Care Home: Grangemoor House Nursing Home

What the care home does well The service is homely and welcoming "The cleaners make a wonderful job of cleaning the home I have found it quite hygienic". People living here can feel confident their needs will be assessed in full and their care will be planned with their involvement. One person said "I came to live here I didn`t know what to expect but I found I love the home". All concerns are addressed promptly and people feel able to voice their thoughts and wishes freely. They told us "If problems arise I can usually mention them to the staff on duty".People are supported by care staff that understand their needs and offer them the assistance they need to lead active lives. They told us "I am allowed to go shopping". "The staff are really helpful". What has improved since the last inspection? The service has reviewed its Statement of Purpose and Service User Guide both documents are available for people to read. People living here have their own individual copy in the bedroom. Care plans are in the process of being reviewed and do seem to be more person centred in their approach. Work is still continuing with the rehabilitation programme but assessments are clearly underway. Staff told us "Our rehabilitation process have proved a valuable experience for all involved. Residents are encouraged to make personal choices and decisions about their care". People`s financial arrangements have been reviewed and bank accounts have been changed so that people are no longer paying tax on their money. Staffing levels have been reviewed since the last inspection. There is more staff on duty. This needs to happen if the home is to support people with their rehabilitation programmes. We looked at the recruitment procedures within the service. We found that they have improved since our last visit. The home is now taking steps to prevent unsuitable people from working with vulnerable adults. What the care home could do better: CARE HOME ADULTS 18-65 Grangemoor House Nursing Home 110 Cannock Road Burntwood Walsall Staffordshire WS7 0BG Lead Inspector Mandy Beck Key Unannounced Inspection 12th September 2008 09:00 DS0000022328.V371129.R02.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 DS0000022328.V371129.R02.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. DS0000022328.V371129.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grangemoor House Nursing Home Address 110 Cannock Road Burntwood Walsall Staffordshire WS7 0BG 01543 675711 n/a 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) Grangemoor Care Homes Manager post vacant Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (23), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (10) DS0000022328.V371129.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th June 2007 Brief Description of the Service: Grangemoor House is nursing home situated in Burntwood registered to accommodate 23 persons. The service in a residential area of Burntwood with good access to public transport and community facilities. Grangemoor is currently registered to offer a home to people with a mental disorder. The service is able to offer care to people from the age of 18 upwards. Accommodation is provided on two floors. On the ground floor, there is a lounge and smoking lounge, a dining room, kitchen, laundry facilities, five bedrooms, one of which is shared, an open shower and toilet facilities. The first floor has a range of shared and single rooms, a computer room/meeting room and suitable bathing and toilet facilities. The fee range for this home is £440 to £650 per week. People should be aware that items not covered by this fee include hairdressing, holidays and toiletries. People are asked to contact the service directly for further information about fees. A copy of the most recent inspection report is available upon request from the home or by contacting the Commission directly. DS0000022328.V371129.R02.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 that people who use this service experience good quality outcomes. We looked at all the information that we have received, or asked for, since the last key inspection. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • Information we have about how the service has managed any complaints. • What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. • The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. • Relevant information from other organisations. • We also spent time talking to the people who use the service and to the staff who support them. • We looked at the care of three people who use this service in depth. This is part of our case tracking process and helps us makes judgements about the home’s abilities to meet. • Ms Amanda Wells, an expert by experience was present for part of this inspection. An “expert by experience” is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. What the service does well: The service is homely and welcoming “The cleaners make a wonderful job of cleaning the home I have found it quite hygienic”. People living here can feel confident their needs will be assessed in full and their care will be planned with their involvement. One person said “I came to live here I didn’t know what to expect but I found I love the home”. All concerns are addressed promptly and people feel able to voice their thoughts and wishes freely. They told us “If problems arise I can usually mention them to the staff on duty”. DS0000022328.V371129.R02.S.doc Version 5.2 Page 6 People are supported by care staff that understand their needs and offer them the assistance they need to lead active lives. They told us “I am allowed to go shopping”. “The staff are really helpful”. What has improved since the last inspection? What they could do better: We looked at staff recruitment, improvements have been made and appropriate checks against the Protection of Vulnerable Adults list (PoVA) and Criminal Records Bureau (CRB) disclosures are being done. What they need to do now is to make sure that when people begin working there with only a PoVA first check in place the situation must be risk assessed and a copy of the written risk assessment kept in their file. The person is supervised until the return of a satisfactory CRB but the manager should make sure that a person is designated as a supervisor on the duty rota. This is an added safeguard that will provide further protection to the vulnerable people living in this home. The service is welcoming but some areas of the home now look tired and dated and in need of redecoration. Our expert by experience said, “some areas of the home would benefit from the carpets and décor being updated”. People living here said, “this room is dull”. They were referring to the main lounge. The service has told us in the AQAA that they intend to decorate the main lounge within the next twelve months. DS0000022328.V371129.R02.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000022328.V371129.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000022328.V371129.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Each person who chooses to live here can be sure that they will have a full assessment of their needs before they move in. EVIDENCE: We looked at the care records of two people using this service. We saw that both people had been thoroughly assessed before they moved in. Each person had been involved in their assessment process and had been encouraged to spend time with staff and the other people living at the service before they agreed to move in. This helps people to make a choice about living here and also gives the staff the opportunity to understand and make sure they can meet people’s needs. Once the assessment has been completed the information is used to make an individual service user plan. This plan clearly shows how people’s needs are to be met. One person who uses the service said “I came to live here I didn’t know what to expect but I found I love the home”. Another person told us “it is a good home it has done me good”. DS0000022328.V371129.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service can expect to be included in planning their own care and the service will manage risks to people appropriately. EVIDENCE: Since our last visit to the service there have been improvements in the approach to care planning and managing risk for people. We saw that care plans and risk assessments were more person centred in their approach and did give an overall picture of people’s needs. The service has told us in the Annual Quality Assurance Assessment (AQAA) that all people have an “individualised care plan and people are supported to take risks as this forms the basis for the rehabilitation programme”. People we spoke to said they were involved in the planning of their own care and felt that the staff supported them when they needed it. We also spoke to staff who told us “we have found through doing regular reviews we have a better rapport with the residents” and “our residents are encouraged to make personal choices and decisions about their care”. DS0000022328.V371129.R02.S.doc Version 5.2 Page 11 Risk assessments are reviewed regularly and look at managing risks positively so that people can lead an active a life as possible. We saw risk assessments in place for reducing the risk of falls, pressure sore development, road safety and managing finances. DS0000022328.V371129.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to lead active lives. They can also feel confident that staff will support them whilst doing so. Meals are of a good quality and are meeting people’s dietary needs. EVIDENCE: The service is continuing to develop its rehabilitation programme for people. We were told that it is currently in its third stage of development. What this means is that people’s needs are being regularly reviewed and staff are beginning to form a good understanding of what support people need to lead independent lives. We saw that people are encouraged to attend colleges, go to work and attend day centres if they choose to do so. The manager also told us that more work has been done to encourage people to take part in activities outside the home. there are also volunteers who visit the home who spend time with people and DS0000022328.V371129.R02.S.doc Version 5.2 Page 13 take them out when they choose. On the day of this visit we saw people were going out shopping and being supported to do so. We spoke to people about how they felt the home supported them they told us they felt staff understood their needs and helped them with activity. People told us they were particularly fond of the art groups and shopping trips. Other people said that they had the choice about participation in activity but preferred to stay in their room. “The staff pop in regularly throughout the day to make sure that I am ok, so I am not on my own”. We spoke to one person who told us they were not happy with the current choices on the menu. We discussed this with the person and the manager. The manager told us that he had recently sat with all the people living here to discuss the menu’s and people had put their suggestions forward. The service has now planned new menu’s that includes at least one of each person’s favourite food. People agreed that this had happened and that they were looking forward to the new menu’s being put into place. Other people said the home manages their dietary needs well particularly those people who need a specialised diet in one form or another. People can choose where they want to eat their meals, the majority of people choose to have their meals in the privacy of their own rooms. The manager is currently trying to encourage more people to eat in the dining room as he feels this will enhance relationships in the home and give people more of an opportunity to socialise. Staff would also be better able to observe those people who are nutritionally at risk. DS0000022328.V371129.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use this service will be supported in meeting their health and personal care needs. There are also good systems in place to enable people to have their medication as it is prescribed. EVIDENCE: People’s need for personal support is clearly recorded in their ‘service user’ plan. This includes each person’s preferences for the times they wish to get up and go to bed, when they would like to bathe or shower and their preference to the gender of carer they would want to assist them. We looked at one person’s plan and they confirmed that the detail in it was how they wanted their care. We saw that people’s need for equipment had been clearly written into the plan and was evident in people’s bedrooms when we looked. People are supported to attend appointments at hospital or in the local community, for example chiropodist, dentistry or the optician. We saw evidence of other health professionals involved in people’s care such as DS0000022328.V371129.R02.S.doc Version 5.2 Page 15 physiotherapists, occupational therapists and dieticians. Each person has access to their own doctor when they need it. People told us “staff understand my needs both physically and mentally they make sure that I get the help I need”. We had the opportunity to speak to visiting professionals during this visit. They said “it is refreshing to come here and see the staff so positive and wanting the best for the people living here”, “they always let us know promptly if there are any changes in people’s needs”. The service has good clear systems in place for the ordering, administration and storage of medications. Only trained nurses give medication to people. At this time there are no people who look after their own medication. We were told, “I was asked but I feel safer if the nurses do it”. DS0000022328.V371129.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service can feel confident that their views, concerns and complaints will be listened to and acted upon. There are systems in place to protect vulnerable people from harm. EVIDENCE: The service has not received any complaints since our last visit. People who responded to our questionnaires told us, they were aware of who to speak to if they were unhappy about anything and they felt confident about making complaints is they needed. One relative was spoken to briefly during this inspection, they said “it is a wonderful place the staff and the care they give is excellent”. The service includes a copy of the complaints policy and procedure inside the Service User Guide that each person has their own copy of. People are protected from harm whilst living here. Staff have received training in safeguarding vulnerable adults and are clear about what to do if an allegation or incident were made known to them. The service also makes sure that when it is recruiting new staff it carries out the required safety checks against the Protection of Vulnerable Adults list (PoVA) and Criminal Records Bureau disclosure (CRB). These checks will help stop unsuitable people from working with vulnerable adults. DS0000022328.V371129.R02.S.doc Version 5.2 Page 17 The manager has recently completed training in Non violent crisis interventions. He now plans to provide training for all staff in this area so that they will be more aware of the strategies available to them when diffusing difficult situations. There are no other methods of restraint in use at the home at this time. DS0000022328.V371129.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a homely environment that they are encouraged to make their own. Some areas of the home would benefit from redecoration. EVIDENCE: We were shown around the home by one of the people who live there. We found that it is clean and tidy and reflects the individual preferences of the people who live here. We saw the bedrooms were of a good size and were furnished in a homely way. Many of the people living here had personalised their rooms. Subject to their risk assessments, people are able to have a kettle in their rooms for making drinks. People have to purchase their own TVs, additional furniture etc. but are assisted in the practicalities of this. Some people have their own computers in their rooms, and there is also a computer provided by the home. DS0000022328.V371129.R02.S.doc Version 5.2 Page 19 The bathrooms, dining room and communal lounges (one smoking, one nonsmoking) were clean and pleasant, although the non-smoking lounge did have a slight unpleasant odour. Some areas of the home would benefit from the carpets and décor being updated. The service has told us in the AQAA of their plans to update the communal lounge in the next twelve months. People seem to spend most of their time in their rooms, but frequently pop in and out of each other’s rooms to socialise. There is a well-equipped laundry room; some people do their own laundry, others prefer to have the staff do it. There is a large and attractive garden to the rear of the home. Access to it is open and people should be aware that it does not afford people a lot of privacy when using it as a result. DS0000022328.V371129.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are recruited safely and trained to perform their duties support the people using this service. There is sufficient staff on duty to meet people’s needs at this time but this will need to be kept under review. EVIDENCE: Since our last visit the service has increased the number of staff it has on duty. This has been done so the people’s need to access more activity in their lives can be accommodated. Staff told us “it has been better, we have more time to sit with people and find out what they really want”. All of the staff are currently working towards further education. Some staff have already completed their National Vocational Qualifications (NVQ’s) other’s are waiting to be enrolled. All new staff are put through an induction that meets the Skills for Care induction standards. Staff told us they felt “supported” by the service and said that there are training events. The service is also waiting access to free training from the local authority so that staff can update their skills. DS0000022328.V371129.R02.S.doc Version 5.2 Page 21 We looked at the recruitment processes in the home and found that they were in good order. We saw the staff files of four people who had been recently employed. In each file was the information required and also evidence of safety checks such as the PoVAfirst and CRB disclosure. The service also makes sure that it gets two written references for all potential new workers. These safeguards will help protect the people living in the home by not employing unsuitable workers. We have recommended the service complete a risk assessment for those new staff that begins working at the home with only a PoVAfirst check in place until a satisfactory CRB has been obtained. This risk assessment should be kept in individual staff files. New workers will also need someone experienced to act as their supervisor during this period. The person acting as the supervisor should be clearly identified on the staff rota. DS0000022328.V371129.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is run in the best interests of the people who live there. EVIDENCE: Since our last visit the service has experienced a change in management. The new manager has been in post since April 2008 and is beginning to make positive changes in the home. He is currently progressing through the registration process with the commission. He has told us that he has many years experience of management within a care setting and understands the needs of the people who live in the home. People using the service told us “I think he is coping well”, “I can go to the office and talk to him anytime”. Staff said “we feel that we are supported, changes are happening but it’s for the best for the residents”. Relatives added, “this is the best home for my son, I DS0000022328.V371129.R02.S.doc Version 5.2 Page 23 never have a complaint about it, they deserve all the praise they get, they do an excellent job”. The Providers have developed a formal approach to monitoring quality across a wide range of activities. This includes a care plan review process that is recorded at least once a month, a staff training programme, and a quality development programme, including the setting of objectives, and target dates to aim for. The home has an open door policy and a commitment to equal opportunities. In addition to this there are regular meeting with people who live at the home to determine what it is they like about the home and what they don’t. The health and safety of people using this service is promoted by safe working practices, training and maintenance of the building. We saw that staff have access to regular mandatory training this included fire safety, first aid, infection control and moving and handling. We spot checked some safety certificates such as the Gas Landlords, five year fixed electrical wiring certificate and the fire records. All were up to date. DS0000022328.V371129.R02.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 X 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 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X DS0000022328.V371129.R02.S.doc Version 5.2 Page 25 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. 1 2 Refer to Standard YA20 YA34 Good Practice Recommendations The temperature of the medication treatment room should be recorded daily. This will ensure that medication is being stored below the recommended 25oC. The service should make sure that a risk assessment has taken place and is recorded in the file of the person who starts work with only a PoVAfirst check in place DS0000022328.V371129.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 DS0000022328.V371129.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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