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Inspection on 30/05/07 for Alexandra Lodge Care Home

Also see our care home review for Alexandra Lodge Care Home for more information

This inspection was carried out on 30th May 2007.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a pleasant, homely, atmosphere, and is kept very clean and well-maintained. Feedback from the service user and relative surveys, as well as from the people individually, was positive, "Alexandra Lodge is run as near to a home from home as possible," and "Everything about this home is first class," were amongst the written responses. Relatives said they are always made to feel welcome and food and drink are always offered. Everyone is treated with dignity and respect and both providers are always approachable. Mr. Cofie-Cudjoe always ensures the he, or someone, goes with any of the residents to hospital or other appointments, for support and reassurance. Care plans contain a range of assessment tools, monitoring the dependency levels, together with plans covering personal and health care needs of residents, which are reviewed on a monthly basis.

What has improved since the last inspection?

Pre-admission assessments are recorded in the care planning, to make sure the home is suitable to meet the needs of residents. Recruitment checks are all in place before staff start work at the home, ensuring staff are eligible to work there and protect residents from potential harm. Improvements have been made in the training of carers, which supports and protects the residents in their care.

What the care home could do better:

Plans must be developed to improve, or maintain levels of physical mobility, as well as maintaining, or improving, mental abilities to help all residents, including those with any dementia, to maintain their full mental and physical potential and well-being. The fridge containing medication must be defrosted regularly and a fridge thermometer placed in it, with the temperature recorded at least daily, to ensure all medication is kept stored correctly to protect it from possible spoilage. Review of the six weekly menus to improve the variations of meals provided, would provide more variety and choice for residents when deciding what to eat. Record keeping, in particular staff files, must be accurate, properly dated and signed, with appropriate identification, including photographs, to ensure staff are eligible to work at the home and to protect the vulnerable residents.

CARE HOMES FOR OLDER PEOPLE Alexandra Lodge Care Home 2 Lucknow Drive Mapperley Park Nottingham NG3 5EU Lead Inspector Lee West Key Unannounced Inspection 30th May 2007 11:45 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 Lodge Care Home DS0000002185.V337551.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 Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alexandra Lodge Care Home Address 2 Lucknow Drive Mapperley Park Nottingham NG3 5EU 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) 0115 9626580 F/P 0115 9626580 Mr Samuel Cofie-Cudjoe Mrs Mercy Cofie-Cudjoe Mr Joseph Crentsil Mrs Mercy Cofie-Cudjoe Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2006 Brief Description of the Service: Alexandra Lodge is a care home registered to provide personal care and support for up to nineteen older people, including people with dementia. Located in a quiet area of Mapperley Park, on the outskirts of Nottingham City Centre, there are local facilities within walking distance and easy access to public transport. The home is a two-storey Grade II listed building, with an added purpose built extension and a well-maintained garden. The older part of the building still has many of its original features. There is one double bedroom and seventeen single bedrooms; none of the bedrooms are en-suite but assisted bathing facilities are provided and there is a stair lift available to residents who have some mobility problems. Fees charged are the same for people funded by social services, or privately funded, at £323.36 per week, with residents paying for extras, such as hairdressing. The registration certificate is up to date and includes the recent variation to accept people with dementia and information on the services provided at the home is available in the reception area. Alexandra Lodge Care Home DS0000002185.V337551.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 on 30th May 2007, starting at 11.45am and ending at 4.30pm. It formed part of the inspection process, which included information gathered by interviewing residents, relatives and staff. Information from 10 service user surveys, 7 surveys for relatives and the pre-inspection questionnaire completed by the manager, together with other records kept within the home and by the commission were also used. The method used was case tracking, where four residents were asked about their experiences and expectations of living at the home and their records analysed. Staff and visitors were interviewed, and the areas of the home used by the service users were inspected. What the service does well: The home has a pleasant, homely, atmosphere, and is kept very clean and well-maintained. Feedback from the service user and relative surveys, as well as from the people individually, was positive, “Alexandra Lodge is run as near to a home from home as possible,” and “Everything about this home is first class,” were amongst the written responses. Relatives said they are always made to feel welcome and food and drink are always offered. Everyone is treated with dignity and respect and both providers are always approachable. Mr. Cofie-Cudjoe always ensures the he, or someone, goes with any of the residents to hospital or other appointments, for support and reassurance. Care plans contain a range of assessment tools, monitoring the dependency levels, together with plans covering personal and health care needs of residents, which are reviewed on a monthly basis. Alexandra Lodge Care Home DS0000002185.V337551.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. The summary of this inspection report can be made available in other formats on request. Alexandra Lodge Care Home DS0000002185.V337551.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 Alexandra Lodge Care Home DS0000002185.V337551.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5, 6, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Potential residents are provided with sufficient information and opportunities to visit the home, to decide if their needs can be met. EVIDENCE: The service user guide contained the information potential residents needed of the service provided by Alexandra Lodge. Residents’ care plans contained evidence of thorough pre-admission assessments, risk assessments and personal preferences to identify care needs and how to deal with them. All service user surveys had positive responses about the level of information they had to decide on the suitability of the home. One quoted, “I rang social services when my relative couldn’t cope. They found this place, she came for a Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 9 visit, it was lovely, and she moved in the next day. I have been very satisfied with the care my relative receives.” A relative visiting said, “I had access to the last report and all the information about the home I needed. My relative then visited and decided to come in.” Residents spoken with said they had been given as much information as they wanted, one said, “I looked at many homes before choosing this one, and I am sure I made the right choice. I have no regrets, they help me in all the ways I need.” It was not possible to assess the help received by people receiving intermediate care as there were none at the time of this inspection visit. Alexandra Lodge Care Home DS0000002185.V337551.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. 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 are thorough and support the residents with specific instructions to meet the residents’ needs, with respect and dignity. Medication procedures were correctly followed, but the fridge containing eye drops needed defrosting and temperatures recording, to make sure medicines were not spoiled by incorrect storage. EVIDENCE: Records of risk assessments were seen in the residents’ files, which were used to develop the care plans. Care plans were thorough, they contained actions required to assist residents. One identified “give verbal descriptions of things, staff need to mention their names,” another, “staff need to put toothpaste onto brush,” for residents with visual impairment. Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 11 Personal preferences in the way help should be given were reflected accurately in the documentation, and there were signed and dated records of regular reviews of the plans. One relative responded in the survey, “They provide a good level of care.” Residents spoken with confirmed they were treated with respect and their privacy respected. They commented that staff always knock on their doors before coming into their room. Another resident explained that when going to hospital appointments, “Sam always goes with me, this is really helpful and reassuring.” The information from hospital visits was seen in the care plans to show this happens routinely. A carer was observed being trained in the correct procedures for storage, administration and recording of medicines. The lunchtime administration of medicines was also observed, with medicines dispensed from a measured dosage system and records accurately completed. Some medication was being stored, as stated on the containers, in the medicines fridge. However, on opening the fridge, a heavy coating of ice was seen, requiring defrosting. There was no thermometer inside the fridge to accurately maintain the proper temperature of the medication stored. There was, however, a gauge on the front, which indicated too cold, safe, and too warm, but the information from this was not accurate, showing “cold,” due to the icing inside.. Residents spoken with were satisfied with the staff administering their medication, but procedures were in place should any resident be able and wish to self medicate. Alexandra Lodge Care Home DS0000002185.V337551.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Physical, mental and social activities are lacking, reducing choices on how residents wish to spend their time, but contact with family and friends is encouraged. The food is wholesome and balanced, but choices are limited, although evidence of provision of meals to meet cultural requirements was seen, to support residents’ cultural preferences. EVIDENCE: There was no evidence of any regular, structured, recreational activities seen and residents confirmed there were no activities. Whilst in the lounge area following lunch though, there were positive, spontaneous, interactions between the staff and residents. The staff put on some music and after a few minutes the residents, who had been sitting with their eyes closed, became interested in their surroundings and began to interact with the staff. Service user and relative surveys also identified the lack of both physical and mental activities. One stated, “my relative appears smaller now, and is unable to move without help.” Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 13 A relative spoken with said they were concerned because there was a “total lack of physical movement” making it difficult for the person to get about, just “pottering from lounge to dining room and bedroom is not activity.” There were a number of residents with varying degrees of dementia, but there was nothing in their care plans, or organised as a group, to stimulate their mental capacity. Family and friends are encouraged to visit the home and are kept informed of their relative’s progress. They are always made welcome, with the positive responses in all of the surveys confirming this and interactions between the manager and visitors were observed to be positive and supportive. Residents have opportunities to spend time with their relatives away from the home, but there was nothing organised for those who are unable to go out with relatives. One relative said, “I visit my relative every day and haven’t seen any activities.” The dining area in the home is small, with residents being served meals at two sittings. Those spoken with said they didn’t mind it being two sittings and they could have meals at any sitting, if there was a space in the dining room. The food served was seen to be appetising and nutritious and residents said, “the food is good”. The survey responses were all positive about the food, but one did say, “the meals can be a bit repetitive.” The menus, which are rotated six weekly, together with a record of the meals eaten for the past month, were supplied, and also contained information on the choices available for each meal. Although there was evidence of choices, review of the menus showed meals were sometimes similar. For example, Menu 1 shows Tuesday lunch as braising steak, Thursday lunch stewing steak. There are sandwiches for tea and supper every day and fish and fishcakes on the menu every Friday. There are African-Caribbean residents living at the home and AfricanCaribbean meals can be accessed through the local African-Caribbean centre, should any of them prefer these. Residents spoken with said they did not wish to have African-Caribbean meals, and were happy with the meals provided, saying, “this is the sort of food I have always eaten.” Alexandra Lodge Care Home DS0000002185.V337551.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. 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. Current complaints procedures assure residents their views and concerns are taken seriously and acted upon but residents have not made any complaints and are satisfied with the service provided. Staff are aware of their responsibilities in safeguarding adults procedures to protect residents from harm. EVIDENCE: The complaints procedure and statement of purpose have been updated to include protection of people with dementia and contained information to support protection and care for all residents Service user and relative surveys all indicated they were satisfied with the way the home dealt with their complaints or concerns and residents spoken with also said they were comfortable in speaking with Mr and Mrs Cofie-Cudjoe, “If I have any worries or am unhappy about anything, I just let them know and they try their best to deal with it.” Staff spoken with explained their role in safeguarding adults and procedures were in place supporting their explanations. At the last inspection there was a Nottinghamshire Committee for the Protection of Vulnerable Adults investigation, following a referral to social Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 15 services regarding bruising to a resident. The records show that this allegation had been withdrawn. Alexandra Lodge Care Home DS0000002185.V337551.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25, 26, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a homely, clean, hygienic and safe environment, with their own belongings personalising their private bedrooms. EVIDENCE: All areas of the home used by residents were clean, hygienic and homely. Furnishings and decorations were well-maintained and personal rooms contained personal possessions. Service user and relative surveys all praised the environment and their own rooms, “everything about this place is first class,” wrote one service user, and a relative wrote, “Alexandra Lodge is run like a home from home.” Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 17 The dining area was small, leading to residents’ meals being served in two sittings, but residents observed and spoken with, were content with this and one said, “I like to take my time with my food and they don’t rush me.” This was also observed as one resident had lunch with the first group and was able to finish whilst the second group were eating their food. All residents spoken with were satisfied with their own rooms and said they had their own personal possessions around them. Alexandra Lodge Care Home DS0000002185.V337551.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. 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. Recruitment procedures are in place to ensure residents are protected, but some records were missing. Staffing levels were sufficient to meet the needs of residents. EVIDENCE: The staff rotas showed sufficient staff working to meet the needs of the residents, and this was reflected in the reduction of incidents to residents recorded in the accident records. During the first lunch sitting the two carers and carer development worker, were observed assisting residents with their meals, leaving the remaining residents with no carers. However, both Mercy and Sam were working with the remaining residents in the lounge areas, assisting them with personal care as well as helping them to the dining area when the first diners had finished. Residents and relatives spoken with said this was usual practice and that Mercy and Sam were always available to help. Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 19 Staff files showed recruitment procedures were being followed, with all containing Criminal Records Bureau checks, which were in place before their start dates. But, one file had no evidence of identification, or photograph. Mandatory training had been undertaken, including First Aid, Moving and Handling, Food Hygiene, Dementia Care, and records of all training were seen in the staff files case tracked. Some carers have just started the National Vocational Qualification training and staff spoken with confirmed they had attended the training. Alexandra Lodge Care Home DS0000002185.V337551.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Mr and Mrs Cofie-Cudjoe have an open style of management, supporting the residents and safeguarding their interests, whilst promoting the safety and welfare of staff and residents. EVIDENCE: Since the last key inspection Mrs Mercy Cofie-Cudjoe has been appointed as the registered manager, and the home has had an application to admit people with dementia approved. During the visit the rapport between the residents, staff and Mr and Mrs CofieCudjoe was observed, and was open and helpful. Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 21 Responses in the service user and relative surveys supported this. One quoted, “when I go to hospital Sam always goes with me, which is so reassuring,” another said, “I feel they try their very best they can for the people in their care. They are very caring and do a good job.” Residents spoken with said they could have their own money whenever they needed it. Records of their finances were accurately kept. The pre-inspection questionnaire, sent to the Commission, identified the dates of the health and safety checks undertaken to protect residents and staff, and these were confirmed with records kept in the home. Quality surveys had been completed by residents and relatives, to audit all aspects of care, such as friendliness of staff, cleanliness of the home, the choices of meals, and general views on the care received. Records of these replies were seen. A relative spoken with about the audit said, “the only real way to judge this is on results, which are very good.” Alexandra Lodge Care Home DS0000002185.V337551.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 3 3 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 x 3 Alexandra Lodge Care Home DS0000002185.V337551.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 OP8 Regulation 16(1) Requirement You must develop and implement a programme of activities to provide residents with opportunities for exercise and physical activity, taking into account the needs of each resident, to maintain, as far as possible, their physical wellbeing and mobility. Timescale for action 30/08/07 2. OP12 16(2) 3. OP29 19(4) 30/08/07 You must develop and implement, following consultation with the residents, a programme of group or individual activities, to provide opportunities through leisure and recreational activities to provide residents with mental stimulation, paying particular attention to residents who have elements of dementia. . You must ensure that all staff 06/08/07 records contain evidence of identification, to confirm the eligibility of the person to work there and to protect the residents. Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 24 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 OP9 Good Practice Recommendations You should make sure the fridge containing medications is kept ice-free and the temperature checked to maintain any medicines kept in the fridge at their proper storage temperature. Reviews of the menus to introduce more variety into the daily meals, particularly, the teatime sandwiches, would provide residents with more choices. 2. OP12 Alexandra Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 25 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 Lodge Care Home DS0000002185.V337551.R01.S.doc Version 5.2 Page 26 - 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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