Inspection on 30/05/08 for Canadia

This inspection was carried out on 30th May 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Canadia 07/04/09

Canadia 28/11/07

Canadia 31/05/07

Canadia 17/08/06

Canadia 28/02/06

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Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 23/11/2008.

CARE HOMES FOR OLDER PEOPLE Canadia 41 Pearson Park Hull East Yorkshire HU5 2TG Lead Inspector George Skinn Key Unannounced Inspection 30th May 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Canadia DS0000064770.V362410.R03.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. Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Canadia Address 41 Pearson Park Hull East Yorkshire HU5 2TG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered registered manager (if applicable) Type of registration No. of places registered (if applicable) 01482 341434 Mrs Heather Feeney Mrs Nicola Jayne Owens Jennifer Rose Watson Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th November 2007 Brief Description of the Service: The Canadia is a three story semi-detached building situated in Pearson Park close to the centre of Hull. It is a period property and the front of the house still gives that impression. The home is on a bus route to the city centre and a short walk from Newland Avenue shopping area. Service users can access a small area to the front garden in warmer months and there is parking space to the side of this for two cars. Service user care only is provided, to a maximum of sixteen service users and mostly in double rooms; 7 of the 9 rooms are double accommodation. Only one bedroom has en-suite facilities of a toilet and a shower. Two lounges offer a pleasant environment in each, while the dining room is extremely small, resulting in some service users having to eat at tables in the lounges and others finding it difficult to get into their places at table. The laundry is sited in a wooden garage at the side of the house. Current weekly fees are £288 per week. Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include: • • • Reviewing information that has been received about the home since the last inspection. A visit to the home carried out by two inspectors. Information provided from surveys. A site visit was carried out which lasted 9 hours over 3 days, which included an evening visit. People who live at the home, relatives and staff were spoken with. Records relating to people, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home. What the service does well: What has improved since the last inspection? The home has improved the information which is given to anyone who wants to move into the home. This now has up to date information about the home so they can make an informed choice. The home have also improved the way the information is recoded about the people who live at the home so the staff can care them properly and they can provide the best care that the home can offer. Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 6 The home have redecorated the hallway and replaced the lounge and the hallway carpets. The home have also replaced the chairs in the lounges and made sure they have followed the environmental health officer’s requirements and have made safe areas of the ground floor. The home has repaired the drive and this no longer poses a trip hazard to both people who live at the home and relatives. The home has made sure that the staff have received the proper training around the health and safety to prevent the people being put at risk of harm. The home has also made sure that the proper checks are done with the Criminal Records Bureau (CRB) for the staff so people are not put at risk of harm or abuse. 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. Canadia DS0000064770.V362410.R03.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 Canadia DS0000064770.V362410.R03.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&6 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s needs were assessed prior to moving into the home, this tells the home what their needs are. EVIDENCE: The records of those people who live at the home were looked during this site visit including those who had recently been admitted. It was found that all had community care assessments, which had been undertaken by the placing authority, and basic assessments undertaken by the home. At the last inspection it was noted that the Statement of Purpose had not been updated to include details of the registered manager. This has now been done and example was seen during the site visit. This has not been distributed to every one yet. Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 9 The home continue to have agreed contracts/terms and conditions were on peoples files. This ensures that both parties understand their responsibilities with regard to their stay at the home. The home does not admit people for intermediate care. Canadia DS0000064770.V362410.R03.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 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Everyone who lives at the home has a care plan which they have been involved in and agreed; this tells the staff how to care for them. The way the home handles medication ensures the safety of the people who live there. This is because staff have had the proper training and there are procedures to follow. EVIDENCE: A sample of peoples care plans was looked at during the site visit. We found that these contained assessments undertaken by the placing authority and basic assessments undertaken by the home. The homes assessments were generic and identified areas of strengths and those areas where the people needed assistance. Risk assessments were undertaken around falls, daily living tasks, mental health and nutrition. At the last inspection it was noted that the updating of these risk assessments was variable and it was not Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 11 possible to always find when these had been updated or changed along with the changing needs of the person. We saw written evidence during this site visit which indicated that the home had improved the way the care plans were up dated and there was evidence of regular up dates and accurate information. The changing needs of the people was monitored better and the home had provided some lifting aids for the staff to use to assist those people who needed this. We saw that people had agreed their care plans and had been involved with the formulation. Most of the care plans contained information on the people’s wishes and arrangements upon death. It was identified at the last inspection the recording of information around nutrition and weight was variable, this has now improved and there was written evidence in the care plans that people’s nutritional intake and weight is monitored on a regular basis, and referrals to the dietician when needed. The home has a key worker system, and when interviewed the staff who are key workers were able to describe the person’s needs and how these should be met. People who live at the home continue to have access to health care professionals some people visit their own GP independently others are supported by the home. There was evidence of other health care professionals visiting people and being involved in reviews. The homes medication is handled appropriately and records were up to date and accurate. At the last inspection the home were required to ensure that all those staff administering medication had received accredited training; staff files indicate that this had been complied with, and staff confirmed this when interviewed. One person who lives at the home self medicates and is actively involved with the monitoring of his diabetes. The staff were observed to treat people with dignity and respect, they were courteous and addressed people using their preferred form of address at all times. Conversations were relaxed and respectful and people seemed to be used this interaction responding appropriately to the staff. One of the people who lives at he home has been deaf from birth, observation made during the site visit indicated the staff were communicating with him very well, they commented that he did not use British Sign Language but communicated his needs very well to them. He has been provided with aids in his room to enable him to know when some one is at the door and when the fire alarms are being activated. When we spoke with the people who live at the home they were very positive about the standard of care one person told us that “the girls are very kind and caring” another one said “ they always make sure I’m safe”. Canadia DS0000064770.V362410.R03.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 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care home supports people to follow personal interests and activities and People are able to keep in touch with family, friends. People are as independent as they can be and lead their chosen lifestyle. People have healthy, well-presented meals, however the availability of snacks for those with diabetes is limited. EVIDENCE: Observation made during the site visit showed us that the staff have a good relationship with the people who live at the home and interaction was informal and relaxed. Staff were sitting chatting with people and engaging those who have dementia well. The people who are more able and independent continue to engage well with the staff and were able to go about their daily lives and exercise choice. The people who are able to leave the building independently are supported to do this; people go out with relatives on a regular basis. Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 13 People continue to be well occupied and the home provides activities on a daily basis, this ranges from craft afternoons to sing-alongs using a Karaoke machine. Staff undertake this as part of their caring duties. At the last inspection it was noted that there were no activities specifically designed for those people with dementia. This is still the case, however the registered manager stated that there are plans for staff to attend training on how to work better with those people with dementia. The people’s records indicate their interests or if they are to be encouraged to join in activities; some records indicated that some people did not what to join in activities. The home encourages contact with relatives and friends; those relatives spoken with during the site visit confirmed that they are made to feel welcome and visit at any time. We saw some visitors being welcomed to the home during the evening. People were observed to be interacting well with each other and conversations were friendly and relaxed. The food continues to be of an acceptable standard. The cook commented on an improvement in the provision of food and she was able to provide a greater choice. The only area of concern was the quality of the meat. The home were supplying supermarket basics brand and this was poor quality and could be improved. The cook commented that there was a lack of items available for those people who have diabetes for example jam. The people who live at the home commented positively on the quality of the food comments included “the food is very good” “there’s plenty of it” “they always ask me what I want” “can’t fault it”. Canadia DS0000064770.V362410.R03.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 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The home safeguards people from abuse, neglect and self-harm, however the home were slow to take action to follow up any allegations. EVIDENCE: The home have a complaints procedure this is included in the Service User Guide and displayed around the home. We saw evidence in the complaint file indicating that there is a record of all the complaints received, what the home did about it, the outcome and whether the complainant was satisfied with the outcome. No complaints have been received by the CSCI; one safeguarding Adults referral has been made to the Local Authority by the home since the last inspection, this is ongoing. The home had received two complaints since the last inspection one has been dealt with and the other is outstanding and refers to the Safeguarding Adults referral. Staff interviewed during the site visit confirmed they knew the home had a complaints procure and what this entailed; they confirmed that they had Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 15 received training on the Protection Of Vulnerable Adults (POVA) and this was recorded in their files. Those people and relatives spoken with during the site visit new that they could complain and to whom that complaint should be made. They told us that the registered manager was approachable and were confident she would sort any concerns out quickly The home has recently dealt with a safeguarding adults referral and eventually took appropriate action to safe guard the well being of the people who live at the home. The home were slow however in invoking the safeguarding adults procedure by making a referral to the Local Authority and only did this following a discussion with the registered manager during the site visit. Canadia DS0000064770.V362410.R03.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 & 26 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. The environment is not fully able to meet and promote people’s diverse needs. EVIDENCE: No further major redecoration of the home has been undertaken since the last inspection, however the home have replaced the remaining chairs in the lounges and replaced the carpet in the hallway. The home has complied with the requirements of the Environmental Health Officer (EHO) and has made the building safe. The EHO is now satisfied with the work undertaken and has not required any more remedial work. Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 17 People who live at the home have access to the garden to the front of the building; this is used as a smoking area for people and staff. The garden continues to be generally tidy. It was noted at the last inspection that the drive is made up of uneven paving slabs which cause a trip hazard to the people and visitors. This work has now been done and the drive has been made safe. The home has enough toilets and bathrooms but due to the needs of some of the people at the home not all are used or easily accessible. At the last inspection it was noted that there was no evidence of a routine maintenance record to ensure the building is maintained and refurbished as required. This has now been implemented and records seen indicated that plans are in place with time scales. The home was generally clean and tidy laundry facilities are located outside of the building in a shed. Staff were seen to be using protective clothing when entering the kitchen and dealing with the needs of the people who live at the home. During the site visit we saw evidence of water ingress on the ceiling of one of the top floor bedrooms. As a result the paper had begun to peel away from the wall. During the site visit the registered manager spoke with the builders who were repairing the drive and asked them to look at the roof. They found the problem and replaced tiles which had become dislodged. Canadia DS0000064770.V362410.R03.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 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have safe and appropriate support as there are enough staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are usually supported because staff get the right training, supervision and support they need from their registered manager. EVIDENCE: The home employ cooks and cleaners so the care staff can focus on the caring for the people who live at the home. Both staff and relatives raised some concerns that there may not be enough staff on duty to meet the needs of the people who live at the home. A calculation was done using the Department of Health’s Forum for Staffing Guidelines in Residential Homes, and we found that there was enough staff on duty. We discussed with the registered manager the possibility that the way the staff are deployed, their working patterns and routines does not giving them enough time to care for the people who live at the home appropriately. She is to look into this and make changes where she can. Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 19 At the last inspection it was noted that the home had not been undertaking the appropriate Criminal Records Bureau checks (CRB) for all staff employed and had used CRB checks from previous employers. We found that all the staff now had a current CRB check and the proper checks were being done for the majority of the staff. We saw one staff file which had only one reference. The registered manager continues to audit the staff training through supervision and those areas which need updating have been identified; she has accessed the local authorities training programme and stated that staff are booked to attend training on dementia and diabetes. Over 50 of the staff are trained to NVQ level 2 standard. We saw evidence on staff files that they had attended mandatory training on basic food hygiene, first aid and health and safety; more was booked this included fire training. Relatives spoken with during the site visit commented on how well trained they thought the staff were and how caring they were. One said, “ I would not have let my wife stay here if I did not have confidence in the staff or their ability”. Canadia DS0000064770.V362410.R03.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 & 38 People who use this service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is adequately run and managed appropriately. People’s opinions are sometimes central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. EVIDENCE: The manager is registered with the CSCI; she now has over one years experience in managing a residential home and has managed changes within the home well. She currently does not hold the Registered Managers Award Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 21 equivalent to NVQ level 4 although she did state that she was pursuing funding for this through the provider. The registered provider undertakes regular visits to the home in accordance with regulation 26 of the Care Homes Regulations 2001 reports are kept on file for inspection. At the last inspection it was noted that the registered manager had developed a limited Quality Assurance system (QA) within the home. We saw that this had been further developed and from results of surveys the registered manager had identified some areas in a report which needed improvement. The QA system now includes the opinions of visiting health care professional and relatives. At the last inspection it was noted that the homes policies and procedures are not updated in line to changes in legislation or good practise guidelines issued by the Department of Health, local health authorities, and specialist professional organisations. We saw written evidence which indicated that the health and safety policies and procedures had been updated in line with the requirements set by the EHO, these included environmental risk assessments. At the last inspection it was noted that the staff have not received regular mandatory training and that this had not been updated as required. Staff files indicate that they had received some mandatory training, but a few still needed updating. The manager stated that she had system which flagged up when this was required; staff spoken with were aware of what needed up dating and when this was to be done. More had been booked and this included fire training. The registered person is required to complete a self-assessment prior to the site visit-taking place (AQAA). This was not returned so information could be use as part of the inspection. Canadia DS0000064770.V362410.R03.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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 5, 12, 16 & 23 Requirement The registered person must ensure that people who live at the home are given the opportunities for stimulation through leisure and recreational activities, particular consideration should given to people with dementia and other cognitive impairments. Outstanding requirement previous time scale not met 30/08/07, 07/03/04 The registered person must ensure that any safeguarding adults incidents are reported and dealt with in accordance with written procedures and in timely fashion. The registered person must ensure that there is robust and effective recruitment and selection procedure to ensure the safety of the people who live at the home and that two references are taken for all staff. Outstanding requirement previous timescale not met Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 24 Timescale for action 01/11/08 2. OP18 5, 13, 17, 18, 19, 20, 22 & 37 18 & 19 31/05/08 3. OP29 01/11/08 4. OP31 4, 5, 18 & 19 30/07/07, 07/03/04 The registered manager must demonstrate that he/she has undertaken periodic training to up their knowledge, skills and competency while managing the home including the registered managers award. Outstanding requirement previous timescale not met 30/08/07, 07/03/08 01/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP15 OP15 OP33 Good Practice Recommendations The registered person should review the meat provision and ensure better quality meat is provided. The registered person should make sure that there is a wide choice of snacks available for those people with diabetes. The registered person should ensure that there is an annual development plan for the home, based on systematic cycle of planning-action-review, reflecting aims and outcomes for service users. The registered should ensure that policies and procedures are regularly reviewed in light of changing legislation and of good practise advice form the department of health, local health authority, and specialist/ professional organisations 4 OP33 Canadia DS0000064770.V362410.R03.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Canadia DS0000064770.V362410.R03.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. 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!