CARE HOMES FOR OLDER PEOPLE
Benoni Nursing Home Ltd Benoni 12 Carrallack Terrace St Just Cornwall TR19 7LW Lead Inspector
Stephen Baber Key Unannounced Inspection 5th June 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 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. Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Benoni Nursing Home Ltd Address Benoni 12 Carrallack Terrace St Just Cornwall TR19 7LW 01736 788433 01736 788433 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) Benoni Nursing Home Ltd Ms Susan Janice Mason Care Home 21 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (21), of places Physical disability over 65 years of age (2), Terminally ill over 65 years of age (2) Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To admit four named service users from age 55 years to 64 years of age. 25th October 2005 Date of last inspection Brief Description of the Service: Benoni is a detached building situated in a residential area of St Just. The home is registered to provide accommodation and care, with nursing, for a maximum of 21 service users. This can include two service users with a physical disability on admission and two service users with a terminal illness on admission. The home is also registered to accommodate four service users from age 55 years of age to 64 years of age. Bedrooms are situated on the ground floor and first floor, and there are three bedrooms for service users receiving residential care on the second floor. There are three double rooms. The first and second floors are accessed by a shaft lift. The grounds are modest in size and there are areas for sitting outside. The slope from the road and car parking area to the main door is fairly steep in places, but is negotiable by a person in a wheelchair with assistance. There is a small step and a threshold at the main entrance; these are accessible with a wheelchair with assistance. The home has a strong link with the community and town of St Just. The registered provider is Benoni Nursing Home Ltd. The responsible individual is Mrs Helen Hutson. Fees range from £288 to £520 per week. Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on 5th and 6th June 2006 and was a key inspection. The duration of the inspection over two days laws 12:5 hours. The purpose of the inspection was to ensure that service users’ needs are appropriately met in the home, with particular regard for ensuring good outcomes for them. This involved looking at the full range of documents, examination of the home’s written policies and procedures and records kept to ensure the welfare and protection of service users living there. It involved a tour of the home’s premises, interviews with service users and visiting relatives and observation of the daily life of the home. Time was spent discussing the management of the home with the manager. The principle method used was case tracking for service users and staff. This involves examining the care notes and documents for a select number of service users and following this through with interviews with them and staff working with them. This provided a valuable insight and enables me to gain a fuller picture on how service users needs are being met in the home. At this inspection, three service users were case tracked and two staff files. Overall the views and opinions of the service users and their representatives was management and staff do all they can to meet their needs. A typical comment from service users was “I am very happy with no complaints to make”. What the service does well:
Although the home does not have specific facilities for rehabilitation, it is able to provide occasional short-term or respite care to four service users from age 55 years of age. This is dependant on vacancies and the assessed needs of people requesting this service. In these situations, service users are helped to maintain and/ or recover their skills, confidence and independence, with input from external professionals, if necessary. Service users have good access to a range of local healthcare providers. Their healthcare needs are considered in their individual assessments, prior to their admission to the home to ensure that their needs can be met there. Their ongoing healthcare needs are considered in their individual care plans and regularly reviewed. One group of relatives said from what they observe when they visit staff are very caring and friendly . Most of the service users interviewed at the time of the inspection indicated that they are satisfied with the care and services provided to them. Ongoing
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 6 training is provided for staff to update their skills and knowledge. One Care assistant new to the care profession said that she was pleased to do her NVQ training and obtain a national recognised qualification. What has improved since the last inspection? What they could do better:
At present assessments and care planning evidence very little change to people’s circumstances. Reviews take place with no written update to reflect the changing needs and current objectives for health and personal care and actions to be taken. Service users and/or their representatives should be actively encouraged to be involved in the care planning process so that they give their agreement to the care to be given. Photographs of service users are required on their care plan. Appropriate signatures from interested parties should be provided as evidence of their participation and agreement with the care planning process. The manager and nursing team should completely review the medication system with regards to how medication dispensed to service users is signed for, storage of unwanted medication should be returned in line with the policy of the home and consideration should be given to a bigger medication cupboard to allow for the better presentation and storage of medication. Some of the policies and procedures require amendments and improvement to update them with correct information such as the complaints procedure and statement about how the needs of the four service users that can be accommodated from age 55 years of age would be met should be included in
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 7 the Statement Of Purpose. The Adult Social Care department should now replace Cornwall County Council Social Services and procedure for the length of time for the retention of CRB forms. Index for the policies and procedures would make the information more easily retrievable. Planned improvements to make the home’s environment safer and more comfortable for service users should be carried out, including replacement of the carpet in the hallways of the ground and first floor. The ramped area from the car park has many potholes and may be dangerous for people. The holes should be filled in which would make it safe for all who wish to live and visit the home. Risk assessments for individual service users and the environment should be carried out and that significant findings of the risk assessment are recorded. 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. Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 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 Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective service users receive written information about the home to support them in making a choice. The needs of service users are assessed before they move in so that they can be assured that the home can provide adequate care. The home does not have specific facilities for rehabilitation but appropriately meets the needs of service users admitted for short term/respite care. EVIDENCE: The provider and manager have recently written a Statement of Purpose and Service User Guide. These documents will now be issued to prospective service users and their families or representatives. Some amendment should be made to these documents to include how the home will meet the needs of the four service users who will receive respite and short stay care from age 55 years. Also the complaints procedure should be included in the Statement Of Purpose. Three service users files were case tracked
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 10 The files evidenced that the manager carries out a needs assessment on all prospective service users. The service users files included, for example, a moving and handling assessment, a tissue viability assessment, pain and nutritional screening assessments. The assessments, in the main, covered the issues for assessment specified in standard 3.3, although they lacked detailed information about the social interests, activities and religious needs of service users. The format should allow for a more person centred approach to assessment and provide more detail about prospective service users’ needs to inform staff and future care planning. Service users and/or their representatives should be invited to sign their assessments as evidence of their participation and agreement. Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Service users have individual written care plans but they need to accurately reflect needs and should be shared with service users. Service users’ are assisted to access the healthcare services they need. The home’s procedures and storage facilities for managing service users’ medication need to be readily accessible so that staff have clear guidance to prevent medication errors. Service users confirmed they are well cared for and their privacy is respected but some specific improvements are required to improve this. EVIDENCE: The home’s care plan format provides information on service users’ needs. Improvements should be made to include more information about the social interests, activities and religious needs of service users. The format should allow for a more person centred approach to care planning and provide more detail about prospective service users’ needs to inform and direct staff. Care plans must have photographs of service users and service users and their representatives should be encouraged to be part of the care planning process
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 12 so that agreement can be reached on the care to be given. Evidence shows that care plans are reviewed but there is only the date and no written update to reflect the changing needs and current objectives for health and personal care and actions to be taken. Information recorded in care plans should be accurate and up to date particularly for those service users in for short term care and who will be returning to their own homes. Service users’ care plans consider their health care needs and show that they are assisted to access a range of local health care professionals. As identified at the inspection a thorough review of the storage and administration of medication. Medication dispensed to service users was difficult to follow from the medication sheets and the medication cupboard was full of medication, which was not presented well. There was also medication in the locked inner unit that needed to be returned. Service users interviewed at the time of the inspection confirmed that they are well cared for and their privacy and dignity is respected. The relatives I spoke with said that they visit regularly and have observed the staff respecting the privacy and dignity of the service users Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13,14,15. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home works to open visiting arrangements and service users know that they can entertain their family and friends in their own rooms or the community areas of the home, however further work should be carried out to establish the social interests, activities and religious needs of service users. The format should allow for a more person centred approach and provide more information about service users’ needs to inform staff and future care planning. The food in the home is of a good quality, well presented and meets the dietary needs of the service users. Staff are trained to help those service users who need help when eating and are sensitive in their approach. EVIDENCE: Service users and their representatives generally felt that the home offered flexible routines in daily living activities. They provided positive comments on the kindness and sensitivity of staff. Due to the great ages and general infirmity of the service users activities were more of a passive nature. The care plans do not detail the service users personal preferences in daily routine, lifestyle and social activities. It would also be good practice for care plans to include the life story of each service user. The relatives I spoke with said they were satisfied with the visiting arrangements
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 14 Rooms had been personalised by the service users with treasured pieces of furniture, pictures and ornaments. Service users were positive about the food and catering arrangements. There is a choice at breakfast. The main meal at lunchtime is based on a four week menu, with two choices each day. Tea is a range of savoury dishes. The menu details a varied and nutritious diet. The home is currently providing some diabetic and special diets. Meals are taken on small tables placed in front of the service users. This means that there is no change of environment and opportunity for social interaction to take place. The environmental health officer report dated 06/02/06 reported that some recommendations were required. The providers will address the areas identified by The E.H.O. when finance permits. Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 15 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): Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service.There are good systems in place to ensure that service users’ complaints are listened to and acted upon. Benoni has policies and procedures regarding protection of service users are satisfactory but all staff should be given training in this area so that they know what immediate action to take and when and who to refer any incident on to. EVIDENCE: The service users told that they would know how and to whom they could make a complaint. New folders have been prepared for new service users with a copy of the complaints procedure available for them. The complaints procedure should be included in the Statement Of Purpose, which is the legal document for the home. There have been no complaints received by the Commission since the last inspection in October 2005. The home has an adult protection policy which makes reference to “No Secrets” “ Whistle Blowing”and the role of the the Local Authority procedures regarding Adult Protection. The Manager and staff member have recently completed training in Adult Protection. Staff who undertake NVQ training cover adult protection but all staff must receive Adult Protection training regularly. Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home’s environment is mainly safe and well maintained although some specific improvements are still needed. EVIDENCE: The home is comfortable and warm, well furnished and has been redecorated. There have been improvements since the previous inspection with provision of equipment, new beds and carpets in some areas of the home. There are plans for more improvements, to make the home safer and more comfortable for service users, which should be implemented. The providers should consider replacing the worn carpet in the hallways of the ground and first floors. Also the steep ramp area from the car park to the home has many potholes and needs to be made safe so that no injury will occur
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 17 Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There are adequate numbers of qualified staff to meet service users’ needs. Service users are generally satisfied that the care they receive meets their needs, but there are occasions when they cannot get the help when they want it and they have to wait. The service has a recruitment procedure that is adequate and generally meets the regulations and National Minimum Standards but further improvement should be made to safeguard and protect the service users. EVIDENCE: The Registered Manager said she aims to maintain a care staff/service user ratio of 1:4 although extra staff are brought in if the need arises. There is a qualified nurse on duty at all times. There are domestic, catering and maintenance to support the home. There are times when the manager works as part of the care team but sufficient time is allocated to undertake her management role. The home has achieved minimum 50 trained members of care staff (NVQ level 2). There was written evidence in the home that staff have undergone enhanced CRB checks but the manager should follow the guidance issued by CRB regarding the retention of the disclosures. There was a lack of full evidence that recruitment of staff is fair, safe and effective, in the
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 19 form of completed application forms and interview records, two references, job descriptions, person specifications. There were no copies of full employment histories for staff employed. Individual records of staff training have improved but there is still no whole team training and development plan. Some staff lack training in key areas, such as, health and safety, emergency first aid, basic food hygiene, moving and handling, risk assessments, multi-agency training in the protection of vulnerable adults from abuse and infection control. The manager did say that the nurses often give onsite training to the staff on specific topics. The manager has brought up to date individual 1:1 supervision with records kept and there are regular team meetings. A staff member said they feel well supported by the manager and nurses and enjoy being given training opportunities. r Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The manager is qualified and has the necessary experience to run the home, is aware of and works to the basic processes set out in the National Minimum Standards. Fire training and safety checks are undertaken, however more attention must be given to health and safety training for all staff, which includes familiarisation with the policies and procedures to ensure the health safety and welfare of service users and staff. EVIDENCE: The management endeavour to ensure that working practices are safe. Mrs Sue Mason has been working at the home for 6 years and has been the registered manager of the home for most of that time. She has a nursing and
Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 21 management qualification and extensive experience of the care of older people. There was no formal quality assurance process carried out recently. However, the manager is about to send out the Quality of Service survey for 2006. The member of staff responsible for the checking and training of staff discussed the other systems in place – for example the use of a maintenance record to inform the handy person of work required, fire training and temperature and legionnaires testing that was in place and up to date. Records showed that staff had received regular formal recorded 1to 1 supervision. Evidence is required that staff have received training in the polices and procedures relating to Health and Safety. There was no evidence of environmental risk assessments to ensure that the home is safe for the more dependent service users. It was noted that the area leading to the home from the car park has many potholes and may prove dangerous for service users and their visitors. The lift shaft that ascends from ground to the second floor and hoists for transferring service users had records for recent services. The fire records evidenced that checks on the alarms, automatic-closing doors, emergency lighting and fire-fighting equipment were being carried out at recommended intervals. The records for fire training documented that all staff but three had recived fire training at the recommended intervals. A monthly check is carried out for Legionella with records detailing what has been carried out. The laundry room is situated outside the home in a building within the grounds. There is a laundry person who takes responsibility for all personal and the homes laundry. Protective clothing and disposable gloves are used and the laundry person is aware of the Control Of Substances Hazardous to Health (C.O.S.H.H.) Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 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 2 X 3 X X X 2 X X X X X X 3 X HEALTH AND PERSONA CARE Standard No Score 7 2 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 2 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 2 X X X X 2 Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 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 OP7 Regulation 15 Requirement Care plans must be shared with service users, contain a photograph of the them, have individual environmental risk assessments, a narrative on the outcome of the review and action to be taken and more information on the social, emotional and any special needs the service users may have. A complete review of the medication storage and administration and dispensing of medication must take place. Timescale for action 31/10/06 2 OP9 13(2) 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations The Statement Of Purpose should detail the complaints procedure and a statement to detail how the home will
DS0000061997.V292689.R01.S.doc Version 5.1 Page 24 Benoni Nursing Home Ltd 2 OP3 3 4 5 6 OP18 OP19 OP29 OP38 meet the needs of four service users who may be accommodated for short stay care. Assessments should record the information about the social interests, activities and religious needs of service users. The format should allow for a more person centred approach to assessment and provide more detail about prospective service users’ needs to inform staff and future care planning. Service users and/or their representatives should be invited to sign their assessments as evidence of their participation and agreement. Social activities Staff should receive training in Adult Protection. The ramped area to the home should be made safe and carpets in the ground floor and first floor corridors should be replaced as part of the ongoing improvement plan. The staff files should be more comprehensive with the required information set out in schedule 2, 9 and 19. All staff should receive training and be familiar with the Health and Safety policies and procedures of the home Benoni Nursing Home Ltd DS0000061997.V292689.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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