CARE HOMES FOR OLDER PEOPLE
Aberdeen House Residential Home 20 Stockerston Road Uppingham Rutland LE15 9UD Lead Inspector
Keith Charlton Unannounced Inspection 17th July 2006 09:30 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 Aberdeen House Residential Home DS0000006456.V304425.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. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Aberdeen House Residential Home Address 20 Stockerston Road Uppingham Rutland LE15 9UD 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) 01572 823308 01572 823308 Mrs Linda-Jane Thornalley Mrs Joanne Chapman Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18), Physical disability over 65 years of age (1) of places Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration. Date of last inspection 1/11/2005 Brief Description of the Service: Aberdeen House is an 18-bedded residential care home for older people. The home, which is a converted farmhouse, is situated in Uppingham, close to the centre of this rural village. Residents rooms are located on two floors with a shaft lift and a stair lift providing access to upstairs facilities. Residents have access to a communal lounge / dining room, a conservatory and a quiet lounge. There is a well-maintained patio garden outside. The weekly fee is from £354 - £480, which was provided on the day of the Inspection. There are additional costs for hairdressing, toiletries, transport, chiropody and dry cleaning. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service user and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Provider and Assistant Manager were present and helped in carrying out the inspection. The Registered Manager was on a day off. Planning for the Inspection included looking at notifications of significant events sent to the Commission for Social Care Inspection and the issues contained in the last Inspection Report. There has been one formal complaint made about the service since the last inspection regarding - staffing levels, the speed of care delivery and outside lighting levels. These issues were not upheld. The Inspection took place between 9.30 and 16.40 and included a selected tour of the building, inspection of records and indirect observation of care practices. The Inspector spoke with seven service users, two members of staff, the Registered Provider and the Assistant Manager. What the service does well:
Overall this continues to be a well managed service. One of the main strengths of this service is the stable staff team led by a senior team with over 15 years working in this service. Service users made the following comments: ‘I like it here. The staff are very good and friendly. If there are things I don’t like I can go to Joanne or Allison and they will get them sorted out. ‘They are good to me. Staff are busy but they try to help me as much as possible. They encourage me to be independent.’ ‘When I am moved staff try to be as gentle as possible’. ‘I like the food here. If we don’t want what they have they will do something else’. ‘This is a well run home. Nothing is too much for Joanne and Allison. They take care of us and all the staff are very friendly’. ‘The girls are great. You couldn’t ask for better.’ Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 6 Staff are assisted to see service users as individuals by the compilation of service users life histories. Staff said they were treated well by management, listened to and supported. What has improved since the last inspection? What they could do better:
Service users welfare could be more effectively met by staff ensuring that – staff who commence employment have the requisite Protection of Vulnerable Adults check in place to offer increased protection for service users, that service users are not pressurised to take medication, that dental visits are regularly arranged and staff always knocking on doors before entering respects rights to privacy. The Registered Manager may wish to consider always having two choices for lunch every day, as per the National Minimum Standard, so that more meal choice is available. There were a number of comments regarding how busy staff were, especially when there are only two care staff on duty, to be able to quickly care for service users with increased care needs – e.g. dementia or confusion and service users who wandered/were at risk of falls. It would normally be expected that there would be a minimum of three care staff on duty for a home accommodating nineteen service users with a significant number of people with dementia needs. The Registered Provider needs to review staffing levels again as there is a duty to ensure that service users needs are met at all times.
Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 7 It is recommended that preferences for times service users wish to go to bed, as there is only one night staff on duty from 8.00pm, so there could be a tendency to regard this time as one which service users who need staff assistance should go to bed before this time to ensure the routines of the service are met rather than individual preferences. This could mean that more staff need to be on duty until later in the evening. The staff training programme is generally comprehensive though would aid staff understanding if training on all service users conditions – parkinsons disease, diabetes, strokes etc – were added to the programme. Regarding the carrying out of Quality Assurance of the service it was recommended that the Registered Manager introduce Residents and Staff Meeting to gain views as to the running of the service and suggestions for improvement, and it was again recommended that quality assurance results are published to give information to all stakeholders – the Registered Provider said this was in hand. The Registered Provider said she was looking into the provision of radiator covers to provide further protection to service users from scalding injuries. 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. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user needs are generally well assessed before admission so that staff are able to meet their needs. EVIDENCE: Service users said that someone saw them from the home before they were admitted, who asked about what care they needed. The Inspector looked at three service users files. There was a good deal of relevant information in terms of medical, physical and social needs of service users, which helps staff to deal with the individual needs of service users. Additionally any assessments completed by an outside professional such as a social worker were also on file. The Registered Provider does not provide intermediate care.
Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The individual needs and choices of clients living in the home are generally well met. EVIDENCE: Some service users said that they could recall having Care Plans. Care Plans seen by the inspector contained information as to the physical, social and medical needs of service users. Staff said that they were encouraged to regularly read Care Plans to ensure they kept abreast of changing needs. Monthly reviews of service users needs were noted in Care Plans by stating whether there had been changes in care needs. Service users said when they felt ill then staff would swiftly summon medical assistance - service users contacts with medical personnel were documented in their Care Plans. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 11 A service user talked about all the medical checks she had since coming to live in the home – optical, chiropodist etc and said staff reminded her about these appointments. However she could not recall when she last saw a dentist. The Registered Provider looked this up and found the last dental visit had been May 2005 and said this would be followed up to ensure there is a minimum annual check. Accident records were checked. There was a recent accident where a service user sustained a head injury though medical assistance was not sought. It was agreed with the assistant manager this would be carried out in future to ensure service users welfare is fully protected. No service users asked wanted to self medicate and all asked appreciated the staff holding their tablets and giving them at proscribed times. There was evidence of staff training from the pharmacist in training records and staff members said they had in house medication training. Medication was issued by two staff which provides good back up for safety reasons. The records were well kept with no gaps. Controlled medication was recorded by two staff with the balance of medication left also recorded. Medication is kept securely in the medication storage room. Service users again said that their privacy and dignity was generally well respected though some service users said staff did not knock on doors before they entered. This was the case when a staff member entered a bedroom without knocking when the inspector was speaking with a service user. Staff were observed to talk to service users in a friendly manner and there appeared to be very good relationships between staff and service users. There was one occasion where a staff member was forceful in trying to get a service user to take a tablet. The Registered Provider subsequenly stated that these issues had been followed up with staff. Service users spoken to who shared a bedroom stated they did required screening for the purpose of maintaining their privacy and dignity, but they could ask the Registered Manager if they changed their mind and it would then again be made available. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users living at the home have a generally good lifestyle, and meals continue to be seen as good. EVIDENCE: Service users again said that they were generally satisfied with the range of activities on offer and they liked it when staff had time to sit and chat with them though staff were busy so did not often have the time. There were comments received that some service users would like to go on outings. The Registered Provider said this had not had interest from service users in the past and the activities organiser checks this regularly, but it would be followed up again to see if there was any interest. Service users said that activities were provided twice a week by an activities person, and also care staff responded to other requests, and these views were supported by an activities record. Service users said they liked being outside and enjoying the garden, which they did on a regular basis during warm weather. Service users can go out if they wish and attend clubs.
Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 13 Service users said that their visitors were made welcome by staff and this was supported by a visiting relative. One comment received alluded to an encouragement for service users who need assistance to go to bed earlier as there is only one staff on duty from 8.00pm. Other service users said they were very happy to go to bed early and this was their choice. One service user said she liked going to bed early and getting up late, and staff respected this. Preferred times for going to bed were recorded within some care plans after consultation with service users. The inspector asked that this be carried out for all service users to ensure there is full choice in this matter. Staff said that it was important that service users were able to keep their independence so they could still do things for themselves. This was confirmed by service users. Service users generally said they enjoyed the food and they could ask for an alternative if they wished. The Registered Manager may wish to consider always having two choices for lunch every day, as personal possessions the National Minimum Standard, so that more choice is offered. One service user said the Registered Provider had listened to her and would be getting her butter instead of margerine, and had obtained ‘properly baked bread’ for her. She also wanted ‘proper beef’. Food records showed there were a variety of vegetables offered. A service user was asked if she wanted an alternative as she did not want the main meal. She was supplied with a sandwiche instead. Staff were aware of service users food preferences and this information was in Care Plans. The food tasted was found to be of a good standard with two vegetables offered and a choice of dessert. A service user said she liked to have her meals in her bedroom and these were always provided there. Evidence in Care Plans showed nutritional needs are assessed. The menu for lunch was displayed on a board in the lounge/dining room so that service users could see what was on offer and be able to ask for an alternative instead. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 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 acted upon and they and their representatives can be confident their concerns will be properly attended to. . EVIDENCE: Service users again said that they would have no hesitation about going to management or staff if they had a problem and were confident it would be properly sorted out. The Complaints book was viewed - the service has had two complaints since the last inspection. These were generally well dealt with by the Registered Manager though one complaint did not contain an outcome – the Registered Provider said this would be followed up. The Commission for Social Care Inspection has received one formal complaint from an anonymous source about the service since the last inspection – this was not upheld. There is a Complaints Procedure, which nearly complied with the National Minimum Standard – the Registered Provider said this would be altered to fully comply with the National Minimum Standard. Staff members were asked about their understanding of the adult protection procedures, and demonstrated a generally good understanding though one
Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 15 staff was unsure as to which Agencies to contact – the assistant manager said staff would be provided with a clear, simple procedure. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients live in a homely and comfortable environment, and standards of hygiene are very good. EVIDENCE: Service users all said that they liked their bedrooms and they could bring in their own things including furniture. These were observed to be personalised and homely by the inspector. The lounge was comfortable and furnished in a homely fashion. It helps in the maintenance of the home that the Registered Provider’s husband is on hand to carry out these tasks. Service users also appreciated the well maintained garden patio area, which had colourful flowers in pots. Facilities were found to be clean and completely odour free. Service users said their laundry was always fresh. A cleaner was available on the day of
Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 17 inspection. This is the case for five days a week. The Registered Provider was asked to consider having domestic cover every day to ensure standards are always covered. The Registered Provider said this would be considered though her initial thought was that cleanliness and tidiness standards were still maintained at weekend periods, even with reduced staff cover. The Registered Provider said that a bedroom floor covering of ordinary linoleum covering chosen by a previous occupant had been reviewed by the Registered Manager regarding the safety of this floor covering against non-slip flooring or carpet. The bath temperature to the rear of the property was measured at 39 degrees centigrade, well within the National Minimum Standard of 43c. The Registered Provider stated no radiators were guarded throughout the property, as surface temperatures were measured to ensure no risk from burning, but that as an extra safety measure this issue was being reviewed with consideration to fitting radiator covers as a further safety measure. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The current staffing levels and recruitment practice may lead to service users welfare needs not being fully met. Staff training is generally comprehensive. EVIDENCE: There were a number of comments regarding how busy staff were especially when there are only two care staff on duty and when service users with dementia or confusion were wandering and some were at risk of falls. It would normally be expected that there would be a minimum of three staff on duty throughout day and evening shifts for a home accommodating nineteen service users, with a number of those people with dementia needs. The staff rota indicated that there are four carers on duty in the morning with one cook and one cleaner, during weekday periods. Staffing ratios reduce at weekends to two care staff. There are two carers including the manager on duty in the afternoon shift then another staff comes on duty from 5pm to 7pm in the evening. Staffing levels then reduce to one awake staff from 8pm to 8am, who has access to an on call worker who can be summoned to arrive at the premises within 15 minutes. The Registered Provider said that often she was on duty when there were reduced staffing levels though she acknowledged that she did not indicate this on the staff rota. The inspector asked that this be carried out so that the rota is a correct record of staffing activity.
Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 19 The Registered Provider needs to review staffing levels again as there is a duty to ensure that service users needs are met at all times. Staff records were inspected. The Registered Manager has ensured that two references are obtained. There were not always copies of passport or birth certificates on file but similar ID was available – driving licence etc. In two instances staff commenced employment without having the requisite Protection of Vulnerable Adults check in place. This needs to be carried out to offer increased protection for service users. Staff said that training is emphasised by the Registered Manager and that there is encouragement to complete National Vocational Qualification training in essential care issues. There is also an induction programme that covers important care topics. Staff are currently undertaking training in the awareness of service users with dementia. The training records were viewed for the staff team and a range of training has been undertaken - District Nurse training for catheter care, in house Monitored Dosage System training etc. The inspector recommended that the Training Programme cover all service user medical conditions – parkinsons disease, stroke management etc. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management systems generally protect the welfare needs of service users. EVIDENCE: Service users and staff spoken to said that the home was run very well and they could not think of any improvements that were needed. This situation is commended. There is a Quality Assurance system in place. This is carried out on a yearly basis to ensure that the service is effective in meeting service users needs and wishes. Some questionaires were seen. The Registered Provider said that they will be analysed and this information published in the Statement of Purpose, to be made available to stakeholders. The Registered Provider was asked to
Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 21 consider setting up service user and staff meetings to ensure that there is a forum to air views and preferences, put forward suggestions etc. Staff said there is a regular staff supervision system in place and this was recorded in staff records. Records indicated the frequency of fire drills meets the requirement and there is regular emergency lighting and fire bell testing. Staff members spoken to had a good awareness of the fire drill procedure. A fire risk assessment was seen which covered relevant issues. Service users monies accounts were checked and found to be in order with proper balances, receipts and two signatures recorded. Regarding Health and Safety training all staff are expected to complete fire training, infection control training, moving and handling training and food hygiene training. It was recommended that there is a trained first aider on each shift. The Registered Provider said this would be considered though thought in practice there was an adequate system as all staff on call were trained first aiders. There were written Risk Assessments for safe working practices and these were evidenced in the Health and Safety records. Service users said that they were warm in the home in cold weather and if not then staff would boost heating or provide portable heaters. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 22 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 X 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 3 STAFFING Standard No Score 27 2 28 3 29 1 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation 19 Requirement (1) The Registered Person must ensure an enhanced Criminal Records Bureau disclosure or a Protection of Vulnerable Adults first check is obtained prior to staff commencing employment. Timescale for action 17/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP10 OP27 Good Practice Recommendations That staff respects the privacy and dignity of service users at all times. That the Registered Manager and Registered Provider review the staffing levels with any interested parties – service users and relatives – to ensure that service users needs are covered at all times. Aberdeen House Residential Home DS0000006456.V304425.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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