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Inspection on 15/08/06 for Woodland House

Also see our care home review for Woodland House for more information

This inspection was carried out on 15th 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Observations took place at different times throughout the fieldwork visit residents received good support from staff that spoke calmly and respectfully. Residents were seen to plan how they wanted to spend their time. Residents were observed moving freely around their home and choosing when to get up, when to eat and when to go out. Residents said they enjoyed a recent holiday to Devon. They said they visit their family and friends and their family and friends are made welcome at the home. It is really positive that resident`s views and comments on the home are included in the Service User Guide. The home is clean, warm and comfortable with a good range of rooms including a games room with a selection of games for residents use. Health and Safety is generally well managed and ensures the safety of residents and staff.

What has improved since the last inspection?

The two previous requirements had been actioned in full. There is a commitment to the ongoing development of the home so that residents benefit from a well run home. The kitchen had recently been refurbished, new windows have been fitted throughout the house and repointing of the brickwork was taking place. This all ensures a comfortable and well-maintained home for residents to live in. All staff completed their training so that they have the skills and knowledge to meet resident`s needs.

What the care home could do better:

The risk assessments in place for residents accessing the community independently required some minor development so that it is made clear how long a person is out independently and at one point staff may become concerned for their safety. It was advised that review sheets are implemented to the care plan format so that there is evidence of when the individual plan has been reviewed and any changes made. Further development of people`s individual plans is required so that all residents have the opportunity to take part in developing their own individual plan. Some minor improvements were required to the homes medication procedures so that resident`s medication needs are well met.

CARE HOME ADULTS 18-65 Woodland House 22 Woodland Road Northfield Birmingham West Midlands B31 2HS Lead Inspector Donna Ahern Key Unannounced Inspection 15th August 2006 12:20 Woodland House DS0000017003.V304111.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 Woodland House DS0000017003.V304111.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. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodland House Address 22 Woodland Road Northfield Birmingham West Midlands B31 2HS 0121 243 9349 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 Brendan Freeman Mr Brendan Freeman Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 10th March 2006 Brief Description of the Service: Woodland House is a three-storey semi detached property situated within a quiet street in Northfield, Birmingham. The home is close to transport links to the city centre, shops, pubs, cafes and places of worship. The home provides care for six younger adults of both sexes who have learning disabilities. All service users living at the home have independent living skills and this is encouraged by staff and is reflected in the flexible way the home is run. The communal areas of the home are spacious and include a large garden, which is well used for such activities as football and barbeques. The service users bedroom are located on all floors of the property, two bedrooms have en suite facilities. A large games room is situated on the second floor. The home does not provide a vehicle for service users, senior staff use their own vehicles; taxis and public transport are also utilised. There is no off road parking available. The fee level for the home is £610 per week. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The fieldwork visit was unannounced involved one inspector and took place on an afternoon and evening lasting six and a half hours. This was the homes first key inspection for the inspection year 2006-2007. During the visit the inspector met with all six residents who live at Woodland House, to observe the opportunities and support provided to them, to look at the premises, and to read records about care, staffing, and health and safety. Time was spent with the deputy manager and discussions took place with one support staff. A pre-inspection questionnaire was completed by the registered manager and returned to CSCI prior to the fieldwork visit. Information from this was used to help compile this report. The home is required to report incidents, accidents and other events that occur in the home to CSCI. These are called regulation 37 notifications. All information reported via a regulation 37 notifications since the last inspection was analysed prior to the fieldwork visit. What the service does well: Observations took place at different times throughout the fieldwork visit residents received good support from staff that spoke calmly and respectfully. Residents were seen to plan how they wanted to spend their time. Residents were observed moving freely around their home and choosing when to get up, when to eat and when to go out. Residents said they enjoyed a recent holiday to Devon. They said they visit their family and friends and their family and friends are made welcome at the home. It is really positive that resident’s views and comments on the home are included in the Service User Guide. The home is clean, warm and comfortable with a good range of rooms including a games room with a selection of games for residents use. Health and Safety is generally well managed and ensures the safety of residents and staff. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Woodland House DS0000017003.V304111.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 Woodland House DS0000017003.V304111.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): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The Statement of Purpose and Service Users Guide give useful information so that prospective residents can make a choice about where to live. Full assessments are undertaken prior to admission. EVIDENCE: Six people both male and female live at Woodland House they have a learning disability and additional needs. All residents have some degree of independent living skills and this is encouraged by staff and is reflected in the flexible way the home is run. The Statement of Purpose and Service User Guide contain all the required information and had been produced in an easy read format making it more accessible for some of the people who live at the home. It is really positive that resident’s views and comments on the home are included in the Service User Guide. There had been no new admissions since the previous inspection. The manager has developed an admission pack for potential residents. The admission procedure was previously assessed as meeting the required standard and states that potential residents would be invited to the home for visits and a trial period prior to admission being confirmed. Sampled case files had copies Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 9 of the Care Management assessments. Individual detailed care plans have been developed for all residents and have been kept under review. Woodland House DS0000017003.V304111.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Comprehensive information is available on each resident. Some development is required so that there is evidence of resident involvement in the care plan process. EVIDENCE: Two peoples files were assessed. Detailed information is available on supporting residents. There was good information about the persons likes and dislikes, health needs, personal care, culture and preferences. There was evidence that staff had consulted with a range of professionals to promote best practice for the individual. It was advised that review sheets are implemented to the care plan format so that there is evidence of when the individual plan has been reviewed and any changes made. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 11 Further development of people’s care plans is required so that all residents have the opportunity to partake in Person Centred Plans as identified in the Government White Paper. The manager indicated that she was very keen to develop these in conjunction with each of the residents. Behaviour management strategies were on sampled files had been kept under review and gave information on how best to support residents. The risk assessment report on file covered general health, personal hygiene, independent travel, finances, behaviour and vulnerability. Discussions with the manager indicated that risk-taking is seen as an essential feature of supporting residents to be independent. A number of risk assessments were sampled and indicated that they are kept under review. One of the residents had recently been involved in an incident in the local community. Records seen and discussion with the manager indicated that appropriate action was taken to protect the resident. The risk assessments in place were fully reviewed in light of the incident. The risk assessments in place for residents accessing the community independently required some minor development so that it is made explicit how long a person is out independently and at one point staff may become concerned for their safety. Observations took place at different times throughout the fieldwork visit residents received good support from staff that spoke calmly and respectfully. Residents were seen to plan how they wanted to spend their time. Woodland House DS0000017003.V304111.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): 12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are supported to undertake activities in the community. EVIDENCE: Residents are involved in a whole arrange of daytime activities. Some of the people attend structured day centres and some plan their own activities and daytime occupation. One of the residents has done some voluntary work and one person delivers a local paper. There is evidence from discussions with residents that they have been supported to try new activities including college placements. The manager was also in the process of supporting one resident to seek out an appropriate daytime placement following some changes in their previous arrangements. Residents said they had enjoyed a recent holiday to Devon. Residents said they have contact with family and friends. Some of the residents visit their family independently and some relatives visit the home as observed on the day of the inspection. A pay phone is available for residents to make private calls. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 13 Residents were observed moving freely around their home and choosing when to get up, when to eat and when to go out. Residents were seen making a choice about what they wanted to eat for their evening meal. Residents confirmed that “the food is good” and “I can choose what I want to eat”. Two residents went out early evening and it was observed that the serving of their evening meal was flexible to fit in with their needs. Food stock seen indicated a range of produce is available. A record of meals served to residents is kept daily. Woodland House DS0000017003.V304111.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 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents are well supported to undertake a wide range of healthcare monitoring appointments, and the staff had sought advice from health professionals. The medication procedure requires some development so that it promotes safe practice for residents. EVIDENCE: Residents personal appearance was good and indicated that residents receive good support to attend to their personal care needs. They wore clothing appropriate to their age, culture and time of year. All residents are mobile and the home has no lifting aids or adaptations. There are plans in place to develop the bathroom on the first floor so that it is adapted to meet the future needs of residents. The home has a stable staff team which gives continuity of care to residents. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 15 The manager has continued to develop health action plans; a health action plan is a plan of what a person needs to do to stay healthy. Specific health needs had been identified. Where appropriate residents weight and food intake is monitored. Resident’s files had details of visits to a range of professionals. There is active input from Community Nurses and Psychiatrist Services. Medication is stored in a separate locked cupboard off the ground floor passageway. Medication records were sampled. Medication administration records (MAR) had been signed when medication had been administered. Sample signatures are required for all staff who administers medication and a protocol must be implemented and signed by a medical professional for medication taken on an as required basis so that the homes medication procedures promotes safe practice for residents. Woodland House DS0000017003.V304111.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are listened to. Arrangements are in place so that residents are protected from abuse. Information about how to make a complaint is available in a format that residents can understand and follow. EVIDENCE: The complaints procedure was on display in the games room and has been produced in a format suitable for residents use. The home had not received any complaints since the previous inspection and CSCI had not received any concerns, complaints or allegations about the home. One of the residents said that they would speak to staff or the manager if they were not happy about something. Staff are trained in protection matters. The policy for Adult Protection required some minor development so that it embraces the Birmingham Multi Agency Guidelines and so that it directs staff to contact the placing Social Care and Health office. Discussions and observations at the time of the fieldwork indicated a strong commitment by staff and managers to the safeguarding of the people who live at Woodland House whilst allowing people to live independent lives. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 17 CSCI have been appropriately notified of incidents that have occurred in the home. Regulation 37 reports have been completed logged and forwarded for information. It is advised that the homes logging system for such incidents are developed so that there is a thorough paper trail in place to demonstrate that issues have been dealt with appropriately. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a comfortable home with facilities provided to suit their individual needs. EVIDENCE: The home is clean and warm. It is domestic in style and layout. The home does not have adaptations for people with a physical disability although handrails are situated on staircase and level changes on the first floor. The home therefore is not suitable for people with mobility difficulties as there is no lift facility and a number of level changes on the ground floor. Furniture and fittings were generally of a good quality. Two of the residents showed the inspector their room. Both bedrooms were very comfortable and had been personalised to the taste of the individual. One resident said “I love living here I have a nice room and all the things that I want”. As raised in previous reports the dining room continues to be utilised as a smoking area by one resident. Smoking is not permitted during mealtimes. A Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 19 risk assessment is in place. The manager advised that smoking mainly takes place outside in the garden. The arrangements must continue to be monitored to ensure that smoking does not impact on the well being of people living and working in the home. The kitchen had recently been refurbished, new windows have been fitted throughout the house and repointing of the brickwork was taking place. This all ensures a comfortable and well-maintained home for residents to live in. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 20 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): 32,33,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Resident’s benefit from a well supported staff team. EVIDENCE: The rota shows a minimum of two staff on duty. The manager and deputy manager do a number of care hours each. At night there is one waking night member of staff and an on call system for back up and support. Staff allocation was adequate for residents to undertake activities of their choice, and to receive the level of support they require. The home has a stable staff team, and some of the staff had worked with the residents for a long time. Agency staff are not used by the home, which ensures continuity of care for residents. Interactions between staff and residents were entirely positive, and the way residents were supported was sensitive and respectful. Two staff files were assessed. The record of staff recruitment contained all the required documents and ensures that residents benefit from appropriately recruited staff. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 21 Staff have received supervision on a regular basis. Staff files contained details of training courses undertaken. All staff completed the LDAF (learning disability awards Framework) in May-July 2006, which covered all mandatory training. Three staff are near to completing NVQ level 2 in care. The manager stated that training is reviewed on a regular basis thus ensuring that staff have the skills and knowledge individually and collectively to meet residents needs. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 22 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Health and safety is generally well managed. Resident’s benefit from a well run home. EVIDENCE: The manager has several years experience of owning and managing a home for people with a learning disability. He has decided that when the deputy manager completes the Registered Managers award; he will relinquish the post of manager. The deputy manager expects to complete the registered managers award by summer 2007 and then plans to forward an application to register with CSCI. She facilitated the inspection process and was open and welcoming to comments and feedback and demonstrated a commitment to the ongoing development of the home. All previous requirements had been actioned. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 23 One resident said they liked the manager and they could ask them for help if they needed it. Another residents said that staff and managers ask their views about the home. Health and Safety is generally well managed and ensures the safety of residents and staff. Fire tests and servicing had been undertaken as required. The Work Place Fire Risk Assessment was just due for review. The fire, electrical and gas supply had been serviced and tested as required. Records showed that staff are undertaking hot water delivery temperatures monthly so that residents are protected from the risk of scalding. Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 24 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 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 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 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X X X X 3 X Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 25 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 YA9 Regulation 13 (4) b,c Requirement The risk assessments in place for residents accessing the community independently required some minor development. Sample signatures are required for all staff who administer medication. Timescale for action 30/09/06 2 YA20 3 YA20 4 YA23 13 (2) 17 (1) (a) Schedule 3 (i) 13 (2) 17 (1) (a) Schedule 3 (i) 13 (6) 15/09/06 A protocol must be implemented 15/09/06 and signed by a medical professional for medication taken on an as required basis. The policy for Adult Protection required some minor development so that it embraces the Birmingham Multi Agency Guidelines 30/09/06 Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 26 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 Further development of people’s care plans is required so that all residents have the opportunity to partake in Person Centred Plans as identified in the Government White Paper. It was advised that review sheets are implemented to the care plan format so that there is evidence of when the individual plan has been reviewed and any changes made. It is advised that the homes logging system for such incidents are developed so that there is a thorough paper trail in place to demonstrate that issues have been dealt with appropriately. 2 YA6 3 YA23 Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Woodland House DS0000017003.V304111.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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