Inspection on 17/01/07 for Broadland House

This inspection was carried out on 17th January 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

Broadland House 26/10/07

Broadland House 09/11/05

Broadland House 12/04/05

Broadland House 19/10/04

Broadland House 18/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Broadland House Bridge Road Potter Heigham Great Yarmouth Norfolk NR29 5JB Lead Inspector Hilary Shephard Key Unannounced 17th January 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Broadland House DS0000059149.V327969.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. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broadland House Address Bridge Road Potter Heigham Great Yarmouth Norfolk NR29 5JB 01692 670632 01692 670632 susan.hollyman@virgin.net 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) Mrs Susan Hollyman Mr Raymond Hollyman Position vacant Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Twenty (20) Older People who may have Dementia may be accommodated. Total number not to exceed 20. 9th November 2005 Date of last inspection Brief Description of the Service: Broadland House is a care home providing personal care and accommodation to 20 older people who may also have dementia. The home is privately owned and changed hands in 2004. The new owners are experienced providers having two other homes in the area. Broadland House is located in Potter Heigham and is within walking distance of shops and other facilities. The service has 16 single bedrooms and 2 double rooms. Eight of the single rooms have en-suite toilets. The home informed CSCI of its charges in December 2006 and charges from £325 to £358 per week for care provision. Residents are expected to pay extra for hairdressing and chiropody at a cost from £8 - £20. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgments for each outcome group. A total of 7 requirements and 1 recommendation were made as a result of this inspection. What the service does well: What has improved since the last inspection? Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 6 Two new single bedrooms with en suite toilets have been built on the first floor increasing the amount of accommodation provided. A new carpet has been laid on the first floor. 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. Broadland House DS0000059149.V327969.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 Broadland House DS0000059149.V327969.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 Quality in this outcome area is good. Residents’ needs are assessed before admission and the assessment forms part of the care plan. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No changes have been made to the way residents are assessed prior to admission since the key inspection visit in April 2005. The home continues to use a satisfactory written assessment process, which is used to provide information about peoples needs when they move into the home. Residents’ files contained a brief care plan, which is put together when they are admitted and expanded on as they settle in. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 9 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 adequate. The outcome of this group of standards could be good if medication was recorded and administered safely and care plans had fuller guidelines with evidence to support residents needs are addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection carried out in April 2005 found that residents’ health care needs were met in most areas, some risk assessments needed improvement and care plan guidelines for staff needed to be better and clearer showing staff how to meet the residents identified needs. The inspection carried out in November 2005 found improvements made to care plans, which indicated an approach to care whereby staff promoted resident choice. Risk assessments and evidence of reviews were in place. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 10 The January 2007 inspection visit found care plans were set out in a way that encouraged staff to provide residents with individualised and person focussed care. The guidelines for staff to follow were brief in the four care plans looked at and didn’t provide enough detail about how residents needs were to be met. One residents care plan for mobility did not have enough for care staff to follow to minimise the risk of falling. This person had fallen 5 times since September 06. This care plan failed to contain detail about the residents footwear, diet, medication or frequency of infections that could be linked to the falls. Guidance for how residents like to be dressed was too brief. One care plan indicated staff should help the resident choose what she wanted to wear, but did not contain any information about her preferred choice of clothes, how she likes to maintain her appearance, wearing makeup or bathing. Care plans for social and emotional needs were also brief with some good detail and some poor. One care plan contained good information about a residents like for gardening and flower arranging but apart from one entry in the daily record there was no recorded evidence to suggest this need was being addressed. Care plans omitted assessments for nutrition and pressure areas. The acting manager stated that although care plans are completed for residents who have special needs relating to diet and pressure areas, there is no assessment format to provide up to date information about each residents nutritional status or pressure areas. No residents have pressures sores at the current time. Observations and discussions with residents indicated their healthcare needs are being met but the home fails to adequately record this. Risk assessments are basic and brief and do not look at risks for each individual with regard to falls. The home has a good robust risk assessment format for the premises, which needs to be adapted for residents. Observations showed staff continue to treat residents with dignity and respect but give them plastic cups instead of glasses for drinks. The acting manager said she was worried residents may damage themselves on the glass and sometimes glasses get thrown. This however is not addressed on an individual risk assessment basis. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 11 One comment card returned so far indicates this person is very satisfied with the care “The staff at Broadland House have proved to be exceptional in their dealing with my mothers severe problems. I cannot praise them highly enough.” One relative spoken with during the visit said he was very happy with the care his wife receives at the home. Two residents spoken with at lunchtime indicated they were happy to live in the home. The inspection carried out November 2005 found that management of medication was good but the home was not risk assessing residents who chose to self administer medication. Medication was inspected at the January 07 visit. The home doesn’t use any type of monitored dosage system for administration of medicines and senior staff dispense medicines directly from the pharmacy containers. Medication administration records (MAR) were checked and an attempt was made to audit some medicines. MAR charts are renewed at two weekly intervals and the amount of tablets received is recorded in a book but not on the MAR chart. This made it very difficult to accurately assess how many tablets have been given against the stock in the home therefore it was not possible to complete an audit trail of medicines received, administered and destroyed/returned. Prescribing instructions for a resident prescribed Warfarin stated “to be given as directed by Doctor” on the MAR and the medicine container stated “dose on yellow card”. The acting manager advised the yellow card is kept at the GP surgery and the home is informed of the dose to be given once the resident has had a blood test. No record was seen of how many tablets are to be given or have been given. There were also dates crossed through on the residents MAR which the acting manager said were when the resident should not have the Warfarin. Again this was not clearly indicated on the MAR or in a care plan. Staff were observed giving medication and did this safely. The acting manager advised that a member of staff from another of the providers homes completes a regular stock control audit and evidence of this was seen. Requirements have been made regarding care plans and medication. Broadland House DS0000059149.V327969.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 good. Residents enjoy the lifestyle and food provided in the home This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection carried out in November 05 found residents were able to exercise choice and control over their lives and maintained contact with family and friends. There was some social activity available. The January 07 visit saw staff interacting well with residents and staff spoken with had a good understanding of how to engage with residents. One member of staff spoke of how activities such as manicures, one to one, group games, knitting, reading and chatting were undertaken with residents. Daily record entries in care plans were brief and most did not provide any useful information about how residents had spent their days. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 13 Generally care plans did not contain enough information about residents’ life histories, activities and occupation. Observation and discussion showed one resident clearly wanting to be kept busy as she was used to being busy throughout her life, but her care plan did not reflect the type of occupation she wanted to be involved with. The care plan of another resident showed her need for occupation had been identified but guidelines for staff to address this and enable her to participate in some occupation was poor. The daily record entries for that resident showed some periods of aggression and wandering which can indicate boredom, frustration and lack of occupation. Nothing was recorded in her plan about addressing those episodes. Staff arranged an activity session during the afternoon of songs and singing and was enjoyed by most residents. Some residents chose not to join in because it was too noisy but were happy to amuse themselves around the home. Relatives were seen in the home and were made very welcome. The inspection carried out in April 05 found a reasonable range of food was provided which was appreciated by residents. The January 07 inspection visit found the food to be of good quality, nicely presented and enjoyed by residents. Lunch was taken with residents and was very good. No choice of main meal is offered and two residents spoken with at lunch were not sure if they wanted a choice of main meal and were quite happy with the way things were. Choice however, is provided in other ways, residents are offered and encouraged to make choices about where they sit, what they drink, what they wear and what they do with their day. At lunchtime, staff were seen to gently and discreetly assist residents who needed help and were very attentive and helpful throughout the meal. A recommendation has been made about choice of main meal. Broadland House DS0000059149.V327969.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 adequate. Residents are supported by a robust complaints and adult protection procedure, however, safe recruitment practices must be used to protect residents from potential harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection carried out in November 05 found that the home had a satisfactory complaints process. Procedures and training were in place to offer residents protection from abuse. The January 07 visit found the home continues to manage complaints well and residents and relatives spoken with knew who to take their concerns to and were confident their concerns would be addressed. The home has a good structure for recording concerns raised and evidence was seen that concerns were managed well and to the complainant’s satisfaction. Information received from the provider in January 07 indicates that staff have received training in abuse and adult protection. Recruitment practices have been reported on under “Staffing”. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 26 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home provided an enabling internal and external environment that addressed the needs of people with dementia and residents were protected from the risk of potential burns from uncovered radiators and hot pipes. This judgement has been made using available evidence including a visit to this service. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 16 EVIDENCE: The inspection carried out in April 05 found that the provider had made improvements to the premises to make the home safer and more comfortable for residents. The home was somewhat run down when the current provider took over (April 04) and a plan of improvement was established. The inspection carried out in November 05 found that more redecoration, refurbishment and work to ensure safety had been carried out. There were plans to further improve the environment and the garden. The building was clean with no unpleasant odours. A new conservatory had been added to the lounge and a new assisted bathroom created on the first floor of the home. The January 07 inspection visit found the corridor carpet on the first floor of the home had been replaced. Two new bedrooms have been built on the first floor which has increased the homes registration to accommodate up to 20 older people. The garden remains tatty and unkempt and the providers advised they plan to improve this. The home had a very comfortable and homely atmosphere and was clean and smelled pleasant. The home lacked cues for residents to find their way around and hadn’t made use of any up to date research into providing an enabling environment for people with dementia. The following areas requiring improvement were noted: The fire door near to room 2, ground floor did not close fully Most radiators were without covers and some were hot to touch There was exposed hot pipework from the radiators on the ground floor Some windows were without restrictors Handrail in newly decorated part of home upstairs was missing The window catch in room 5 was broken off No names on residents doors or memory cues to help them find their rooms/communal areas/toilets The new conservatory was cold, smoky and had no integrated heating, it was difficult to access because of a large step and the glass door was not easily identified as glass causing potential harm. The April 05 visit identified that most radiators were guarded and others were risk assessed as being safe, however this visit showed that not to be the case. A requirement has been made regarding the environment and garden. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home followed safe recruitment procedures. Residents receive good standards of care, which is provided by competent and well trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection carried out April 05 found staff to be well trained and providers putting a great emphasis on providing good quality training. The inspection carried out November 05 found the home had a consistent staff team who were able to meet the needs of residents in an appropriate and safe way, staffing levels were sufficient and staff files demonstrated a generally sound recruitment process. The January 07 inspection visit found sufficient numbers of competent staff on duty providing a good standard of care to the residents. Staff were spoken with and confirmed the training opportunities are very good and dementia care training was planned for the following day. The acting manager advised they are using new induction standards introduced by Skills for Care in November 06. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 18 Files of two new staff members were checked and showed the homes recruitment practices had slipped and they were not thoroughly vetting staff before commencement. Both files failed to contain two written references and one contained a “to whom it may concern” reference, both staff commenced before the receipt of their criminal record check and there was no evidence of any checks made on the protection of vulnerable adults (POVA) register on their files, however, the provider stated this had been done. The criminal records checks were not available on staff files as one of the providers had taken them home. This happened at the November 05 inspection visit and the providers were requested then to make sure the checks were always available for inspection. It was not clear when references had been received as they were undated. The acting manager carries out interviews and keeps a written record, however these were undated and did not provide evidence that gaps in employment were being explored and one application form indicated a gap in employment of 5 months. Requirements have been made regarding recruitment. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38 Quality in this outcome area is adequate. The outcome of this group of standards could be good if the home had a manager who was qualified and registered and ensured measures were in place to minimise potential risk of harm to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection carried out November 05 found that the home was without a registered manager and a trainee manager was in place. The registered manager left soon after the new owners took over in 2004 and the home has not had a registered manager since then. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 20 A trainee manager who has been in post since 2005 currently manages the home. She has completed 2 (of 10) units of the registered managers award (RMA) but no formal accredited dementia care training. The January 07 inspection visit found the home to be competently managed but with areas that need urgent improvement: • • • • Some aspects of safety (radiators, fire door) Recruitment practices Care planning Medication One of the providers regularly visits and works in the home and offers a good level of support to the acting manager. Senior staff from the providers other two homes also visit and offer their support. One relative spoken with said he was happy with the way the home was run. The provider advised they have just completed a quality survey consisting of sending questionnaires to relatives, residents and healthcare professionals. They have yet to compile a report or feedback to participants. Although the provider visits the home frequently she does not complete formal quality monitoring. Records of fire alarm testing and servicing were checked and testing of fire alarms had not been recorded since 29/12/06. Maintenance records indicate home monitors hot water temps and none exceeded the recommended temp of around 43º. Fire risk assessment had been completed in February 2006 but no indication on the file to confirm the recommendations from that had been addressed. Residents finances were not looked at, however, the inspection carried out in November 05 found that the home looked after personal monies for a number of residents and records checked then were accurate. Requirements have been made regarding safety. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 2 2 X X X X X 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 2 X 3 X X X X 2 Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? None 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 (1) Requirement Timescale for action 30/04/07 2 OP8 15 (1) 17 Schedule 3 (m) 3 OP9 13 (2) The registered person must ensure that care plans contain full and clear written guidelines in respect of how the residents identified individual needs are to be met. The registered person must 30/04/07 ensure that care plans contain details and assessments of how residents’ health and welfare needs are to be met, in particular needs relating to nutrition, pressure areas and falls. The registered person must 31/03/07 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home, particularly with regard to: 1. all medicines must be accounted for within an audit trail 2. Prescribing instructions for all medicines must be clear. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 23 4 OP19 23 (1a) (2a, n) 5 OP20 23 (2) (o) 6 OP29 19 Schedule 2 7 OP38 13 (4, c) The registered person must ensure the physical layout and design of the environment meets the needs of the residents, particularly those who have dementia. The registered person must ensure that the external grounds provided for residents are suitable, safe and well maintained. The registered person must not employ anyone unless full and satisfactory information is available about them as detailed in Schedule 2 of The care Homes Regulations 2001. The registered person must ensure that unnecessary risk to the health or safety of residents are identified and so far as possible eliminated. Particular attention should be paid to: • Radiators • Hot pipes • Fire doors • Window restrictors 31/07/07 30/09/07 31/03/07 31/07/07 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 OP15 Good Practice Recommendations The registered person should discuss offering choices of main meals with all residents and relatives and take action as necessary. Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 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 Broadland House DS0000059149.V327969.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!