Inspection on 15/02/07 for 98 to 100 Gloucester Avenue

This inspection was carried out on 15th February 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

98 to 100 Gloucester Avenue 01/02/06

98 to 100 Gloucester Avenue 01/07/05

98 to 100 Gloucester Avenue 07/10/04

98 to 100 Gloucester Avenue 28/04/04

98 to 100 Gloucester Avenue 18/02/03

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 98/100 Gloucester Avenue Hyndburn Respite Facility 98/100 Gloucester Avenue Accrington Lancashire BB5 4BG Lead Inspector Mrs Lynn Mitton Unannounced Inspection 15th February 2007 09:30 98/100 Gloucester Avenue DS0000040870.V323360.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 98/100 Gloucester Avenue DS0000040870.V323360.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. 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 98/100 Gloucester Avenue Address Hyndburn Respite Facility 98/100 Gloucester Avenue Accrington Lancashire BB5 4BG 01772 563002 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) Lancashire County Council Mrs Rebecca Toman Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Rebecca Toman is registered as manager of Gloucester Avenue (respite facility) only The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 1st February 2006 Date of last inspection Brief Description of the Service: Gloucester Avenue provides personal and social care for up to 5 adults with a learning disability and additional support needs aged over 18 years. This facility offers respite/short term care only. The establishment belongs to Lancashire County Council. The home is two semi-detached houses, located approximately one mile from the centre of Accrington. The home offers single bedrooms, and has a large lounge/dining room. Two of the bedrooms and one bathroom are on the ground floor for service users with mobility difficulties. The home is maintained to a good standard throughout. The care staff team aim to offer a homely environment. Service users are either private or Local Authority funded. Fees for the cost of a visit to this home is £9.24 per night (£64.65 per week). There was some information available to potential service users advising them about the home and information about the type of service they could expect. 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced, and took place over two days. A tour of the premises took place. The registered manager and care staff on duty were spoken to, and interaction between staff and service user observed. Throughout the report there are various references to the “tracking process”, this is a method whereby the inspector focused on a small representative group of staff member and service users. Records pertaining to these people were inspected. Policies and practices were also looked at. Prior to the inspection, the registered manager completed a pre inspection questionnaire. Questionnaires were forwarded to service users relatives and two were returned. The inspector conducted the inspection with the staff on duty and the registered manager. During the inspection a number of records, policies and procedures were also viewed. Two service users were case tracked, their files examined in detail. What the service does well: One service users relative wrote; “My husband and I are very happy and content with the way our son is looked after at Gloucester Avenue. The staff are always ready to answer any questions we may have, and are very friendly and helpful. Our son’s needs are always their first priority, so we can enjoy our own time, knowing that our son is looked after with care”. The admission procedure for new service users ensured that all information about their care needs was obtained before they arrived for a stay. This enabled staff to have a clear understanding of what they needed to do for them. The responsibilities of both parties were made clear in the terms and conditions of stay contract. The care needs of service users were clearly identified and well documented. Regular reviews of care plans and risk assessments ensured that any changes were regularly documented and that any action needed was taken. Service users were enabled to make day-to-day decisions about their lives, and risk assessments and management framework supported service users to take responsible risks. The home was run to make sure that service users had opportunities to enjoy their stay and to fulfil their potential. 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 6 Service users were able to make day-to-day decisions about their lives. Individual dietary needs were catered for. Personal support was offered to service users in a way that promoted empowerment, choice, dignity, respect and autonomy. Service users health needs were well documented and being met. Good practice was in place with regards to the administration, safekeeping, storage and disposal of service users medication. There were clear complaints and protection policies and practices in place. Staff spoken to had a good understanding of adult protection issues and how to deal with complaints made by service users. The standard of décor and furnishings provided a comfortable and homely environment for service users. The standard of cleanliness and hygiene in the home was good. 50 of care staff had obtained their NVQ3 training to enable them to better meet the needs of service users. Staff spoken to and observed by the inspector demonstrated a good understanding of the needs of the service users. Training had been undertaken to ensure that care staff had the skills to care for the residents. The home was run to ensure the safety and welfare of service users and staff. General good practice was in place with regard to the safety and welfare of the staff and service users. What has improved since the last inspection? What they could do better: Not all staff have completed POVA training, this was due to be undertaken in March 2007. The registered manager must complete management training. The registered person and the Commission were not being kept informed about the home. 98/100 Gloucester Avenue DS0000040870.V323360.R01.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. 98/100 Gloucester Avenue DS0000040870.V323360.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 98/100 Gloucester Avenue DS0000040870.V323360.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): YA2 & YA4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure for new service users ensured that all information about their care needs was obtained before they arrived for a stay. This enabled staff to have a clear understanding of what they needed to do for them. The responsibilities of both parties were made clear in the terms and conditions of stay contract. EVIDENCE: During the inspection, a prospective new service user, and his family arrived for a introductory visit. After being shown round the home and chatting about the prospective service users needs, two tea visits were arranged. New service users wishing to stay at Gloucester Avenue would have an assessment completed prior to their admission. The inspector saw completed assessments on the service users files case tracked. Contracts explaining the terms and conditions of service users stay at Gloucester Avenue. The inspector saw completed contracts on both service 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 10 users files case tracked, however, they were out of date, and did not contain the most up to date costings. 98/100 Gloucester Avenue DS0000040870.V323360.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): YA6, YA7 & YA9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care needs of service users were clearly identified and well documented. Regular reviews of care plans and risk assessments ensured that any changes were regularly documented and that any action needed was taken. Service users were enabled to make day-to-day decisions about their lives, and risk assessments and management framework supported service users to take responsible risks. EVIDENCE: Service users case tracked had a comprehensive care plan in place that included a plan of action of how to address service users specific needs. Two care plans were examined in detail during the inspection. It gave a good account of each person’s specific support needs and how these should be met 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 12 by the care staff team. They also contained a personal profile, lifestyle information, and individual behaviour records. Daily records seen gave a good account of events and activities undertaken during the time spent at Gloucester Avenue. Whenever possible, service users were given information and options to help them make positive decisions about their own lives. Risk assessments were an integral element of the service users care plan and a number had been completed. Each risk assessment included a management strategy. Care plans and risk assessments had been recently reviewed. Staff spoken to by the inspector talked about the importance of care plans in meting each service users needs. 98/100 Gloucester Avenue DS0000040870.V323360.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): YA12, YA13, YA15, YA16 & YA17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was run to make sure that service users had opportunities to enjoy their stay and to fulfil their potential. Service users were able to make day-to-day decisions about their lives. Individual dietary needs were catered for. EVIDENCE: Service users had regular access to their local community; and activities accessed within the local community at evenings and weekends during their stay at Gloucester Avenue. Public transport must be used, as the home does not have its own vehicle. Records of service users leisure activities are made on their daily records. 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 14 Most service users continued to attend their day care centre during the day whilst staying at Gloucester Avenue. Family and friends may visit Gloucester Avenue at any reasonable time, although usually families maintained contact by phone in order to ask how service users were during their stay. Some service users choose to stay at Gloucester Avenue at the same time because they get on well together. The inspector spoke to the staff member on duty about how service users would be treat with dignity and respect. One service users relative commented that it was important for their relative to bless their food before eating, and that reference to supporting service users religious and personal beliefs was made in the homes literature. This information had helped them make a choice about using the service. A record was made of meals served to service users. Menus for the home were decided on a daily basis, dependent on the number of service users at the home and their preferences. Any specialised dietary requirements would be accommodated, this included use of halal meat, diabetic and soft diets. Gloucester Avenue did not employ a cook. Care staff prepare meals and service users were encouraged to participate in the shopping, preparation and planning of meals to the best of their ability. Staff were ready to offer assistance with eating where necessary, discreetly, sensitively, and individually, whilst independent eating is encouraged. Adapted cutlery/crockery was used for those who need it. 98/100 Gloucester Avenue DS0000040870.V323360.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): YA18, YA19, YA20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support was offered to service users in a way that promoted empowerment, choice, dignity, respect and autonomy. Service users health needs were well documented and being met. Good practice was in place with regards to the administration, safekeeping, storage and disposal of service users medication. EVIDENCE: 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 16 Service users required varying degrees of prompting, guidance and one to one and two to one personal support. The inspector was advised by the care staff on duty that they endeavour to ensure sensitive, consistent and flexible support for service users by understanding each persons preferred routines, likes and dislikes, and by working in close partnership with the service users, their families and other significant people involved in the service users life. Care staff had completed equality and diversity training. The service users case tracked had their health needs recorded clearly and in detail on their care plan. There was information regarding meeting the service users health needs and how this would be done. Policies and practices for managing and administering medication were in place. Service users consent to administration of medication was obtained and recorded in care plans. A clear account of how medicines were booked into and out of the home was in place. Four staff administering medication had obtained accredited training by completing the “Safe Handling of Medicines” distant learning training course. Because there were no service users staying in the home at the time of the inspection there was no medication available to examine. 98/100 Gloucester Avenue DS0000040870.V323360.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There were clear complaints and protection policies and practices in place. Staff spoken to had a good understanding of adult protection issues and how to deal with complaints made by service users. Staff training regarding dealing with complaints and protection of vulnerable adults was due to be held in the near future. EVIDENCE: There had been one complaint made to the home since the last inspection. The inspector was satisfied that this was being recorded and dealt with in accordance with the homes policies and procedures. The complaints procedure was now available in a pictorial format, which was more appropriate for some service users living at Gloucester Avenue. The complaints procedure was on display in a communal area of the home. Staff spoken to were able to describe the complaints procedure and how they would deal with someone making a complaint. Staff spoken to were also able to give definitions of different types of abuse and how they would act if they witnessed abuse of any kind. The staff member was aware of the homes whistle blowing policy. The inspector was advised that not all staff have completed POVA training, but that this was due to be undertaken in March 2007. 98/100 Gloucester Avenue DS0000040870.V323360.R01.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): YA24 & YA30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of décor and furnishings provided a comfortable and homely environment for service users. The standard of cleanliness and hygiene in the home was good. EVIDENCE: The furnishings and fittings were compatible with the needs of the service users and the purpose of the home. The conversion of the homes garage for alternative storage space of specialist equipment was completed, but still awaiting the floor to be sealed. The treatment/changing bed had been disposed of and a new specialist bath had been installed. 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 19 All the bedrooms had been redecorated. Plans were being considered to extend the home, adding a further ground floor bedroom and extension to the bathroom. The home was clean and tidy, and there were no offensive odours. Adaptations and specialist equipment was in place to meet the needs of the residents. Suitable laundry facilities, appropriate for the home were in place. 98/100 Gloucester Avenue DS0000040870.V323360.R01.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): YA32, YA34, YA35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 50 of care staff had obtained their NVQ3 training to enable them to better meet the needs of service users. Staff spoken to and observed by the inspector demonstrated a good understanding of the needs of the service users. Training had been undertaken to ensure that care staff had the skills to care for the residents. EVIDENCE: The inspector noted that 3 out of 6 care staff members had now completing their NVQ level 3 training. One member of staff had almost completed this training. 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 21 The inspector was not able to case track an employee file due to the members of staff on duty not having access to staff files. There had been only one new member of staff transferred from another establishment since the previous inspection. There was evidence of staff training, and that 1:1 support meetings took place with the manager and individual staff members. Monthly team meetings took place and minutes of these meetings were seen. All staff had completed LDAF (Learning Disability Award Framework) induction and foundation training. In addition to this, there was an in-house induction checklist, which gave new staff member’s detailed information about their role and policies and procedures of the home. 98/100 Gloucester Avenue DS0000040870.V323360.R01.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): YA37, YA39 & YA42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. An experienced manager ran the home; completion of training would further demonstrate that the attitude of the staff and management was to run the home with the needs and safety of the service users as the highest priority. The registered person and the Commission were not being kept informed about the home. The home was run to ensure the safety and welfare of service users and staff. General good practice was in place with regard to the safety and welfare of the staff and service users. 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 23 EVIDENCE: As reported at the last inspection, the registered manager was undertaking NVQ 4 training in Care and Management. The inspector advised that completion of this was a high priority in accordance with conditions of registration with the Commission. The registered manager advised that it would be completed by June 2007. The home had participated in a Lancashire County Council Standards Audit in October 2006. This overall outcome was “met to a high standard”. An in house “Have your say” telephone survey was conducted with 25 service users and their families. The results had been collated and published, and actions plan drawn up from the results. The first edition of “A Gloucester Avenue Newsletter” had been published in December 2006; it was intended to publish 4 newsletters a year. The inspector noted that regular reports on behalf of the registered person had not been received by the Commission. Records regarding the prevention of fire, and routine maintenance records of the gas and electrical supplies and appliances were seen and found to be in good order. Staff training had been undertaken with regards to ensuring the complete health, safety and welfare of service users and staff, for example in 1st Aid, administration of medication, COSHH and Fire Awareness. 98/100 Gloucester Avenue DS0000040870.V323360.R01.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 2 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 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 X 34 2 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 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 2 X X 3 X 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 25 Yes 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 YA4 Regulation 5(1)(b) Requirement The terms and conditions in respect of accommodation to be provided for service users including the amount and method of payment of fees. The registered person must ensure that by staff training or other measures, to prevent residents from harm, abuse or being placed at risk or harm or abuse. Documentary evidence as described in Schedules 2 & 4 of the Care Home Regulations must be kept at the home and be available to the inspector. Not complied with following the inspection of July 2003 The registered manager must achieve NVQ 4 in care and management training. The registered person or his representative must visit the home unannounced and at least once a month. Timescale for action 27/07/07 2 YA23 13(6) 31/03/07 3 YA34 Sch 2 & 4 01/07/07 4. 5 YA37 YA39 9(2b) 26 01/07/07 01/07/07 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 98/100 Gloucester Avenue DS0000040870.V323360.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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. 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