Care Home: Meads House Residential Care Home

What the care home does well The residents are treated as individuals, this is evident from the care plans, which are individual to each residents. The deputy manager looks at ways in which further development of individuality for each resident can be achieved. There is good provision of activities in the home with further developments being made. Residents have access to the local community, with assistance from the care staff. Meals in the home offer a choice and are nutritious and balanced, and specialised diets can be catered for as and when requested. The complaints procedure is well managed with good records being kept, of the complaint and the outcomes. A good percentage of staff have achieved their National Vocational Qualification. Residents said, "I like living in this home." "I like the food in here." "The staff are very kind to me." What has improved since the last inspection? Some recruitment practices have improved and all staff have a current Criminal Records Bureau check and health declaration. From observation the staff practice safe moving and handling techniques. What the care home could do better: The registered person must ensure that all visits from external professionals are recorded in the care plan or daily review for each resident. The registered provider must ensure that medication that needs to be kept chilled is stored inan appropriate medication refrigerator. If this medication is not stored at the correct temperature it may break down or `go off`. From observation on the day of this key inspection not all staff respect the privacy and dignity of the residents when personal hygiene is being carried out. There is one bedroom in the home where it was noted that a bedside table was broken and this needs to be replaced. There are some issues in the home relating to infection control, and staff must be provided with liquid soap and paper hand towels in the laundry, and also in some of the communal toilets. The washing machine needs to be replaced with an industrial washing machine that provides a sluicing facility. Two rooms in the home have an offensive odour and the registered person must ensure that the home is kept free from offensive odours at all times. Not all staff have received mandatory training in health and safety issues or dementia care training, although this is a dementia care registered home. CARE HOMES FOR OLDER PEOPLE Meads House Residential Care Home 26 Denton Road Eastbourne East Sussex BN20 7ST Lead Inspector June Davies Key Unannounced Inspection 5th February 2008 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 Meads House Residential Care Home DS0000065559.V357925.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. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meads House Residential Care Home Address 26 Denton Road Eastbourne East Sussex BN20 7ST 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) 01323 732632 homelea96@hotmail.uk Nifinara Limited Prital Moskal Care Home 17 Category(ies) of Dementia - over 65 years of age (17) registration, with number of places Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is seventeen (17). Service users accommodated must be older people aged sixty-five (65) years or over on admission. One named service user to be accommodated who has a mental disorder. One named service user to be accommodated who is aged under sixty-five (65) years 28th September 2006 Date of last inspection Brief Description of the Service: Meads House is a large three-storey detached property in the Meads area of Eastbourne. It is registered to provide care and accommodation for up to seventeen older people. There are sixteen single rooms all of which have ensuite facilities, with the exception of one room, which has a toilet and wash hand basin nearby. The home has two communal bathrooms of which both have bathing hoists and there is also a shower. The ground floor has a large lounge/dining area. A stair lift facilitates access to all floors. All parts of the grounds and gardens are accessible by the provision of ramps. Call bells are available in all accessible areas and handrails provided where required. Local shops and the seafront are easily accessible to service users and although the home is situated in a quiet residential road, Eastbourne town centre is only a short drive away. The home has an attractive, well-maintained garden to the rear of the building and parking to the front. Nursing care is not provided. Following the pre-admission care assessment the service provides prospective service users with a copy of the Statement of Purpose, the service users guide, and a contract prior to them moving into the home. The range of fees charged as from 1 April 2008 is from £410.72 to £550.00, which includes inhouse activities, basic toiletries and some outings. Additional charges are made for hairdressing, chiropody, newspapers and dry cleaning. Intermediate care is not provided. Currently the home does not have a website. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 09:45 and was in the Service for seven hours. It was a thorou8gh look at how well the Service is doing. It took into account detailed information provided by the Service’s owner and manager and any information that CSCI has received about the Service since the last inspection. There are four Required Developments at the end of this Report. What the service does well: What has improved since the last inspection? What they could do better: The registered person must ensure that all visits from external professionals are recorded in the care plan or daily review for each resident. The registered provider must ensure that medication that needs to be kept chilled is stored in Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 6 an appropriate medication refrigerator. If this medication is not stored at the correct temperature it may break down or ‘go off’. From observation on the day of this key inspection not all staff respect the privacy and dignity of the residents when personal hygiene is being carried out. There is one bedroom in the home where it was noted that a bedside table was broken and this needs to be replaced. There are some issues in the home relating to infection control, and staff must be provided with liquid soap and paper hand towels in the laundry, and also in some of the communal toilets. The washing machine needs to be replaced with an industrial washing machine that provides a sluicing facility. Two rooms in the home have an offensive odour and the registered person must ensure that the home is kept free from offensive odours at all times. Not all staff have received mandatory training in health and safety issues or dementia care training, although this is a dementia care registered 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. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 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 Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 & 6 People who use this service experience good quality outcomes in this area. People move into the home knowing that their needs can be met and that their independence will be maximised and promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three pre-admission assessments were viewed and found to contain detailed information relating to prospective residents. There was sufficient information for the home to be able to assess if it could meet the needs of the prospective residents and form the basis of a care plan. The home does not offer intermediate care. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 9 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): Standards 7, 8, 9 and 10 People who use this service experience good quality outcomes in this area. There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet the residents’ needs. The medication in the home is generally good, but the correct provision must be made for refrigerated medication. Personal care needs to improve to ensure that residents’ privacy and dignity is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the four care plans viewed; there was good evidence that each care plan is individual to each resident and was based on information gathered at preadmission assessment. Care plans contained risk assessments with clear Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 10 guidelines for staff to follow to ensure that the identified risk is reduced. The daily evaluation sheets showed good follow through regarding health care needs. It was noted however that not all visits to or from health care professionals such as the chiropodist and optician has been recorded. There were good records kept of visits from residents’ doctors, and district nurses. Individual health care needs are well met, and where the registered manager requires a more specialised service referral is made via the resident’s own doctor. Where necessary the continence nurse is requested to carry out an assessment. There is evidence that all residents have a nutrition assessment carried out each month. All care plans are reviewed on a monthly basis. The deputy takes responsibility for the ordering, receipt, storage and administration of medication. Medication is well managed with good audit trials of medication being received into the home, including mid cycle medication. All MAR sheets were correctly initialled when medication is administered. Good medication policies and procedures are in place. Only staff that have received medication training are allowed to administer medication and there is a list of trained staff with their initials. The refrigerator used for storing chilled medication needs to be replaced with a proper medication refrigerator that keeps a temperature of between 2°C and 8°C. On the day of the inspection it was noted that not all staff on duty were respecting the privacy and dignity of the residents, and that any person in the building would have been able to overhear discussion regarding personal hygiene tasks. It was noted however that staff do keep toilet doors shut when in use. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 11 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): Standards 12, 13, 14 and 15 People who use this service experience good quality outcomes in this area. Improvements are being made to the activities programme to ensure that all residents receive one to one time to pursue their individual interests. Residents are able to maintain links with the community with assistance from care staff. The meals in this home are good offering both choice and variety and catering for specialised diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does have an activities programme but the deputy manager is in the process of updating this to introduce more one to one specific activities for the residents. Due to the differing dementia care needs in the home, the residents do not always want to take part in group activities, and therefore one to one activities covering the interests of the resident would be more appropriate. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 12 Outing to the seafront and local tearooms are provided, in addition to shopping trips and accompanied walks. Sometimes when a resident has a healthcare appointment they will also visit a café, to make it more of a social occasion for them. Visitors are welcome in the home at any time and residents can choose if they wish to entertain in the communal lounge or their own bedroom. Due to the residents dementia levels none are able to manage their own finances and relatives have arranged an enduring power of attorney. From a tour of the home the inspector noted that residents are able to personalise their own bedrooms with items brought in from their homes. A four-week rotating menu with a varied and balanced diet is offered to the residents. One resident said, ‘I like the food in the home, it is very good.’ Residents’ likes and dislikes are recorded in their individual care plans and cooks also have a list of these. One resident needs to have a soft diet due to some recent dentistry work and this is also appropriately recorded. A daily record is kept of all food eaten by each resident in the home. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 13 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): Standards 16 and 18. People who use this service experience good quality outcomes in this area. The home has a satisfactory complaints system, with evidence that the deputy manager makes herself available to listen to the residents. Some staff have knowledge of adult protection issues, which helps to protect the residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has ensured that the complaint policy and procedure is kept up to date, and this is displayed in the front foyer of the home. There has been one complaint since the last inspection, and the complaints files showed that this has been investigated and the complainant has been appropriately informed of the outcomes within the timescale set out in the policy and procedure. The residents spoken to do not have much understanding of how they would complain, but from observation on the day of this inspection, it was evident they would feel comfortable speaking with the deputy manager if they were not happy. The home has up to date policies and procedures for safeguarding vulnerable adults. There have been no adult protection incidents in the home since the Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 14 last inspection. From the training certificates and the training matrix the inspector found the 46 of the staff have received protection of vulnerable adults training, and more training is planned for this year. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 People who use this service experience good quality outcomes in this area. The standard of the environment in the home is generally good providing residents with an attractive and homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises showed that generally the home is well maintained. Two rooms in the home had an offensive odour. The carpet is due to be replaced in the communal lounge and the registered manager is aware of an odour in one of the bedrooms. Through discussion with the inspector she is considering with permission from the residents and or their families to replace the carpet with non-slip vinyl flooring to ensure that odours are eliminated. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 16 One bedroom had some broken furniture, and the deputy manager agreed that this needed to be replaced. The rear garden of the home is large, well tended and secure. There is a concrete ramp from a patio area down onto a lawn area. Some attention needs to be paid to infection control issues in the home, especially to ensure that liquid soap is available where staff may need to wash their hands. Where it is impracticable to have a bottle of liquid soap this should be provided via wall dispensers. The laundry room is situated at the side rear of the building away from the kitchen area. The washing machine in the laundry room should be replaced at some point with an industrial washing machine that has a sluicing and disinfecting facility. The home has a contract with a clinical waste disposal firm. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. People who use this service experience good quality outcomes in this area. Staff are employed in sufficient numbers to meet the needs of the people using the service. Recruitment practices can be improved upon to ensure that people using the service are not placed at risk. Staff training needs to improve to ensure that staff have the knowledge and skills to meet the assessed needs of people using the service. The arrangements for the induction of staff are good with staff undergoing orientation and ‘Skills for Care’ induction. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are three care staff on duty during the two, day shifts and one sleeping in night carer. Ancillary staff are employed in sufficient numbers to ensure that the home is kept clean and sufficient cooks are employed. The registered manager must ensure that night staffing is reviewed at regular periods so that the needs of the residents are always met. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 18 The registered manager and deputy manager encourage staff to undertake NVQ training, and at the present time 53 of staff have this qualification. The inspector viewed four staff files these show that the application form needs to be reviewed so that a full employment history can be obtained from each applicant, and any gaps in employment can be investigated. The registered manager ensure that all potential staff have a POVA first check and CRB check prior to being deployed in the home. The inspector did note that two files did not contain two references. Through discussion with the registered manager she explained that these two members of staff are also deployed from time to time in the sister home, and that their references would be available there, therefore the manager needs to ensure that a copy of these references are kept on the Meads House file as well so that they are available for inspection. The staff, training matrix showed that 46 of staff have received POVA training, 26 have medication training, 13 have Dementia care training, and 13 have skin care training. Further training has been booked for February and March 2008. Staff receive orientation and ‘Skills for Care’ induction training, and this was evidenced via the staff personnel files. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 People who use this service experience good quality outcomes in this area. The manager has a good understanding of the areas in which the home needs to improve. Planning is in place and sets out how this will be managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is experienced in the care industry and has satisfactory management qualifications and had completed all modules of her NVQ level four. The registered manager is at the present time working parttime and the home is mainly being managed by the deputy manager who is in Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 20 the process of completing her NVQ level 4 and Registered Managers Award with a view to being the registered manager in the future. The deputy has worked hard in implementing improvements in the home to ensure that residents receive individual care according to their assessed needs. Staff working in the home are happy and found the registered provider, registered manager and deputy manager were approachable. The home does have a quality assurance system, and through conversation with the registered manager, she acknowledge that improvements do need to be made to ensure that systems used in the home are monitored on a monthly basis. There was evidence that the views of relatives, doctors, district nurses and care managers are sought and published into a report on an annual basis. The registered manager plans to seek views from other professionals to come into the home or have contact with the residents. There is a six monthly health and safety and fire risk assessment both internally and externally of the home. The registered manager and the deputy manager do not deal with the personal allowances for residents. Expenditure is made from petty cash on the resident’s behalf and relatives are then invoiced for the expenditure, with a copy of the receipt accompanying the invoice. All staff have regular supervision. Supervision files are available for inspection and the deputy manager has an up to date list of staff who are due for supervision. As mentioned previously under staff training in this report not all staff have received mandatory training related to health and safety issues, therefore a requirement has been made. Current maintenance certificates are available for all appliances used in the home. The fire call system is checked weekly as are the temperatures of hot water outlets. All windows have opening restrictors fitted all hot taps have temperature control valves. The registered manager is aware that some health and safety policies and procedures need to be reviewed. The Health and Safety Executive Accident book is appropriately filled in when an accident occurs, and pages are filed in accordance with the Data Protection Act 1998. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 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 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP9 Regulation 13 Requirement The registered provider must ensure that a proper medication refrigerator is purchased for medication that needs to be stored between 2°C and 8°C. The registered provider must ensure that at all times the staff respect the privacy and dignity of the residents. The registered provider must ensure the home is kept free of offensive odours throughout. The registered provider must ensure that all staff have the relevant training in mandatory training which must included health and safety issues and work related training to meet the needs of the residents. Timescale for action 24/03/08 2. OP10 12(4)(a) 24/03/08 3. 4. OP26 OP30 16 (2)(k) 18 (1)(a) 28/04/08 28/04/08 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 Good Practice Recommendations DS0000065559.V357925.R01.S.doc Version 5.2 Page 23 Meads House Residential Care Home 1. 2. 3. 4. Standard OP8 OP19 OP26 OP26 Visits from all external health care professionals and the hairdresser should be entered in the plan of care or onto the daily evaluation sheet. The registered provider must ensure that furniture is kept in a good state of repair. The domestic style washing machine should be replaced with an industrial washing machine that offers a sluicing facility. The registered provider must ensure that liquid soap and paper hand towels are supplied in all communal toilets and the laundry room so that staff may wash their hands. Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Meads House Residential Care Home DS0000065559.V357925.R01.S.doc Version 5.2 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. 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