Inspection on 24/05/06 for Woodleaze EMI Unit

This inspection was carried out on 24th May 2006.

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

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

Other inspections for this house

Woodleaze EMI Unit 30/04/09

Woodleaze EMI Unit 03/05/07

Woodleaze EMI Unit 05/01/06

Woodleaze EMI Unit 13/05/05

Woodleaze EMI Unit 13/10/04

Woodleaze EMI Unit 16/04/04

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

CARE HOMES FOR OLDER PEOPLE Woodleaze EMI Unit Station Road Yate South Glos BS37 4AF Lead Inspector Melanie Edwards Key Unannounced Inspection 24 May 2006 09:00 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 Woodleaze EMI Unit DS0000034159.V290567.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. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Woodleaze EMI Unit Address Station Road Yate South Glos BS37 4AF 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) 01454 866043 01454 866041 South Gloucestershire Council Mr Daniel Gerard Rooney Care Home 34 Category(ies) of Dementia - over 65 years of age (34) registration, with number of places Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: Condition of registration: The Home cares for people with Dementia aged over 65 years. South Gloucestershire Council operates Woodleaze and the Manager is Mrs. Sue Tasker. The Home is registered to accommodate thirty-four older people with dementia. Two of these places are kept for short-term care. Each of the 34 single bedrooms has a wash hand basin. None of the rooms have an ensuite facility. The property is arranged over two floors with shared space on the ground level and bedrooms on both floors. There is a central courtyard, which is pleasantly laid out with flower and plant containers and exterior furnishings. Woodleaze is a purpose built home, which was built in the 1980s. It is one of 8 care homes for older people operated by South Gloucestershire Council. Woodleaze is the only one of the 8 homes that offers specialist care for the Elderly Mentally Infirm. The Home is close to shops, amenities and bus routes. The fees that are charged for staying at the Home are around £574 a week. There are extra charges for chiropodist, and hairdresser services. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Please note due to their differing levels of confusion some of the residents are unable to express their views verbally about the Home. The manager, Mrs Sue Tasker, three care staff and the cook were interviewed about their roles and responsibilities, their training needs, and how they assist and support residents. A sample of records relating to the day-to-day running and management of the Home were inspected. A selection of resident’s care records and care plans were also inspected. The Home was operating within the required conditions of registration set down by the Commission for Social Care Inspection. The conditions of registration detail the type of care and the needs of residents as well as the numbers of residents who may stay at the Home. These judgments have been made using available evidence including a visit to the service. What the service does well: What has improved since the last inspection? What they could do better: Care plans and assessments of residents’ needs must be more regularly reviewed and updated. This is to demonstrate residents’ needs are being monitored and updated. Also one resident’s care plan did not reflect a significant change in their physical health. The care plan must demonstrate how the person’s care needs are met. Where residents are restricted access to their bedrooms during the day. There must be robust documentation supporting the decision process, in the form of a detailed assessment. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 6 Residents should be safeguarded by written protocols to guide staff when to give residents medication that they only need when required. This will guide staff and ensure such medication is given based on clearly identified needs of residents. Residents’ individual weights should be checked on a more regular basis. This is to ensure residents health is monitored, and residents overall dietary intake is satisfactory. There should be separate charts used to record when a resident needs to be assisted by staff to be moved, and their fluid and food intake is monitored. Currently for one identified resident this information is being recorded on one record. This makes it difficult to accurately monitor the information and keep it up to date. Foods that are`high risk’ foods must be temperature probed before serving to ensure the food has reached above minimum required temperature. The fire fighting equipment must be checked on a more regular basis to ensure it is in working order. 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. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is adequate. Residents assessed needs are met by caring staff. However resident’s assessment information is not being regularly reviewed and updated. There are no residents staying at the Home specifically for intermediate care needs. EVIDENCE: To find out how residents’ care needs are assessed and how the care they need is being planned, two residents’ assessment records were looked at in detail. The assessments included a range of information, and detailed each resident’s range of complex care needs. There are also risk assessments in place to support residents to demonstrate they are being encouraged to live an independent and fulfilling life. This helps residents to maintain independence despite experiencing varying levels of confusion that has an impact on their daily lives. The resident’s assessment records that were looked at had not been reviewed regularly by the staff. This should be carried out to demonstrate staff monitor residents’ changing needs. Several residents’ relatives were asked about how residents are helped by staff with their needs. Comments made by relatives were positive about the staff Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 9 and their caring attitude. These comments help to demonstrate that residents’ relatives feel their needs are being met, and that they are treated well at the Home. There are no residents staying at the Home specifically for intermediate care needs. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. Residents are supported with their needs by caring and skilled staff. However care plans and care records are not being reviewed regularly. Also one resident’s care plan does not reflect their current care needs. The practices for storage and disposal of medication are safe. However there are no guidelines to assist staff administering medication that is given only when required. EVIDENCE: Three resident’s care plans were read to find out how well residents care is being planned and delivered by the Home. There was a range of helpful information written for each resident stating how to support the person with his or her full range of needs. Care plans also included information showing how to support residents who have varying levels of confusion, due to their dementia. However one resident’s care plan that was looked at, did not reflect a significant change in the person’s overall physical health. The three care plans that were read had not been regularly reviewed or updated. This is necessary to help demonstrate residents’ needs are being kept under review and updated. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 11 Residents are registered with local GP surgeries and are further supported with their health needs by the psychiatrist who reviews residents’ health care needs when required. There is a medical health record maintained for each resident. This records when residents see a doctor, optician, dentist and chiropodist and the reasons for the referral, and any outcomes, including what treatment was required. Residents are also supported by district nursing staff when required to assist them with their needs while they are in the Home. There was information in the daily records that demonstrated staff were monitoring and observing residents and call a doctor, if they were concerned about the resident. However the three residents weight records that were looked at, were not being kept up to date. Residents weights should be checked regularly where practical to ensure residents health is being monitored, and those residents overall dietary intake is satisfactory. One resident is currently being cared for in bed, and needs assistance to be moved when in bed, as well as assistance with eating and drinking. Currently all of this information concerning when they have eaten and had a drink and when they have been `turned’ is written on one sheet of paper. This makes it difficult to accurately monitor the information and keep it up to date. Throughout the inspection all of the staff on duty were observed helping residents with their needs in a warm, friendly and respectful way. To find out if safe medication practices are carried out, the practices and procedures for administration, and storage of medication were checked. Medication supplies are stored in secure cupboard in a secure clinic, and in a locked moveable metal trolley. Three resident’s medication administration charts were looked at. There was a photograph of each resident with his or her chart. This should ensure medication is administered correctly to the resident named on the chart. The administration charts were up to date, legible and in good order .The staff had signed for medication administrated, or recorded the reasons for any omissions. All senior staff who administer medication attend regular training to enable them to do this safely. However, for residents who are being given medication that they need ‘when required’ there are no written guidelines in place to advise staff on when residents may need such medication, for example if a resident becomes agitated. This will guide staff and ensure such medication is given based on clearly identified needs of residents. The stock of medication held in the Home was generally satisfactorily organised. Medication that was no longer required was being returned to the pharmacist. This helps ensure residents’ medication supplies are kept in good order and can be easily monitored. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Quality in this outcome area is good. Residents are able to keep close contact with relatives,friends and the community. Residents are also offered a varied and nutritious diet, and can take part in a range of social and theraputic activities. EVIDENCE: Residents take part in a range of social and therapeutic activities. There are allocated staff responsible for organising social activities and these include bingo, memory and reminiscence groups, trips to a local theatre, and trips to areas of interest in the community. Several residents were observed taking part in a ‘knitting circle’ with staff. Residents looked as if they were enjoying the activity. Residents were observed walking around the Home, and approaching staff. Residents looked reasonably relaxed and settled in their environment. Residents and staff access community transport for regular trips into the local community. During the inspection a number of visitors came to see friends or family at the Home. Staff were warm and friendly in manner to visitors. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 13 There is a reasonable sized dining room for residents to take their meals in. Tables were covered with linen tablecloths. The Home operates a rotating menu. The menu choices were checked and were all well balanced, traditional and varied. Residents can make a choice at meal times of what meal they would like to have. The daily menu is written on a large notice board in the dining room to assist residents. A portion of the lunchtime meal was sampled; this consisted of a choice of chicken stew, with mashed potato, cabbage and carrots, or tuna salad. There was a choice of homemade apricot cobbler, ice cream or fresh fruit for dessert. The meal was tasty, and well cooked. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 14 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): 16,18 Quality in this outcome area is good. Residents’ complaints will be taken seriously and acted upon. The Home also has systems in place, and practices and procedures to protect residents from abuse. EVIDENCE: There is a copy of the complaints procedure on display in the reception area. This includes up to date contact information for the area office of the Commission for Social Care Inspection. A copy of the complaints procedure is included in the service user guide. The complaints book record was reviewed and there had been no complaints recorded since the last inspection. All of the visitors said they felt very able to speak to any of the staff if they had any concerns. They said staff would respond promptly and take their concerns seriously. Staff also demonstrated in discussion that they had a good understanding of how to support residents, who may be very confused, to be able to make a complaint. Residents are protected from the risk of harm or abuse by staff following the South Gloucestershire Council’s `protection of vulnerable adults from abuse’ policies. There was also evidence in the staff training records that staff attend training on the protection of vulnerable adults from abuse, to help ensure residents are protected. The staff also demonstrated in discussion a good understanding of the topic of `protection of vulnerable adults from abuse’ and how to protect residents in their care. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 15 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is adequate. The Home looked satisfactorily maintained, clean and tidy and suitable for residents needs. However residents currently have restricted access into their bedrooms. EVIDENCE: Woodleaze is a purpose-built Home located close to private houses and a short distance from the local town of Yate and nearby to bus stops. This helps ensure residents can be a part of the community. The Home is wheelchair accessible; and there is a lift servicing the upper floor. The Home is a twostorey building, and residents have access to all areas. There are adaptations in place to assist residents and visitors with disabilities throughout the Home. There is a dining area and four lounges. Residents were observed sitting in the lounges and dining room, looking reasonably relaxed and comfortable in their environment. There are bedrooms situated on the ground and first floor. However staff explained that due to their levels of confusion and dementia residents currently have restricted access into their bedrooms during the day. To support and Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 16 demonstrate the reasons for this practice, there must be a robust assessment based on residents’ needs supporting the decision process. Bathrooms include specially adapted baths to assist residents who may have reduced mobility. Toilets are situated in readily accessible parts of the Home near to communal areas and bedrooms. The bathrooms and toilets were clean, and were well stocked with hand towels and soap to help minimize risk from cross infection in the Home. The Home looked clean and tidy in all areas that were viewed. The Home is set in its own grounds. The gardens are satisfactorily maintained and there are patio seats and a secure garden where residents can sit and walk safely. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Residents are cared for by sufficient numbers of competent staff that are provided with training to fulfil their roles and responsibilities. The recruitment procedures could not be checked on this inspection. EVIDENCE: The recruitment procedures were not checked on this inspection. South Gloucestershire Council keeps staff recruitment records at its head office. Inspectors from the Commission for Social Care Inspection carry out periodic checks of the records to verify if required ‘safety checks’ are being carried out when employees are recruited. The staff duty record for the previous two-week period was checked to find out if residents are cared for by a sufficient number of staff on duty to ensure their needs are met. There are a minimum of five care staff on duty as well as at least one manager working during the day with extra staff available at busy periods. There are three staff on duty at night. Based on the evidence from the inspection the number of staff on duty is meeting residents’ needs. The training records of three members of staff were looked at to find out if staff are provided with a range of training opportunities These consisted of three care staff and one manager. All of the staff concerned had attended recent training and update sessions on topics and matters relevant to the needs of residents in the Home. Training sessions staff had attended included courses in understanding dementia to further assist staff in understanding the needs of residents in their care. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 18 Staff also spoke positively about the range of training and development opportunities that they are able to attend. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36, 37, 38 Quality in this outcome area is adequate. Residents benefit from an experienced and well trained team of managers. Staff are well supervised in their work and have a good understanding of their roles and responsibilities However residents’ health and safety is only partly protected. EVIDENCE: Residents are cared for by a management team consisting of the Manager, Mrs Sue Tasker and three duty managers, who have a number of years of experience between them. Managers are working towards obtaining various management awards. Mrs Tasker has completed National Vocational Qualification in care award Level 4 in Management. Mrs Tasker has been registered as a manager of another care Home run by South Gloucestershire City Council. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 20 The staff reported that staff meetings are held regularly, although records were not looked at on the inspection. There are separate meetings held for cooks, managers, domestic and care staff. The monthly monitoring visits of the Home that must be carried out by a representative of South Gloucestershire City Council are being undertaken as is required by law. There are detailed and informative records of these visits being sent to the Commission for Social Care Inspection. The records demonstrate that the designated individual responsible for the visits spends time consulting with residents and their representatives and observing staff carrying out their duties. Residents’ records are kept securely locked away in filing cabinets in the Home’s office, but are less available to staff if they should need them. All records seen were legible, up-to-date and in satisfactory order. The environment looked satisfactorily maintained throughout. The fire logbook records showed fire alarm tests are being carried out. There are also fire drills carried out on a regular basis to help protect the health and safety of residents and staff. However in 2005 there was a period of time of seven months when the fire fighting equipment had not been checked to ensure it was in working order. The kitchen was tidy and organised when viewed. Up to date checks of kitchen fridges and freezers are maintained, to ensure they are operating within food safety guidance levels. However records demonstrated that `high risk’ foods are not always being temperature probed before serving to ensure the food has reached above minimum required temperature. Staff are provided with regular training in health and safety matters including first aid, food hygiene training and moving and handling practices. This should help protect residents’ health and safety if staff are knowledgeable and well trained in these health and safety principles and practices. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 21 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 N/A 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 2 Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 22 NO 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 OP19 Regulation Schedule 3. (q) Requirement Where residents are restricted access into bedrooms during the day there must be an assessment based on residents’ needs supporting the decision process. `igh risk’ foods must be temperature probed before serving. One resident’s care plan must demonstrate how their needs are currently being met. Care plans and assessments of residents’ needs must be regularly reviewed and updated. The fire fighting equipment must be checked on a regular basis. Timescale for action 24/07/06 2 3 4 5 OP38 OP7 OP7 OP38 16.2(i) 15 15.2(b) 23.4c(v) 25/05/06 25/05/06 25/05/06 24/07/06 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 OP8 Good Practice Recommendations Where practical, residents weight should be checked on a DS0000034159.V290567.R01.S.doc Version 5.1 Page 23 Woodleaze EMI Unit 2 3 OP7 OP9 more regular basis. There should be separate charts used to record when a resident needs to be assisted by staff to be moved when in bed, and for their fluid and food intake. There should be written protocols in place to advise staff when to give residents medication that they only need occasionally. Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Woodleaze EMI Unit DS0000034159.V290567.R01.S.doc Version 5.1 Page 25 - 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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