Inspection on 01/06/07 for The Shires Care Centre

This inspection was carried out on 1st June 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Shires Care Centre 02/06/06

The Shires Care Centre 04/10/05

The Shires Care Centre 25/04/05

The Shires Care Centre 07/06/04

The Shires Care Centre 05/06/03

The Shires Care Centre 26/09/02

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

CARE HOME ADULTS 18-65 The Shires Care Centre The Oval Sutton In Ashfield Nottinghamshire NG17 2FP Lead Inspector Jayne Hilton Unannounced Inspection 1st June 2007 02:00 The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Shires Care Centre Address The Oval Sutton In Ashfield Nottinghamshire NG17 2FP 01623 551099 01623 550788 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr S A Zaman Lindsay Pargin Care Home 42 Category(ies) of Physical disability (42) registration, with number of places The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users shall be within category PD Date of last inspection 20th December 2006 Brief Description of the Service: The Shires is a care home providing accommodation, personal and nursing care for 42 service users aged 18-65 with physical and associated learning disabilities. The home provides both long term and planned respite care and is owned by Mr Zaman who also owns a number of other homes. The home is located in the centre of a residential estate in Sutton in Ashfield with access to local shops and facilities. The home opened in 1996 and is a two- storey purpose built building; all parts are accessible for wheelchair users. Staff actively encourages participation, independence and inclusion within the local community. All rooms are single with en suite facilities, there is a passenger lift to the upper floor and the home has a mini bus to facilitate access to the local community. Information given in May 2007 by the manager, states that fees range currently between £464 and upwards based on individual dependency levels. Additional charges include newspapers, magazines, some taxis and hairdressing. A copy of the last inspection report was displayed in the home. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection took place over 5 daytime hours. The main method of inspection used was called ‘case tracking.’ This involves selecting three service users and looking at the quality of the care they receive by talking to them, examining their care files and discussing how support is offered to them by staff members. Four members of staff and the manager were spoken with as part of this inspection, documents were read and medication inspected to form an opinion about the quality of the care provided to residents. Prior to the inspection twenty-seven survey questionnaires were returned by, service users and relatives and three were returned later but before the inspection report was finalised. Also the provider prior to the inspection completed an information questionnaire. Information gathered from all of these sources has been included within the report. A random inspection was made to the service on 20th December 2007. Copies of the Inspection report can be obtained by request in writing to the Commission for Social Care Inspection What the service does well: The home is well managed and run in the best interests of service users and their health and safety is promoted and protected. Information is available about the home and service users have their own individual copy of this. Their needs are fully assessed and service users confirmed they have comprehensive care plans in place and said they could make decisions about life in the home, are fully consulted, enabled to take risks and listened to. This ensures their individual needs are met. A wide range of activities is catered for and service users are part of the local community and can engage in appropriate leisure activities. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 6 Service users are offered a healthy diet and enjoy their meals. They can engage in relationships as they choose and equality and diversity is promoted within the home. Service users said that they were happy with the support provided and that their healthcare needs were met. Service users live in a comfortable clean and homely environment with personalised and suitable bedrooms. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Shires Care Centre DS0000024660.V337830.R01.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 The Shires Care Centre DS0000024660.V337830.R01.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): 1, 2, 5, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available about the home and service users have their own individual copy of this. Service users have their needs assessed and are provided written confirmation that the home can meet their individual needs. EVIDENCE: A statement of purpose and service user guide was displayed in the main reception. Service users said they have their own copy and confirmed that the Service User Guide had been discussed in the quality circle meeting The Service Users Guide contained terms and conditions for living at the home and that contracts are agreed with placing authorities. The registered person provides service users with confirmation in writing that the home can meet the individual and specific needs prior to them moving in to the home. The care plan folders examined contained an assessment, which was based on Activities of Living and the National Minimum Standard 2.3 a record of the preassessment/visit supports this document and equality and diversity is well promoted. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 10 Information provided in the returned service users and relative’s surveys confirm they have information about the home. Comments included the following “They tried to put us at ease when we first visited and stayed, they are outstanding”. “The management very helpful, Shires is improving all the time all staff and care workers are very patient and polite” “If we have any problems, they will always be there for you and will in to help in any way they can” “They look after people in a warm and friendly environment” The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 11 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have comprehensive care plans in place and they make decisions about life in the home, are fully consulted, enabled to take risks and listened to. This ensures their individual needs are met. EVIDENCE: Three service users care was audited and their care plan folders were examined, the quality of the information contained within the three folders were noted, to be, much improved since the previous key inspection. Service users spoken with were happy with the care and that staff contacted GP’s promptly if they needed attention and that their healthcare needs were met. Service users were able to inform the inspector of their key worker and said they were involved in their care planning. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 12 Service users or their representatives sign their care plans but their signature is placed on the biographical data and it is not clear what the service user is actually signing for, therefore it is recommended that a short sentence be added to ensure service users are clear that they are signing to agree their actual plan of care. Some service users were able to confirm that they lived their daily lives as they chose within reasonable limitations of their conditions and individual needs and risks. Risk taking and independence is promoted. Service users reported that they have choices and make decisions about most aspects of their lives such as getting up and going to bed, what food from the menu offered. Service users reported that staff, were respectful and polite and confirmed that call alarms were answered promptly and that they were not left unattended when needing care/assistance. Surveys received confirm diversity, choices and decisions are promoted. Comments include the following: “They give excellent one to one care cant see anything to improve” “My relative didn’t like being bathed by male carers, she told them and they sorted it. Staff, are flexible friendly and considerate at all times. They make her feel at home and make her laugh whilst looking after her incredibly well” The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 13 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 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A wide range of activities is catered for and service users are part of the local community and can engage in appropriate leisure activities. Service users are offered a healthy diet and enjoy their meals. Service users can engage in relationships as they choose and equality and diversity is promoted within the home. EVIDENCE: The home employs two activities coordinators to work with service users and a varied plan of activities is arranged during service users meetings. Activities take place in groups and on an individual basis according to the level of service users needs and preferences. Several service users attend the day centre and college and undertake studies of their choice. One service user also has a job within the community. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 14 Staff facilitates service users to access these services and gain employment if required. Records were seen of activities and participation. The records do not however show where opportunities are offered and refused or that every service user is supported with their leisure or recreational time and this is recommended. Particular attention should be made where service users remain in their rooms. There are no restrictions on visiting and service users may choose who they wish to see. If desired relatives are involved in service users meetings and their plan of care. Visitors can be received in private should it be desired and personal relationships are dealt with accordingly. Equality and Diversity is well promoted and staff have not had formal training in this area. A varied menu is on offer and service users are given choice at each meal, service users spoken with were able to substantiate this and stated food was plentiful and at a good standard. Special diets are catered for. Food and drink is provided at intervals throughout the day and services users also have access to drink making facilities should they choose to use them. Comments include. “I don’t know anything the home could improve on, even the cleaners help, two of them make sure my daughters mobile is kept charged and given to her so we can keep in touch every day” “My relative is always very clean an tidy when I visit and I know the meals served are good they always looks well looked after” The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 15 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the support provided in a way they prefer and require. Service users have the equipment they need and outside professional input as required to meet their individual healthcare needs. Medication management and practices in place are safe for service users. EVIDENCE: Service users said were happy with the support provided and the improved documentation within the care plans supported this. All service user’s spoken with said they felt listened to and self- advocacy information was clearly posted in the home and is used by some individuals. Improvement has been made to the care plans and healthcare records. Care plans demonstrated that service users had the equipment they need and outside professional input to meet their needs. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 16 Risk assessments are in place for the use of bedrails but these need expanding on to ensure that all people involved are consulted about the risks and agree to their use on that knowledge. Staff appeared to have a good knowledge about the needs of service users and confirmed they are involved in care plans where they wished to be. Weight records were not always consistent and it is recommended that these be monitored regularly as part of the healthcare package. Service users confirmed that their privacy and dignity is respected and observations on the day demonstrated that staff was attentive and respectful. Service users had keys to their bedroom doors and to their lockable facilities. Medicines management was assessed and overall this appeared to be well managed. It is recommended that the manager look into comments made by service users about some inconsistency of practice of agency staff and care plan information re dressings and times of medication administration to ensure both are consistent to meet with the wishes and needs of the service user at all times. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 17 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users views are listened to and they feel safe in the home. Policies and training are in place to protect service users from abuse, neglect and selfharm. EVIDENCE: Complaints procedures are displayed in the home, are in large print and at wheelchair height. Service users confirmed that this information was also in their service user guide and said they were confident that complaints would be dealt with appropriately. Service users have also posted their own version on their notice board. Eight complaints were documented within the complaints records since the last key inspection. These were mainly about lack of information/communication provided for relatives on accidental injuries when service users return to their family home, some personal care issues and individual service user issues. All were noted to have been addressed appropriately. Service users expressed that they felt safe. The manager is aware of the correct protocols for referral of safeguarding adult’s issues if they should arise and has used these and most staff, have The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 18 attended training in adult protection. Further training for staff is planned for later in the year. The security of the building was discussed with the manager and although panic alarms are fitted the inspector felt that further security measures should be explored to ensure service users are fully protected. The system in place for managing service users finances has been improved and records and protocols viewed. There is scope for further improvement in respect of staff having clearer guidance in respect of offences considered under ‘The Finance and Markets Act.’ Numbering of receipts and ensuring that where receipts cannot be obtained that the manager countersigns the transaction would also improve the system. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable clean and homely environment with personalised and suitable bedrooms. EVIDENCE: The home is spacious and homely. Acceptable wear and tear of doorways and carpets was evident but not assessed as excessive or unsafe. The Shires appeared homely and decorated, furnished and maintained to an acceptable standard. There is a planned redecoration programme and maintenance is well managed. Individual thermostats can control heating and radiators were covered or low surface types. Windows were fitted with safety restrictors. Bedrooms were well personalised. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 20 Provision of a shelter from adverse weather should be considered for service users who smoke. The home appeared clean and good infection control practices observed. Staff wear protective clothing and policies are in place for minimising cross infection. Attention is needed for storing of mops and buckets, toiletries and to ensure toilet rolls are replenished promptly. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 21 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): 32,33,34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by sufficient staff that is competent and qualified, appropriately trained and supervised. Recruitment practices need to be improved to ensure service users are fully protected. EVIDENCE: The staffing numbers provided meet service users needs. Information deemed from the manager and staff confirmed that an induction to skills for care standards is undertaken and that staff are paid to attend training. Copies of ‘The General Social Care Council’s Code of Conduct’ were also confirmed as issued. There was evidence of formal supervision and the manager is working to achieve six sessions a year for individual staff. Training records and staff confirmation provided evidence of appropriate training for staff. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 22 Four members of staff personal files were examined and all were satisfactory in relation to recruitment standards apart from one. There appeared to have been some confusion over the guidance for staff that are also employed by another provider and employed at the home in relation to Criminal Records Disclosure and Protection Of Vulnerable Adults checks. The Provider had made an application for a new Criminal Records Disclosure [CRB] for the staff member but had allowed the staff member to commence work on the basis of the existing CRB being in place. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 23 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of service users. Service users health and safety is promoted and protected. EVIDENCE: The manager was registered early in 2006 and has been undertaking changes to improve some previously not so good practices in record keeping and care administration. She is a qualified nurse and holds the Registered Managers qualification. She states she is committed to ensuring equality and diversity is promoted within an overall quality service to clients. Staff spoken with confirmed confidence in the managers abilities to run the home and that teamwork was good. They also remarked that improvements The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 24 had been made such as rotas and the skill mix of staff on duty at one time etc, which will improve outcomes for those who reside at the home. Quality monitoring systems are in place including audits and regular visits from the provider. [Reports were not available for all visits and this needs to be improved] Service user surveys are carried out periodically; evidence was seen of completed questionnaires and action taken from feedback. Service users have regular meetings facilitated and also run quality circle meetings. Not all service users are able to attend and therefore all service users should be provided with opportunities to put forward agenda items and have assistance with reading minutes of all meetings. There were no health and safety issues noted from the inspection. Policies and procedures are in place to ensure service users are protected from harm. The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 25 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 3 2 3 3 X 4 X 5 4 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 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 3 X 3 X X 3 X The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 26 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA34 Regulation 19 Requirement Ensure receipt of a new Criminal disclosure check [CRB] with Protection of Vulnerable Adults List check [POVA] for all newly recruited staff prior to their employment with the company. CRB’s are not transferable between employers even if the person is still employed by the other employer and the check had been recently undertaken. This will ensure recruitment procedures are robust and service users fully protected. Timescale for action 01/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations Include a sentence statement to the care plan documentation to inform service users/and or their representatives that they are signing they agree to the DS0000024660.V337830.R01.S.doc Version 5.2 Page 27 The Shires Care Centre plan of care contained. 2 YA12 Record where service users are offered opportunities to participate in leisure/recreational activities and refuse and ensure all service users have some time allocated for support for recreation. Ensure risk assessments for bedrails fully inform the user or their representative of the risks and obtain a signature for authorisation/agreement to their use. Ensure service users weights are monitored in a consistent way as part of their healthcare needs. The manager has been requested to look into comments made by service users in relation to inconsistent practice of agency staff and care plan instructions. Review the security arrangements in the home Further develop/improve the systems in place for managing service users finances as discussed. Provision of a shelter from adverse weather should be considered for service users who smoke. The provider should ensure consistency in producing reports for his visits to the home as required by regulation. 3 4 5 6. 7 8 9 YA19 YA19 YA20 YA23 YA23 YA24 YA33 The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 The Shires Care Centre DS0000024660.V337830.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!