inspector Linda Trenouth Key Unannounced Inspection 17th May 2006 9:30 West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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 West Bank Care Home DS0000001145.V292626.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 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. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service West Bank Care Home Address 21 Crow Tree Lane Bradford West Yorkshire BD8 0AN 01274 547864 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) Mr Sariff Jomeen Care Home 10 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (1), Mental disorder, excluding of places learning disability or dementia (5), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3) West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2006 Brief Description of the Service: West Bank is registered to care for adults who are recovering from a mental illness. The house has been converted to provide residential accommodation for male and female adults under and over the age of 65 years. Accommodation is provided on three floors and all but one room are single. A lounge and dining room are situated on the ground floors. Two domestic style bathrooms and three single toilets are situated over the three floors. The home is close to public transport and some parking is available within the grounds. There is a large garden with a summerhouse, which can be used by the all the residents. The fees charged to the residents at the home fees are between £410 and £420 per week. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Copies of previous inspection reports are available at the home or on the Internet at www.csci.org.uk. This was an unannounced inspection carried out by two inspectors who were at the home from 09.30 until 17.00. The main purpose of this inspection was to make sure that the home continues to meet the key standards and provide a good standard of care for the residents. The methods used at this inspection included looking at care records; observing working practices and talking to residents and staff. Comment cards were sent to the home to provide residents and visitors with the opportunity to comment on the service. The findings from these cards are included in the report. A pre inspection questionnaire was sent out to the provider prior to the inspection but was not completed and returned. Feedback was given to the Mr and Mrs Jomeen at the end of the inspection. Requirements and recommendations made during this visit, and outstanding from previous inspection visits can be found at the end of the report. What the service does well: The home has introduced a no smoking policy to protect the residents and staff who do not smoke. Smoking areas have been provided in the porch area and outdoors. Most residents felt this was a very positive improvement for the home. Residents felt that they had a good relationship with the staff and the owner of the home. Individuals also felt that the home was relaxed with no rules or routines imposed upon them. They felt they were free to leave the home when they wanted and could spend time in their rooms, with other residents or go out into the community as they pleased. The residents have all been given service user guides and have signed their individual contracts and care plans. Each resident has a named key worker and those spoken to were able to confirm they had taken part in their care plans and reviews. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The residents need more activities and options for therapeutic interventions. Staffing levels do not include the numbers of staff required to promote activities. The maintenance and appearance of the environment is poor. Some carpet and furnishings required cleaning, repair and replacement. The registered provider must ensure that the health and safety of the people in the home is maintained by ensuring that procedures are followed and accurate records are kept. Staff skills and training must be further developed to ensure that the needs of the residents are met, this in the areas of managing physical and verbal aggression, adult protection and first aid. The home must consult with environmental health regarding food hygiene training updates and the development of environmental risk assessments. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 7 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. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 8 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 West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 9 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 and 5. The contracts containing the terms and conditions of living at the home are agreed and signed by each resident. Assessments are undertaken on prospective residents to ensure that personal aspirations and needs can be met by the home. EVIDENCE: The service user guide is given to each of the residents in the home in a format they can understand Documentation reviewed and discussions with staff and residents confirmed that each resident has a contract with the home, which they have signed. Recent amendments to the contract have also been discussed with the residents. The management continue to charge in addition to the fees for the cost of transport, this is now included in both the contract and the service user guide. The homes minibus is no longer in use, however Mr Jomeen and Mrs Jommen use their own vehicles to transport the residents for appointments to GP, hospital and shopping trips. The Care Management Team undertake a full assessment of each prospective resident before they are introduced to the home this is a multi-disciplinary assessment with mental health input. The home receives a copy of the assessment and uses this to base their own initial assessment of the resident. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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 and 9 Care plans address aspects of individual need and personal need but need further development to address the social needs of the individual. Annual reviews are held with the resident and their keyworker and relatives, these now need to be held at 6 month intervals. EVIDENCE: The care plans continue to provide a basic outline of the individual needs of the resident but do not sufficiently identify the social needs of individuals or therapeutic activities or interventions. Risk assessments are included to cover aspects such as restrictions of freedom such as controls of cigarettes through the day and access to the local community after dark. Each resident has a named key worker and are individually involved with their care planning and review. The care plans are signed by the residents to indicate their involvement and agreement. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 11 Residents spoken to say that they were aware of their care plans and agreed they took part in their reviews and confirmed their involvement. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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): 12,13,15,16 and 17. The staffing levels limit external leisure and therapeutic activities. The residents are supported to maintain friendships and family contacts. EVIDENCE: There is a lack of a planned and adequate staffing levels to provide meaningful social activity. Residents have been told that day trips would take place last year but none have been organised. One resident attends a day centre locally and other residents go into town and to the local shops independently of staff. There are individuals however who would benefit from some activity supported by staff beyond the home but unfortunately the staffing levels do not allow for this. The staff discussed that they do activities such as dominoes and board games with the residents and occasionally do activities such as hand and nail care. Some residents spoken to said that they like to organise their own day and are quite happy to occupy themselves but would be interested in any additional West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 13 activities if they were on offer. Residents also enjoy watching DVDs, videos and television generally. One resident said he enjoyed talking to other residents and staff at the home. All residents spoken to said that they were happy living at West Bank. At previous inspection the provision of Sky television was included in the brochure. Mr Jomeen said that this was a misunderstanding and that he would organise a free-view/ digital box for the residents. This would give them a greater selection of television programmes. This has not been provided. A menu in the dining room was up to date with the menu of the day displayed. In addition residents approached staff to enquire about the food for the day. Four weekly menus were available. Residents said that the food was good and that they got plenty to eat and could always have an alternative at any mealtime. The residents also felt that they contributed to the menus with ideas for meals and changes to the menu. The food at lunch on the day of the visit was chicken sandwiches followed by yogurt and fruit. The main meal held at teatime was home made fish, chips and peas. There was also a choice at breakfast time and supper. Residents were also happy that they could get drinks whenever they wanted from the kitchen. Residents were observed often making drinks for one another, staff and visitors. Cultural and health needs were considered when planning the catering and weekly menu plans. From discussions with the staff it was evident that they were sensitive to residents individual religious and cultural requirements when preparing their meals. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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 and 20 The service users require minimal intervention in their personal care, where this is necessary this is done in a sensitive and positive manner. The residents physical and health care needs are met. The registered person does not adequately monitor out of date medication and general storage within the medication cupboard. EVIDENCE: The residents decide the routines of the day for themselves, residents spoken to say that they got up and went to bed when they wanted. Meals were set at defined times but if they missed a meal the staff would get them something afterwards. Residents confirmed that they are encouraged to manage their personal care and that they are encouraged to use the laundry facilities. The residents liked the staff and felt that they dealt with any personal care sensitively. One resident commented that he liked his bath time and looked forward to a nice soak. The assessments, care plans and reviews identify where residents are supported to maintain their own health care. The residents access community West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 15 health facilities and are encouraged to attend their local GP practice. Residents confirmed that they had visited opticians, dentists and chiropodists to maintain their health care needs. Residents mental health needs are reviewed regularly within a multi agency approach, recommendations made are included in the individual care plan. The medicines are stored in the kitchen area of the home. The storage of medicines must be monitored and checked by the registered person regularly. It was found that foodstuffs were stored in the medication cabinet and that medicine was out of date. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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 and 23 Whilst staff are made aware of the recognition of abuse in their induction training further adult protection training should be undertaken to ensure the safety and protection of vulnerable adults. Residents valuables are protected whilst living at the home. EVIDENCE: The staff have undertaken some adult protection awareness training within the home and are aware of the whistle blowing procedures. Mrs Jomeen has enquired about the availability of further adult protection training. The first available dates are in November 2006 it was agreed that these dates would be booked for staff at the home. Until this is completed it was advised to address the issue by ensuring that Abuse, Whistle blowing and Adult Protection are regular topics to be discussed at staff meetings. The residents are given the option of keys to their bedrooms and lockable storage in their rooms. Some residents confirmed that they did use this facility. If they lost their keys they were aware they had to pay for a replacement key to be cut. The residents also have the option of valuables being held in safekeeping but all those spoken to prefer to manage their own monies and look after their own belongings. Records were available relating to residents personal monies which residents sign for weekly. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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 and 30 The laundry, staff and communal toilets compromise effective hygiene management within the home. Some carpets and furnishings in the home are not clean and effect the quality of the environment for the residents. Environmental risk assessments must be developed and COSSH procedures followed to ensure health and safety at the home. EVIDENCE: The laundry and staff toilet areas must be refurbished to meet an adequate standard. The floor coverings in the single toilets must be fitted to ensure cleaning can be maintained effectively. The carpets in the hall and lounge and lounge furniture must be cleaned or replaced to ensure the residents live in a comfortable and clean environment. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 18 The home had not developed environmental risk assessments and staff were not following COSSH ( Control of hazardous Substances) procedures. It was advised that further advice be obtained from Environmental Health. An Environmental Health visit undertaken in January 2006 found that the kitchen met satisfactory hygiene standards, the report advised the use of antibacterial solution to cleanse surfaces. This has been introduced. Concerns were raised about the safety of the gas cooker; the oven regulator/ control was broken and could not effectively regulate temperature or close off the gas supply. The annual gas safety check could not been located during the inspection and it was advised that the cooker was switched off and the gas supply terminated. Mr Jommen said that the gas cooker would be replaced immediately. The staff were also storing chemicals in the kitchen and whilst the residents do not have direct access to the basement it was recommended that the door to the basement is now fitted with a lock and access is restricted to staff only. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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): 32, 34 and 35. Residents are protected by safe recruitment practices. Whilst staffing levels ensure that the residents are safe at the home they do not realistically provide for residents to be involved in activities within the local community. The staff training needs to be further developed to ensure the safety and the needs of the residents are met. EVIDENCE: The staff have attended a diabetic study day to promote the health and well being of the diabetic residents in the home. Staff have also recently had training in health and safety in the work place. The staff have training in managing the differing mental health needs of residents in the home but the registered provider must now develop the skills of staff further to manage the potential physical and verbal aggression of the residents. Some updates of food hygiene training may be required for staff it was required that the registered provider contacts environmental health for further guidance. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 20 Three staff are presently undertaking the NVQ award level 2 and 3. One member of staff has achieved level 2. Mrs Jomeen was awaiting confirmation from TOPPS that the two overseas staff can have their nursing and midwifery qualification recognised as equivalent to NVQ level 3. The home is working towards achieving 50 of staff at NVQ level 2. The NVQ level 2 incorporates first aid training but the home must ensure that all other staff undertake certified training in first aid. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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): 37, 39, 42 and 43. The registered provider for the home does not effectively manage the health and safety of the residents, staff and visitors to the home. There is no registered manager for the home and the staff lack support and guidance. EVIDENCE: Health and safety policies are reviewed and updated regularly however the date of review should be recorded. Staff confirmed that they have access to the policies and procedures. The accident records were incomplete. The accident book’s last entry was 2004 and did not provide sufficient detail. The fire system tests were evident but the fire drills were not recorded, however both staff and residents confirmed that they participated in regular West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 22 fire drills. A record of fire drills must be maintained which records who participated and what problems there were (if any). The registered provider must ensure that all health and safety records are maintained accurately. The home does not have a registered manager for the home and has not had since January 2003. The registered person Mr Jommen has in the past made attempts to recruit to the post but with no success. Whilst Mr Jomeen and his wife support the home it is evident that the lack of a registered manager is impacting on the health and safety and support and leadership of staff and residents at the home. The registered person does not have an effective method for monitoring the quality assurance of the home. West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 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 x 2 3 3 x 4 x 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 2 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 2 13 2 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 1 x 2 x x x 1 West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 24 Yes 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 YA12 Regulation 16 Requirement There must be more stimulation, activities and outings undertaken with service users. All service users on long-term placement must be offered a seven-day annual holiday. (previous timescale 1.09.04 and 10/06/05 and 16/03/06 not met) Timescale for action 01/07/06 2 3. YA20 YA24 13 16 The registered person must 01/07/06 ensure that the storage of medication is monitored. Some carpets and furnishings in 01/07/06 the home are not clean and must be cleaned effectively or replaced. The laundry and staff toilet areas must be refurbished to meet an adequate standard. The floor coverings in the single toilets must be fitted to ensure cleaning can be maintained effectively. 50 of care staff must have NVQ level 2 or equivalent. Previous timescales of 16/03/06 not met. All staff must have certified training in first aid and their DS0000001145.V292626.R01.S.doc 4. YA30 13 01/07/06 5. YA32 18 01/07/06 6. YA35 13 01/07/06 West Bank Care Home Version 5.1 Page 25 skills be further developed in the management of potential physical and verbal aggression. 7. YA37 8 A registered manager must be appointed at the home (previous timescale 1.07.04 and 10/06/05 and 16/03/06 not met). 01/07/06 8. YA42 13 Advice must be sought from 01/07/06 Environmental Health re environmental risk assessments and staff up dates and training in food hygiene. COSSH procedures must be followed by staff to ensure health and safety at the home. 9 YA43 24 The registered person must ensure that there is adequate quality assurance monitoring in the absence of a registered manager. 01/07/06 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 YA23 Good Practice Recommendations The staff should undertake further training in adult protection. Until this is completed it was advised that Abuse, Whistle blowing and Adult Protection are regular topics to be discussed at staff meetings. The basement door should be fitted with a lock to restrict residents access to this area. 2 YA24 West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 West Bank Care Home DS0000001145.V292626.R01.S.doc Version 5.1 Page 27 - 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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