Inspection on 25/09/06 for Albany House

This inspection was carried out on 25th September 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Albany House 43 Bridge Street Fakenham Norfolk NR21 9AX Lead Inspector Ruth Hannent Key Unannounced 25th September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Albany House DS0000066421.V313842.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. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albany House Address 43 Bridge Street Fakenham Norfolk NR21 9AX 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) 01328 863753 01328 863861 mail@albanyhouse.info Woodspring Care Ltd. Miss Clare Susan Hatcher Care Home 20 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (16) of places Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: Albany House is a care home providing personal care and accommodation for up to 20 older people. The home is owned by Ms D Hannent and Mr T Armitage.The home is located in the market town of Fakenham, close to shops, pubs, the post office and other local amenities, including transport.Albany House is an adapted family home on three floors and facilities include 16 single and 2 shared occupancy bedrooms. The home has 3 lounges, including a smokers lounge, a dining room and conservatory. Assisted bathing facilities are located on each floor. A shaft lift provides easy access to all parts of the home.The conservatory overlooks the gardens and a main thoroughfare to the town centre, allowing service users to watch activity outside. Off-road parking is available. Fees £325 - £360 per week Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to Albany House to carry out a key inspection. On the day of the visit 19 residents were living in the Home with many of them spoken to throughout the day with various questions asked regarding the care they receive. A pre inspection questionnaire had been partly completed by the Deputy Manager and the Registered Provider with the rest of the evidence obtained during the inspection. Families were coming and going throughout the day and were spoken to. Staff were able to answer questions while carrying out their duties. Very little information or notification had been received at the commission since the last inspection so most of the evidence for this report is what has been gathered on the day. The comment cards for residents were completed, but on talking to the Manager had been filled in with a staff member and may not be the true response, due to the inability of some residents to understand and answer the questions asked. No comments were written in the space provided and only ticks in boxes of all ten received. No relatives had returned comments. One comment card from the GP was positive and gave complimentary remarks about the staff and food within the home. A tour of the building took place with the Manager. Records were inspected including care plans, training, health and safety, personnel and residents personal money accounts. What the service does well: The Home offers a good choice of meals for residents and is very good at monitoring the amount of food residents are eating and will introduce fortified meals if necessary. Residents are weighed regularly to ensure they are maintaining a suitable weight. The link between the GP surgery and the Home is positive with good communication in place to offer continuity of care. Care plans are informative and enable staff to deliver the care required. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 6 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 contacting your local CSCI office. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. Residents do undergo a thorough assessment prior to admission. The Management need to be clear that admitted residents must be inside the registration category to ensure needs can be met. EVIDENCE: Two assessments that are held within the care plan folders were looked at in detail. Comprehensive information had been sought to ensure the resident’s needs could be met. Families do visit the home and look around and if possible the potential resident will visit prior to admission. The Manager and Deputy had just returned from carrying out an assessment on someone who clearly could not have their needs met and had told the placing person the outcome of their assessment. Although it had not been the intention to look at Standard 4 of the National Minimum Standards it became apparent throughout the visit that many of the Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 9 residents have needs that are outside the registration category. To talk to the residents and gain information was difficult and on talking with seven of the twenty residents conversation was not easy to understand and questions of how their care needs were met or how they were offered choice could not be identified. Records were available but choice for people with memory problems needs to be approached in a different way and this was not evident. As the Home is only registered for four people with dementia this needs to be rectified. It appears that not only have residents who have been in the Home for a period of time developed symptoms of dementia but that new residents have been admitted with some form of memory problems that have increased. The home does review the care but not always involve specialists or Social Workers. One lady is waiting to move on to a Home that has a specialist unit for people with dementia and who is at present challenging the service at Albany House which is having an impact on the needs of others. (Requirement). Albany House DS0000066421.V313842.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 and 10 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. The residents do have a comprehensive care plan that is reviewed. The Home is supported well for the health care needs of the residents. Medication procedures are followed correctly if medication is witnessed as ingested. Residents are treated with respect and their rights to privacy is upheld. EVIDENCE: Two care plans were looked at in depth. The content in each one gave a comprehensive picture of all the needs required and appeared individual. The carers have easy access to these documents and add information to any that require updating. On all care plans each person hair washing, bath times and nail care were all dated and regularly recorded. (One noted change was for as resident that the staff, were having difficulty in giving the care now required). The care plan had been updated and signed Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 11 with all the new details clear for staff to follow. This person was seen during the site visit and it was evident how the needs had developed and careful monitoring of the care was required which appeared to be happening through observation and the daily records completed by staff. The Home works well with the GP practice with a complimentary comment card received at the Commission from the Doctor. The notes on health issues are kept up to date and time is spent monitoring blood sugars, weights and food intake to promote good health. The Home has a medication monitoring system from Boots with all medication recorded on a MAR chart. The stock is all held in the small staff office with medication administered from this cupboard. Each dose has to be removed the cupboard locked between each persons medication administration. Some of the residents do not take their medication straight away but the chart is completed. No initials should be placed on the MAR chart until the person has been seen to ingest the medication to ensure the person has taken it and not dropped it or had it removed by someone else. (Requirement). The records were correct but it is a (Recommendation) that a card divider is placed in between the records and has each resident’s photograph and a list of allergies on the front for clear reference to the correct residents and their medication administration records is in place. Throughout the day residents were treated with respect. They were spoken to in a polite manner and all instructions were made clear to the resident in when they needed to interact with the staff who were assisting with their care. The comment cards all ticked the box that showed the care was appropriate and residents who were able to say stated the staff treated them with respect. Room doors were knocked on and all personal care tasks were done in the privacy of the resident’s bedroom. Albany House DS0000066421.V313842.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 and 15 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. The Home works hard to have a varied and interesting programme of events to please all residents. Families are welcomed and come and go as they wish. Choice is offered but due to some residents with communication problems it is not always certain this is achieved. Meals are wholesome and balanced but not particularly served in ideal surroundings. EVIDENCE: The Home has a list of activities and each afternoon a staff member will interact with residents socially. The Home has regular entertainment and a special effort is made for any birthdays. The local children are involved and regularly visit. The past months programme of activities was shown and on talking to resident’s the activities are enjoyed especially the recent harvest festival however some of the less able residents do not always have the person centred stimulation that is relevant for them and it was noted four people in Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 13 the one lounge left with just music playing in the background and little to occupy them. How and in which activity the residents has participated in is recorded in their care plan and in the entrance are many photographs of the sports day held in the summer and the events held with the local school children. Visitors were coming and going and were spoken to during the inspection visit. One person stated she was always welcome and kept informed of how her relative was. Another wanted to speak to the staff member who interacted in a friendly helpful manner. Throughout the visit residents were asked choice. “Would you like a cold or hot drink”. “Do you wish to sit in this chair”. “Would you like blanket” were just some of the comments to offer choice overheard. The meal of the day was chicken and chips or meat pie. The staff have a form they complete for anyone who is not eating well or their fluid intake is poor. Fortified drinks are available via prescription if any resident is having difficulty eating. and the cook is very proactive in offering an alternative by asking them what is their favourite food. Three residents spoken to could not remember what they had just eaten and another was asking for her dinner yet it had just been eaten. Four people in the far lounge had one staff member to assist with the meal and was standing over the residents with encouraging words without sitting at eye level. All of these people needed assistance with their meal and this staff member was moving from one to the other throughout the mealtime. The Deputy Manager arrived at pudding time and was able to help. (Recommendation) Albany House DS0000066421.V313842.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 and 18 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives can be assured that their complaints will be listened to and acted upon. Residents are protected from abuse. EVIDENCE: One complaint had been notified to the Commission by the Home. The Responsible Individual has investigated and no evidence has been found to back up this complaint. Full records are held in a locked drawer in the office and were seen by the inspector. Staff are very aware of whistle blowing and the procedure to follow if they suspect any form of abuse. One staff member spoken to talked of the training they had attended and would report any concerns to the Manager or Deputy. Evidence is held on file and was seen of all staff who have attended the training in ‘The Protection Of Vulnerable Adults’. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 26 The quality outcome for this group of standards is adequate. This judgement has been made using available evidence including a visit to this service. Residents do live in a fairly safe home that is reasonably maintained. The environment is fairly comfortable with nice outdoor areas. There are adequate lavatories and washing facilities. Resident’s bedrooms are homely and personalised. The Home is very clean and hygienic. EVIDENCE: The Home is in need of redecoration in certain areas. The lounge by the front entrance has wallpaper coming away from the wall. Corridors and doorways are badly marked from wheelchairs and some curtains are in need of repair and washing. The top floor corridor has been redecorated and all doors are Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 16 painted the same. There is no way to identify which is the lift, toilet or bedroom in an area that has no natural light. (Standard 4 Meeting the Needs) The Home needs to consider the needs of the residents who would have less vision and with memory problems who may struggle to find their room or the bathroom etc if all doors look the same. (Recommendation). The grounds are tidy and the Home has obviously used the garden in the nice weather as noted by the entrance photographs showing lots of outside activities. The Home has no fire risk assessments in place to date, although the Manager has obtained a risk assessment format it needs to be completed as soon as possible. (Requirement). The fire alarm checks are carried out, (records seen) and random drills are done, including nights to ensure staff carry out the correct procedure when they hear the alarm whichever shift they may be on. The Home has some rooms that are small and if all twenty people registered wanted to eat in the dining room this could not be achieved. If building works are being considered a bigger dining room will be required. The small lounge is used by resident’s who need assistance with eating their meals and who will then remain in this area for most of the day. The bathroom on the ground floor has just been altered and offers a good facility to have a bath in comfort in a specialist style tub with hoist and bubbles. To alter the area to accommodate this new room a door with a large step into the corridor is now seen as a hazard and although signs are in place to warn people there was concern shared with the Manager over the lack of the ability of some residents to comply with written notices. (Requirement) Bedrooms vary in size and were inspected. Noted was the homeliness of the rooms with resident’s personal belongings and small items of personal furniture. The cleanliness was apparent with all areas walked being odour free and pleasant. The new laundry has the ability to manage the laundry better in the new environment that has just been created. The staff member spoken to was very happy with the new set up and able to keep on top of the daily washing. There were two washing machines and two dryers, which is adequate for the number of residents. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. Residents do have a good staff team to care for their needs that have a good skill mix. The recruitment procedure is in place and protects the residents. The home works hard to ensure all staff are trained and competent. EVIDENCE: The Rota’s are all available on the wall in the small office with shift patterns planned to meet the needs of the residents. (A recent change has been the need for more staff to assist with meals so more are on duty at the peak times). According to the Manager the Home does not use agency as the team of staff are supportive and will cover during leave or sickness. The rota’s have been challenged at past inspections as having shifts that are too long and staff becoming overtired. This has been improved and staff appeared happy with the shifts offered. The staff on the day of the inspection, were interacting and appeared bright and cheerful while carrying out their duties. Two personnel files were looked at that showed all records required as listed in Schedule 2 of the National Minimum Standards were in place except for one reference that is to be chased up immediately by the Manager. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 18 A conversation was held with the Manager of the need to gain CRB certificates for all people who are involved within the Home. All employed staff do have the CRB check but people such as the hairdresser do not. The training certificates were also in the files with records of supervision. The Home works hard to get staff trained and informed as much as possible with dates planned each month for training. All statutory training is covered on a regular basis and any specialist need training will be sought. All the records seen show a huge effort is in place to build the skills of the staff team. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. The Home is managed by a person who is fit to be in charge and carry’s out the duties fully. Residents do benefit from the ethos and management of the home. The quality assurance system has room to improve to ensure the best possible care is in place. Residents money is safeguarded with good procedures in place. Staff are supervised appropriately but it needs to be more timely. The Health and safety of all residents and staff is protected and promoted. EVIDENCE: Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 20 The Manager throughout the visit was able to show competence and clear accountability. Although the Managers qualification is not yet in place half of the units required are now completed and hopefully will be in place within the next year. Distance learning courses have also helped the Manager in her role who is keen to be always updating her own knowledge. The Manager is shortly to go on maternity leave and is working closely with the Deputy to ensure the Home continues to operate smoothly in her absence with clear information sharing and guidance. The Home does aim to get some form of quality assurance system in place but a completed collated document with all stakeholders input is yet to be produced. To move forward and improve the service this should be an ongoing piece of work and is a requirement with a list of how this could be achieved under Standard 33 of the National Minimum Standards. The procedure for handling resident’s money was seen. The Manager has locked away wallets for each resident. Within these wallets are all receipts and cash that is recorded and signed by the manager of all transactions in and out. The cash was checked and receipts were in place for items purchased. Staff supervision is taking place but not as regularly as it should be. The sessions, when held, are documented well with lots of detail recorded. Staff are valued by this Manager and this is reflected both in supervision notes and the commitment to train the staff and build skills as much as possible. Some health and safety records were looked at which were mostly around fire procedures with records of testing alarms and in various zones to ensure over the year all alarm points are tested. A recognised company regularly tests the system. Fire drill recordings with times and who was involved were also seen and dates on the fire extinguishers were noted as serviced in 07/06. Full up to date records of statutory training in health and safety areas were all current such as moving and handling, fire safety, first aid, food hygiene and infection control. Staff who had attended and those still outstanding had dates planned in the near future to ensure no staff member slips through the net. All COSHH chemicals are locked within a store cupboard in what was the old laundry. Hot water taps were tested in the baths and ran at the correct temperature. All new staff have a thorough induction and evidence of new staff employed was seen within the personnel files. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 2 3 3 x 3 x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x 3 3 x 3 Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 22 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 OP4 Regulation 4.1 16.1 Requirement The Registered Manager must ensure that residents are cared for in the category stated in the Statement Of Purpose (4 people with dementia). The Home appears to have over this number. Reviews of residents should take place and diagnosis needs to be sought. The Registered Manager must ensure that all residents are observed ingesting their medication to carry out a safe administration procedure. The Registered Manager must ensure fire risk assessments for the building are in place. The Registered Manager must ensure that residents are not at risk due to the large step through the door leading to the lounge (opposite the kitchen). Timescale for action 01/12/06 2 OP9 13.2 26/09/06 3 4 OP19 OP19 23.4 13.4 01/12/06 01/12/06 Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 23 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 3 Refer to Standard OP9 OP15 OP19 Good Practice Recommendations It is recommended that photographs of the resident and any known allergies be placed on the front of each persons MAR chart. It is recommended that the Home makes provision so staff can sit and assist someone to eat their meal and not have to move between residents. It is recommended that the decoration/alteration of the home takes into consideration the needs of frail elderly people who have visual and memory problems. Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 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 Albany House DS0000066421.V313842.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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