Inspection on 05/09/07 for Alexandra House

This inspection was carried out on 5th September 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 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

Alexandra House 15/05/06

Alexandra House 02/11/05

Alexandra House 01/08/05

Alexandra House 11/02/05

Alexandra House 22/07/04

Alexandra House 04/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Alexandra House 1 Narborough Road Huncote Leicestershire LE9 3AN Lead Inspector Keith Charlton Key Unannounced Inspection 5th September 2007 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 Alexandra House DS0000049312.V341501.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. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra House Address 1 Narborough Road Huncote Leicestershire LE9 3AN 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) 0116 2753669 Mrs Jacqueline Ann Skubala Mr Albert Konrad Skubala Mrs Jacqueline Ann Skubala Care Home 17 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (17), Physical disability over 65 of places years of age (7) Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To be able to admit the named person of category DE named variation application number V000000223 dated 10/12/03. Named Person To be able to admit the person of category SI(E) named in variation application No. V27292 dated 15 November 2005 15th May 2006 Date of last inspection Brief Description of the Service: This is a registered home for older people. It is situated in the village of Huncote. There are local facilities nearby. Residents all enjoy the benefit of a single bedroom with toilet en suite. There is a choice of lounges and a good sized garden to the rear. The weekly fees range from £430 to £600 - the Registered Provider provided this information on the day of the Inspection. There are additional costs for individual expenditure such as hairdressing, toiletries, etc. The home provides information to residents and prospective residents in the form of a Statement of Purpose and service users guide that describes the services it offers, and a copy of the last Inspection Report. They can be provided to enquirers upon request to give a view as to the quality of life for residents. Alexandra House DS0000049312.V341501.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 residents and their views of the service provided… The primary method of inspection used was ‘case tracking’ which involved selecting three residents 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, conducted with the Registered Provider, Mr. Albert Skubala. Planning for the Inspection included reading the Annual Quality Assurance Assessment completed by the Deputy Manager prior to the inspection, checking on notifications of significant events sent to the Commission for Social Care Inspection and reading the last Inspection Report. There has been one complaint made to the Commission for Social Care Inspection since the last inspection regarding insufficient staff on night duty and call bells not being answered. This was investigated by the management of the home, and found not proved. The Inspection took place between 9.30 and 15.35 and included a selected tour of the home, inspection of records and indirect observation of care practices. The Inspector spoke with seven residents, two staff members, one visitor and the Registered Provider. What the service does well: Residents said that staff and management were always very friendly and helpful towards them, that they were encouraged to retain their independence as much as possible, and that staff welcome visitors. Staff were observed to be friendly and positive towards residents. The inspector observed a relaxed and friendly atmosphere in the home. Residents said that the food was good in general and that they are given a choice for each mealtime. They again said they liked their bedrooms and they could bring in their own things and they liked the garden. Staff said that they are asked to read service users Care Plans and the Policies and Procedures of the home so that they aware of service users needs and are consistent in their work. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 6 Facilities are kept in a clean and tidy condition and decoration is of a high standard. Residents said they would feel confident to raise concerns if they ever had any and were satisfied that these would be listened to and acted on by staff and management. Residents said they liked staff spending time with them when they were able to do so. 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 Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Alexandra House DS0000049312.V341501.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 Alexandra House DS0000049312.V341501.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. 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. The admission process is well managed and residents receive a satisfactory assessment, thereby ensuring that their health and welfare needs are being met. EVIDENCE: Residents said they had been provided with information about the services the home offers and they have received contracts from the management. One resident showed the inspector the brochure he received from the home prior to his first visit. It was recommended that the Statement of Purpose and copy of the last Inspection Report be displayed to be easily noticed and accessible to current Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 10 residents and their representatives. The Registered Provider said this would be arranged. Residents said that they could visit the home if possible prior to their admission usually by way of a trial period, to give them a good idea of what services the home offers. A resident said that she could recall being asked questions about what care she needed before coming into the home. There was evidence of assessments undertaken by the Registered Manager available on the residents files examined by the inspector, which covered their needs, medical conditions etc. The assessment form mirrors that of the National Standard, which means all essential issues of care are covered. The home does not offer intermediate care facilities. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Care plans describe identified care needs to ensure proper care is supplied by staff though they need to include details of all essential medical checks. Medication systems are good in general though security and ordering procedures need to be enhanced. EVIDENCE: No residents asked knew they had a Care Plan and no Plan seen by the inspector had a signature of a resident/representative agreeing to its contents – this needs to be followed up. Care plans and risk assessments continue to be good in general. There were a small number of gaps, for example when health checks took place – dental, optical, hearing tests etc. This needs to be recorded so that these can be Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 12 arranged at regular intervals as needed. In general residents contacts with medical personnel were well documented in Care Plans. Care plans are reviewed at regular monthly intervals and this was seen as recorded in the Plans. It is recommended that there is a record of residents full personal histories compiled so that they can be seen as individuals with a valued history. Residents said that if they were unwell and wanted to see a GP staff would arrange this. There was evidence on residents files as to medical appointments being arranged. Staff members said that they were asked by management to read the residents Care Plans, which is good practice so that there is full awareness of residents needs. The inspector observed that a resident used a wheelchair without footplates, which she wanted so that she was able to move around under her own steam and it kept her independence. Residents spoken with said that staff were very kind and caring and that the standard of care was always of a high standard. The inspector noted that staff and management always addressed residents in a friendly manner. The visitor spoken with said that he was always made welcome. Residents thought staff carried out personal care in a way that respected their privacy and dignity. The inspector viewed accident records. The Registered Provider said that medical services are always called if there has been a potentially serious injury, e.g. a head injury. Such incidents need to be reported to the Commission for Social Care Inspection under the Regulation 37 procedure so that there is proper monitoring of the service. This was stated in the 2006 Inspection Report and needs to take place for all relevant instances as stated in the Regulation e.g. deaths of residents. Some residents said that they were taking care of some of their own medication, which helped them feel independent. Others said they were glad that staff kept it and gave it to them. The medication system was inspected. The Registered Provider and staff confirmed that only staff who had received in house training were able to issue medication. It is recommended that training is provided by a recognised outside body as well, e.g. pharmacist. Medication recording was complete apart from one resident whose medication had not been received by the home, as the pharmacist did not have it in stock. The Registered Provider said that a proscription had been mislaid from the pharmacist. This needs to be followed up with the pharmacist and a policy put in place to cover this issue, as it is not acceptable residents are without Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 13 prescribed medication. It also needs to be reported as a Regulation 37 incident, as it is a situation that could affect residents welfare. Medication is kept locked away apart from insulin. The Registered Provider said this would be followed up. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Residents have the opportunity to lead full lifestyle and can exercise choice. Menu planning appears thorough the food supplied needs to be reviewed to ensure variety and taste. EVIDENCE: Residents said that there were some activities, which they enjoyed – e.g. quizzes and bingo. Some residents some wanted more activities. One resident said she would like the cooking class to be restarted. The Registered Provider said this was already going to be arranged. It is recommended that a daily Activities Programme be set up based on residents wishes. Regarding outings they said they liked going out sometimes and went out with their families but may like some more outings. It is recommended that this be explored in a residents meeting. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 15 There are no residents meetings currently held. The Registered Provider agreed to look to follow the National Minimum Standard of having regular meetings to ascertain residents views and record what was discussed and what action is carried out. Residents again said that there were no rules that they knew of, e.g. no one reported that there were set going to bed and rising times, and everyone thought the atmosphere of the home was friendly and relaxed. The inspector observed that residents came down for breakfast at their preferred time. Inspection of residents accommodation again demonstrated that they were able to bring in to the home their personal possessions. Both residents and the visitor spoken with said that visitors are always welcomed to the home and no one reported any restrictions. There were again generally positive views regarding the food though one comment that the food was sometimes bland. Another resident wanted to have more variety at tea time and to have more freshly baked food. The Registered Provider said teas were based on residents choice so this could not be correct but agreed to display the choice prominently in the dining room. Menus were inspected and found to have choice of food each day and the cook was observed to ask residents what they wanted for breakfast. The food tasted at dinnertime, which offered three courses, was found to have flavour with two fresh vegetables served with potato and a choice of fresh fruit dessert, thereby offering a healthy choice of diet. The Registered Provider agreed to review the food with residents. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident in the system of managing complaints. Staff have a generally good level of understanding regarding the prevention of abuse. EVIDENCE: Residents again said that they thought that if there was a problem then they were confident that the management would sort it out. The Complaints Procedure is generally satisfactory and gives the complainant the opportunity to contact the Commission for Social Care Inspection at the initial stage, as per the National Minimum Standard. The Registered Provider is to add that the local Social Service Department is now the Lead Agency for complaints investigations, with these contact details. Complaint records were inspected and there was one complaint since the last inspection. This was investigated in detail by the Deputy Manager and found not proved. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 17 The Registered Provider said there was the occasional complaint regarding the food, e.g. toughness of meat. These concerns need to be recorded and followed up. The Registered Provider said they would be in the future. Policies and procedures for are in place for protecting Vulnerable Adults. Staff members spoken with were aware of most of the full procedure but did not know all the agencies to contact if the in house arrangement failed. The Registered Manager said this would be followed up. It is recommended that a short procedure be set up to remind staff of which agencies to contact. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents see facilities as homely and clean. Odour control is generally of a very good standard. EVIDENCE: Residents said that they liked the facilities of the home and they could organise their bedrooms in the way they wanted. The inspector observed that bedrooms had been personalised and accommodated residents personal possessions. Facilities were found to be clean and odour free in general with only one issue in a bedroom, which the Registered Provider was aware of and taking steps to tackle. Residents said they always found the home to be clean and tidy. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 19 Two storerooms on the first floor were open which was a potential health and safety hazard as they had tripping hazards in the stores. The Registered Provider said this would be followed up by a Risk Assessment and locking them if found to be needed. A first floor bathroom had a lock but it was not working properly. The Registered Provider said this would be attended to. Radiator covers have been fitted to prevent scalding injuries to residents. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels may not fully meet residents needs. Recruitment processes need to be strengthened to ensure full protection of residents from unsuitable staff. Staff training systems need to show that it covers training on all essential issues. EVIDENCE: There were some comments that care staff are very busy, as they have to carry out both care and domestic duties and help in the kitchen at times. The rota and the Registered Provider confirmed that there was normally a minimum of three staff on duty during the morning (one management staff and two Care Assistants) and two staff on duty for the afternoon/evening period plus an awake and sleeping in staff on duty during the night. The Registered Provider said that management also carry out care duties but said that workloads were being looked at and they were actively seeking a cleaner. He agreed to add the sleeping in staff to the rota. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 21 As there are now up to fourteen residents accommodated there needs to be a review of staffing levels to ensure that they are always sufficient to meet needs, and for an increase as necessary. Residents were again very happy with the staff team and said they are very helpful. Three staff files were inspected and contained most of the information required though one staff only had one reference. The Registered Provider that although a verbal reference was obtained he recognised that two written references were needed by law before staff can commence employment and said this would be followed in the future. There was evidence of training by way of training certificates though not all staff had received training on essential care practices – e.g. food hygiene, health and safety, first aid, infection control, dementia, training on residents health conditions – stroke, diabetes etc. The Deputy Manager said that she is in the process of compiling a Training Matrix, so that this would indicate at a glance what training needed to be organised for individual staff members. The Registered Provider and staff stated that there is encouragement to undertake National Vocational Qualification level 2 training and that the home was meeting the National Minimum Standard of 50 of staff with National Vocational Qualification level 2 or equivalent training, and also that staff are due to start this training. Staff said the Deputy Manager goes through a detailed induction programme with them. This was seen to be in the records. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Systems are in place to protect the health and safety of residents though reporting procedures need to be put in place. EVIDENCE: Residents and staff said that they thought the home was run in a positive and friendly manner. Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 23 There was evidence of that Staff Meetings have been held, though the last one was on 7/6/07. It is recommended that meetings be held at two monthly intervals as per the National Minimum Standard. There was no evidence on staff records that staff have ongoing one to one supervision. The Registered Provider said this issue would be followed up. The Registered Provider said the Quality Assurance system is currently being worked on by the Deputy Manager to send out questionnaires to residents other interested parties – GPs, District Nurses, relatives etc to gauge their views as to the services the home provides. It is recommended that the results of this be contained in the Statement of Purpose. The Registered Provider said that they do not keep records of residents monies, as these are dealt with by residents or their relatives. There is a Health and Safety folder with Risk Assessments for safe working practices. Fire Precautions: System testing was on required weekly schedules for fire bell testing and emergency lighting. The Registered Provider said that regular fire drills had been carried out though this had not been recorded in the fire records, and there was a completed fire risk assessment in place. A staff member was asked about the fire procedure and was aware of what to do. The water temperature was taken in a first floor bathroom, which measured 39c from the bath, the National Standard being close to 43c. A water valve had been fitted to ensure residents are not at risk from scalding. As stated in the Report all instances of a serious nature need to be reported to the Commission for Social Care Inspection, e.g. incidents involving hospital treatment, deaths of residents, thefts from residents etc. Alexandra House DS0000049312.V341501.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 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 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 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 1 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 1 Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 25 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 OP27 Regulation 18 Requirement That the Registered Providers review staffing levels to ensure that they are fully sufficient to meet residents needs. Staff must not commence employment without two written references being obtained. All serious incidents regarding residents need to be reported to the Commission for Social Care Inspection under the Regulation 37 procedure. Timescale for action 05/11/07 2. OP29 19 05/09/07 3. OP38 37 05/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Care Plans need to contain the details of essential medical checks – dentist, optician etc so that regular appointments can be made. DS0000049312.V341501.R01.S.doc Version 5.2 Page 26 Alexandra House 2. OP9 The Registered Provider should check with the pharmacist regarding medication security for one medication and have a procedure in place if medication is not delivered. It is recommended that regular residents meetings be held to ascertain views to enable input into planning the home’s services. A review of the home’s food is recommended to look at flavour in food and the provision of home baking. A staff training programme to be set up to ensure staff have received training in all essential issues. It is recommended that staff receive regular supervision to provide a forum for personal development and ensure consistency of care practice. 3. OP14 4. 5. 6. OP15 OP30 OP36 Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Alexandra House DS0000049312.V341501.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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