Care Home: Evergreen Residential Home

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What the care home does well The service provides a good level of care for people with a dementia. People are given sufficient information to decide on whether to move in, and they have their needs well assessed. The manager writes down what care people need in a plan, and staff are all familiar with what is written down. Plans are changed if people`s needs change. Risk is well assessed and people are enabled to live as independently as they can. Health care professionals are consulted for advice on a regular basis and the home has good working relationships with social and health care professionals alike. Visitors are made very welcome and the food is good quality. Complaints are handled well and staff have good training in abuse awareness. Staff are well recruited and trained for their role. Staffing levels are good. The manager has worked hard along with senior staff to improve the quality of care in the home. She makes sure that the views of people living at the home and others are taken into consideration when planning care. Personal allowances are well handled and people are kept safe by good health and safety policies and procedures. A number of people returned surveys and there were a large number of positive comments about the quality of care. Many people emphasised the improvements in care over the year. One person wrote: `I feel the team at Evergreen have brought a very individual and tailored approach for service users. There is a lovely relaxed atmosphere, very different to before and people are relaxed/happy and getting very personalised care.` A visitor said: `I can leave my mum and feel she`ll be okay. It`s great peace of mind.` What has improved since the last inspection? All previous ten requirements have been met and all five previous recommendations have been carried out. Assessments and care plans have improved so that staff all know what care each person needs. Medication handling has improved so that people`s health is protected. Social and recreational needs are better assessed and catered for. Staff competence has been addressed. Staff recruitment, training and staffing levels have improved, so that staff have the skills to offer the care people need. The manager is now registered with CQC. Evidence of safety certificates, which were missing at the last inspection, was provided at this one. The handling of laundry has improved to protect people form the risk of cross contamination. Communication with relatives, health and social care professional and all others coming into the home has improved greatly. One health care professional wrote: `I am very pleased with the huge change in this home.` What the care home could do better: The manager has identified that the home requires further redecoration; the outside of the building looks shabby in contrast to the interior and now needs attention. The steps leading up to the building needs attention. Consideration could be given to improve access to communal areas for people living at the home. CARE HOMES FOR OLDER PEOPLE Evergreen Residential Home 22 Prince Of Wales Terrace Scarborough North Yorkshire YO11 2AL Lead Inspector Karen Ritson Key Unannounced Inspection 7th April 2009 10:00 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 Evergreen Residential Home DS0000070816.V374760.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 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. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Evergreen Residential Home Address 22 Prince Of Wales Terrace Scarborough North Yorkshire YO11 2AL 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) 01723 375122 Caliburn Care Homes Ltd Care Home 17 Category(ies) of Dementia (17) registration, with number of places Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Dementia - Code DE The maximum number of service users who can be accommodated is: 17 9th April 2008 2. Date of last inspection Brief Description of the Service: Evergreen is a Victorian terraced property located in the South Cliff area of Scarborough, within walking distance of the Esplanade. The home is registered to provide residential care for seventeen residents over 65 with dementia. The home is located on the first five floors. A lounge is located on the lower ground floor and a dining room on the ground floor, stairs or a passenger lift can access all floors. The care home does not have a garden but is conveniently situated for access to the main community facilities including the public transport network. Restricted on road parking is available. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CSCI reports, are available on request at the home. Hairdressing and newspapers are not included in the weekly fee and these are charged at cost. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection for this service took twelve hours. This includes time spent gathering information and examining documentation before and after a site visit. It also includes the time taken to write the report. The site visit took place on 7th April 2009 between 10:00 and 15:30. Information for this inspection was gathered from the following: 1. A visit to the home. 2. Speaking with people living at the home. 3. Speaking with staff. 4. Speaking with Adult and Community care staff. 5. Case tracking three people on the day of the site visit. 6. Reading survey forms from people living at the home, health care professionals and staff. 7. Looking at information provided by the manager prior to the site visit. 8. Notifications sent to the commission from the home since the last inspection. 9. Examining policies, procedures and records kept at the home. 10. Examining information regarding the home on the file kept by CQC. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations -but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: The service provides a good level of care for people with a dementia. People are given sufficient information to decide on whether to move in, and they have their needs well assessed. The manager writes down what care people Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 6 need in a plan, and staff are all familiar with what is written down. Plans are changed if people’s needs change. Risk is well assessed and people are enabled to live as independently as they can. Health care professionals are consulted for advice on a regular basis and the home has good working relationships with social and health care professionals alike. Visitors are made very welcome and the food is good quality. Complaints are handled well and staff have good training in abuse awareness. Staff are well recruited and trained for their role. Staffing levels are good. The manager has worked hard along with senior staff to improve the quality of care in the home. She makes sure that the views of people living at the home and others are taken into consideration when planning care. Personal allowances are well handled and people are kept safe by good health and safety policies and procedures. A number of people returned surveys and there were a large number of positive comments about the quality of care. Many people emphasised the improvements in care over the year. One person wrote: ‘I feel the team at Evergreen have brought a very individual and tailored approach for service users. There is a lovely relaxed atmosphere, very different to before and people are relaxed/happy and getting very personalised care.’ A visitor said: ‘I can leave my mum and feel she’ll be okay. It’s great peace of mind.’ What has improved since the last inspection? What they could do better: Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 7 The manager has identified that the home requires further redecoration; the outside of the building looks shabby in contrast to the interior and now needs attention. The steps leading up to the building needs attention. Consideration could be given to improve access to communal areas for people living at the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. People who may use the service and their representatives have the information needed to choose a home that will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a comprehensive assessment of needs on file. A deprivation of liberty assessment is included to ensure people are enabled to make decisions within their capacity. Assessments cover all areas of required care including assessment of risk for each individual. One visitor to the home said: ‘The manager was very good at giving us information about the home before we thought about mum coming here. She encouraged us to look round and ask questions.’ This ensures people have enough information to make an informed Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 10 decision before admission and that the home has enough information to ensure it can meet needs. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 9 and 10. Quality in this outcome area is good. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a care plan developed from the assessment. This records daily needs and how these will be met, with objectives in place for people to achieve their full potential. Risk assessments are specific to individuals and detailed, with appropriate strategies in place. Staff sign each care plan to show they have read and understood them, and the care plans are regularly reviewed with information gathered from the person, family and health care professionals. In addition, each person has a nutritional assessment, a daily living risk assessment and skin integrity assessment as standard. This ensures plans are in place to minimise avoidable risk. All accidents are recorded and kept in individual files in keeping with data protection legislation. GP visits and Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 12 family visits are recorded separately to make it easy to track medical interventions and social calls. All activities are also recorded to build a profile of each person’s daily life. A large number of surveys were returned and all made positive comments about the quality of written plans. One health care professional wrote: ‘Communication has greatly improved.’ Another wrote: ’Well done to the staff for the vast improvement and dedication to care.’ Another wrote: ‘Staff are extremely vigilant about all health concerns and fully involved in all decisions about health.’ Another wrote. ‘The home have been excellent regarding the very sensitive and individualised care they have given my clients. They have all thrived in the care of Evergreen.’ The home manages medication well according to policy and procedure. Staff are well trained and medicines are safely stored and administered. One health care professional wrote: ‘The home is really involved with issues regarding medication and have been extremely useful in providing good information to health professionals to allow effective, appropriate medication to be prescribed.’ One visitor said the home ‘gets medical help whenever needed. Mother needed a chiropodist when she was first admitted. The manager got one straight away, we didn’t have to wait for the regular chiropodist to come on her regular visit.’ Throughout the inspection people living at the home were treated with respect and with regard to their privacy and dignity. The home has policies on how to treat people with respect and staff receive training through induction, foundation and NVQ level two. Surveys also stated that staff were respectful. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. People who use services are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has developed person centred activities for people living there. There are some group activities on offer such as musical bingo, reminiscence, soft ball, dominoes, baking and craft work. People are assessed individually about what they prefer to do and staff have time to sit with people and talk, look at magazines, play games or go for walks around the building. One health care professional wrote: ‘The home has looked at the people as real individuals and will go the extra mile to ensure they are happy and have care appropriate to them.’ Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 14 Staff said is was not always possible to have the same one to one attention with people in the afternoons as there was usually one member of staff less on duty. As a result most activities take place in the mornings. Visitors are welcome at any reasonable hour and several visitors were present on the day of inspection. All said they were welcomed into the home, given refreshments and made to feel a part of what was going on. People made good comments about the quality of food. One person living at the home said: ‘ The food is marvellous, really good.’ The home has employed a qualified chef and menus are drawn up with the involvement of people living there. The chef was spoken to and confirmed that menus were regularly updated in line with preferences. Specialist diets are available according to assessed needs. Each person has a nutritional assessment to ensure that diet is appropriate. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. They are protected from abuse, and have their rights protected This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a comprehensive complaint policy and procedure. Any complaints are recorded with their outcomes. The recording for one complaint was examined and it was clear that the home looked into this in detail and gave feedback to the person making the complaint. One health care professional wrote of the home’s handling of complaints: ‘This has improved greatly in the last 12 months.’ Staff said the home had an open attitude towards people who wished to raise a concern and the said the manager wanted to get things right. The home has a policy on abuse, staff have received abuse awareness training and training in challenging behaviour. Staff were observed dealing with people in an effective manner on the day of inspection. When asked what the home did well, one health care professional wrote: ‘Caring for people with severe Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 16 dementia and behavioural problems. Senior staff have an understanding of this illness and are skilful in coping with some of the most difficult behaviour.’ Staff all have a Criminal Records Bureau check before they start work, and also have a Protection of Vulnerable Adults check as standard. This protects people from staff who are not suitable to work with vulnerable adults. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. People live in a safe and well maintained home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is clean and smells pleasant. Although the building is not ideal for the care of people with a dementia as it is on several levels, there is a good staff ratio, which means that people are not restricted in their movement around the home. The lounge is located on the lower ground floor where there is access to a toilet and the dining room is accessed via stair or the lift. The dining room is sometimes also used for craft and baking sessions. The manager plans to create a quiet area in the dining room where relatives can Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 18 visit people in privacy, or where people can sit in peaceful surroundings. Some redecoration has taken place since the last inspection. The lower ground floor, the ground floor and a landing have been redecorated. Some bedrooms have also been redecorated as part of a rolling programme of refurbishment. The front of the building remains a little shabby and the steps to the home require attention. The laundry is still located at the rear of the home and the infection control issues regarding carrying laundry through the kitchen have been resolved. Laundry is carried through before and after cooking, in sealed bags. Whilst this is not ideal, it is an adequate temporary measure until the laundry can be relocated. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing ratio is sufficient, with three staff and the manager or senior on duty each morning and two staff with the manager or senior in the afternoon. The home has two waking night staff and separate domestics and chef. Staff are well recruited according to procedure, with Criminal Records Bureau checks in place. More than 50 of staff have achieved NVQ in care at level two. When staff are recruited they spend time shadowing a senior member of staff before taking on their duties. They receive induction to skill for care guidelines, which is provided by an external trainer. Within the next six weeks following their recruitment they also receive foundation training in care. Additional training includes dementia awareness. Each member of staff has a training profile and a computerised spreadsheet is kept with an annual training matrix for each Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 20 member of staff. Staff commented that they felt the training was good. One member of staff wrote that her induction ‘covered everything very well.’ One relative wrote about an issue she had regarding staffing. The manager said she aware of this issue and was dealing with it according to procedure. All staff who filled in survey forms wrote that they always received sufficient support to fulfil their role. One relative of a person living at the home wrote: ‘The staff work so much better as a team now.’ A health care professional wrote: ‘A good team approach. No concerns re lack of skills/experience. Willing to learn and discuss with professionals where necessary.’ This ensures people get the care they need. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. The management and administration of the home is based on openness and respect. People’s health and safety is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is well qualified with the Registered Manager’s award and has almost completed NVQ at level 4. She has also completed dementia awareness training. People made very positive comments about the manager Linda Quantril and the senior carer Linda Cheetham in the surveys. One health care Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 22 professional wrote. ‘The manager has worked excellently with us and we have a good regular working relationship with the home.’ Staff agreed that the manager was approachable and that they could go to her with any genuine concern. One person said: ‘The home has not enjoyed a good reputation in the past but the approach of the manager has changed all that. The care has improved hugely and is incomparable to how it was before.’ In surveys and in conversation with staff it became clear that Mrs Quantril and Mrs Cheetham worked very well together as a team to provide effective and appropriate care. Mrs Cheetham has a great deal of experience working with this client group and Mrs Quantril has excellent organisational and managerial skills. Their teamwork has created a good quality of life for the people at Evergreen. The manager has been in post just over a year and although safety audits are in place, she has yet to implement a fully functioning quality assurance system. However, it is clear that the views of residents at the home and those who visit are canvassed through reviews and through the ‘open door’ policy of the manager. These views have been taken into consideration in planning changes in the home over the past year and in the year to come. The home is responsible for looking after the personal allowances of two people living at the home. Money was checked against records kept by the home and all tallied. This ensures people’s money is kept safe and accounted for. People at the home are kept safe by the health and safety policies and procedures of the home, by well trained staff and by good recording. Several maintenance documents were examined and all were up to date. The home complies with the fire service and environmental health requirements. This means people live in a safe environment. Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Evergreen Residential Home DS0000070816.V374760.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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