Inspection on 30/05/07 for Care-a-lot Ltd Trading As The Old Rectory Nursing Home

This inspection was carried out on 30th May 2007.

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

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

Other inspections for this house

Care-a-lot Ltd Trading As The... 10/06/08

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

CARE HOMES FOR OLDER PEOPLE Care-a-lot Ltd Trading As The Old Rectory Nursing Home Church Lane Barham Ipswich Suffolk IP6 0PS Lead Inspector Jane Offord Unannounced Inspection 30th May 2007 10:30 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 Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Care-a-lot Ltd Trading As The Old Rectory Nursing Home Church Lane Barham Ipswich Suffolk IP6 0PS 01473 833383 01473 833373 Address 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) Ms Prema Antionette Dorai Mrs Noreen Theresa Warde Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of service users to be accommodated at any one time shall not exceed 27 but may be up to 29 including 4 day care service users. Service users may be accommodated in the home if they come within one or other of the following categories of service users: OP old age (defined by reference to the service users` presenting conditions and chronological age) not falling within any other category set out in schedule 7 part II paragraph 7 of The National Care Standards Commission (Registration) Regulations 2001 (Categories DE dementia and TI terminally ill being amongst those other categories as explained by annex F to the Guidance entitled `NCSC - Transitional Provisions and Transfer of Registration` (circular HSC 2001/21:LAC(2001)30)) February 22nd 2006. Date of last inspection Brief Description of the Service: The Old Rectory is a privately owned care home situated in Claydon, a small village on the outskirts of Ipswich. Claydon has a number of shops, public houses and a post office and there are bus links to the nearby town of Ipswich. The home has done some extension work and can now accommodate thirtytwo residents. Further work is ongoing to increase the communal areas and eventually accommodate thirty-four residents. All the residents’ rooms are located on the ground floor and comprise twentysix single rooms and four double. Seventeen of the rooms have en suite facilities. There are two bathrooms and two shower rooms for communal use. At present there is a large lounge with a small dining area attached but the plans include a large conservatory that will look over the enclosed courtyard to increase the choice of sitting areas. The fees for the home range between £400.00 and £560.00 but do not include the cost of special toiletries, newspapers, hairdressing or chiropody. Basic toiletries are provided by the home. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection looking at the core standards relating to care of older people took place between 10.30 and 16.30 on a weekday. The owner of the home and the registered manager were both available during the day and assisted with the inspection process. This report has been compiled using information that was available and evidence found during the inspection. A tour of the building was undertaken but all areas were revisited again during the day. A number of residents, staff and visitors were spoken with and care practice was observed. Part of a medication administration round was followed and the medication administration records (MAR sheets) inspected. A number of other documents and records were seen including some residents’ care plans, some staff records, the policy folder, maintenance records and the activity programme. On the day the home was clean and tidy and residents were using all areas of it that were accessible. Residents looked relaxed and comfortable. The lunchtime meal was hot and appetising and residents said they had enjoyed it. Visitors were welcomed and residents joined in with the activities being offered by staff. What the service does well: What has improved since the last inspection? The two requirements left after the last inspection have both been actioned. One related to duty rotas and the other to management of residents’ personal monies. The new extension with eight new rooms has been completed and the décor and furnishings are most attractive. Two older rooms have been altered to enlarge them allowing an en suite facility to be added. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 6 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. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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 Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5, 6. Quality in this outcome area is good. People who use this service can expect to have an assessment of need prior to entering the home and have the opportunity to assess the service offered. The home does not offer intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records of three new residents were seen during the inspection and each one had a pre-admission assessment. Areas of care need that were covered included personal hygiene, diet, mobility, communication and night needs. Other information was about behaviour and relatives’ involvement in the care given prior to admission. Special needs such as a walking frame, particular chair or bed were also noted. Past medical history and present medication was included. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 9 Residents and relatives spoken with said they had had the opportunity to visit the home and assess the service before making the decision to move in. One resident said they had been in hospital so one of their children had visited on their behalf. The Statement of Purpose was seen and was up to date and informative, containing all the required elements. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. People who use this service can expect to have health needs met but cannot be assured that their care plan will reflect all their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans and daily records for three newly admitted residents were seen. The care plans had interventions for areas of care such as personal hygiene, skin integrity, mobility, elimination and night needs. Two residents who were known to be diabetic, one who was insulin dependent, had no interventions related to the management of their diabetes. Another with a history of depression had no plan for management of their mood or recognising any triggers that may result in the need for specialised input. A further resident with a diagnosis of dementia and showing agitation and the need, at times, for restraint had no care plan interventions for guidance in managing this behaviour. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 11 In one file a resident had had a nutritional assessment as they were on a low potassium diet but the weight records had not been completed. A number of the records were not signed or dated. The files seen all had contact details of the residents’ GP and other health professionals involved with their support. Records were kept of any visits to or by these professionals and any treatment prescribed. The medication policy was seen and contains guidance on storing, administering and disposing of medicines. It needs to be extended to include guidance on the covert administration of medication and altering medication from the format licensed by the manufacturers i.e. crushing tablets or opening capsules. Part of a medication administration round at lunchtime was followed. The MAR sheets folder contained a list of the signatures for staff authorised to dispense medicines and some MAR sheets had identification photographs of residents with them. Medication was given sensitively at a speed appropriate for the residents to manage. The MAR sheets seen showed there were no ‘carry forward’ figures for tablets to allow for an audit trail. ‘As required’ medication that allows a choice of dose i.e. one tablet or two, did not have the amount given recorded again not allowing an audit trail. Staff were observed knocking on doors before entering bedrooms and bathrooms. One member of staff spoken with was able to give examples of the way they worked to preserve the dignity of residents. Interactions between staff and residents were friendly and respectful. Residents spoken with said they had no concerns that their dignity would be compromised by poor practice. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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 excellent. People who use this service can expect to have a lifestyle to meet their expectations and receive good quality meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does not have fixed visiting hours but welcomes visitors at any reasonable time. Visitors were seen to come and go on the day of inspection and those spoken with said staff were always welcoming. In the residents’ files that were seen there were contact details of the next of kin and emergency contact if that was different. The home employs a dedicated activities co-ordinator who was observed on the day interacting with a number of residents, doing jigsaws and colouring books. They said they prepare a four-week programme that includes a variety of pastimes such as quizzes, exercises, board games, sing-a-longs, general discussions and reminiscence, knitting and bingo. A quarterly newsletter is produced recording what has happened and announcing future plans. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 13 The most recent letter records the celebrations organised for St. Valentine’s Day, the Chinese New Year and St. David’s Day when the lounge was decorated with daffodils. The activities co-ordinator has a complete list of all annual religious festivals, not just the Christian ones, and plans to mark many of them with appropriate activity. They spend time with each resident on a daily basis and make a point of visiting those who prefer to remain in their room. They make notes about past life and favourite hobbies as they get to know new residents. They liaise with the care staff but have no direct input into care planning for residents. The home has visits weekly from a Roman Catholic priest and monthly from a Church of England vicar. The local chapel sends a representative monthly as well. Schoolchildren visit regularly and the home subscribes to the ‘pat dog’ scheme. Residents spoken with said they enjoyed the range of activities and liked having the choice of participating or not as the mood took them. The lunchtime meal was seen served and looked hot and appetising. It was pork casserole with mashed potatoes, carrots and spring greens followed by Angel Delight or fruit salad with ice cream or yoghurt. There was a choice of sandwiches or egg Mornay for tea. Residents said the food was ‘lovely’ and one said they had eaten too much since they had been admitted to the home and needed to be careful not to put on too much weight but the food was hard to resist. A visit to the kitchen showed it was well stocked with a wide selection of ingredients and fresh fruit and vegetables. It was clean and tidy with records of the temperatures of refrigerators and freezers showing they were functioning within safe limits for food storage. In one small refrigerator there was some bacon and ham stored that was not labelled or dated otherwise food was correctly stored. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. People who use this service can expect to have complaints taken seriously and be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Neither CSCI nor the home has received a complaint about this service since before the last inspection. The complaints policy is robust and available in the entrance hall. Residents spoken with were clear whom they would approach if they had any concerns about the service they received. The home has a protection of vulnerable adults (POVA) policy that is in line with the guidance given by the Vulnerable Adult Protection Committee of Suffolk and a whistle blowing policy to protect staff who report any concerns. Staff spoken with were very clear about their duty of care. Some staff had had POVA training as part of their study towards achieving an NVQ in care but the training matrix shows that a number of staff need updates on POVA. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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, 26. Quality in this outcome area is good. People who use this service can expect to live in a safe, homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was undertaken with the administrator who explained the building work that is going on and the proposed layout when it is completed. One corridor with eight new rooms has been completed and is finished most attractively. The new rooms all benefit from ensuite facilities and during the work the opportunity to change two older rooms that were shared into single rooms with ensuite was taken. Above the new corridor some new office space and a training/conference room have been built. Work is continuing on the proposed new conservatory that will increase the communal space available for residents. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 16 The home was clean and tidy on the day of inspection with no unpleasant odours. Residents’ rooms that were seen were pleasantly decorated and had personalized items evident in them such as family photographs, ornaments and pictures. One resident spoken with said they liked their room near the front of the home because although they enjoyed their own company they also enjoyed seeing people coming and going in the car park. The laundry was visited and the washing machines seen had sluicing and hot wash programmes on them for the safe management of soiled linen. Staff spoken with were able to explain the procedures taken to prevent crossinfection and there was evidence of protective clothing being available. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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 good. People who use this service can expect to be supported by correctly recruited and trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rotas were seen and showed that there was a trained nurse on duty throughout the twenty-four hours assisted in the morning by five carers, in the afternoon by three carers and during the night by two carers. Ancillary staff including a cook and kitchen assistant, two domestics and an administrator supported the care team. The home employs an activities co-ordinator. The registered manager is usually supernumerary and the owner is frequently present in the home. Staff spoken with said they felt the staffing levels were sufficient to meet residents’ needs at present. The owner agreed that when the building work was completed and they had filled all their places then the staffing would need reviewing to ensure that needs were met. The files for three newly appointed members of staff were seen and contained evidence that identification documents had been seen and that criminal records bureau (CRB) checks had been done prior to commencing employment at the home. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 18 A number of staff are from overseas and additional checks with authorities in the country of origin had been done and evidence kept. Some trained nurses from abroad were employed as carers and supported through the adaptation programme from the nursing and midwifery council (NMC) to allow them to practice in the U.K. The owner uses an agency to recruit them in their own country but the agency retains the candidates’ references. They know that the agency will only accept people with suitable references but have been trying to get copies for the files kept in the home so far without success. The files contained evidence that an induction programme had been followed and this was confirmed by staff spoken with. It included moving and handling, fire awareness, infection control and POVA however the training matrix supplied shows that a lot of training updates have not been completed. The home has four carers with an NVQ level 2 award and three more working to achieve one. The other carers’ posts are filled by adaptation nurses, which means the 50 ratio recommended in standard 28 of the National Minimum Standards (NMS) has been more than met. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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, 35, 38. Quality in this outcome area is good. People who use this service can expect to live in a well managed home and have their welfare protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a stable and committed management team as both the registered provider and the registered manager have been at the home a number of years. They are both trained nurses and the registered manager has had ten years experience managing a nursing home. The manager has also achieved the registered managers award. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 20 The home undertakes to distribute quality assurance questionnaires to residents and relatives annually. They were preparing to send out new questionnaires in the next month. Feed back from the last survey was positive with one respondent commenting, ‘the service could not be any better’. On the day of inspection the hairdresser was visiting the home to do hair for residents and the administrator was paying for the service from the residents’ personal monies. The opportunity was taken to check the procedures for managing personal monies. The recording allowed for an audit trail and the wallets checked tallied with the records. Some maintenance and service records were seen and showed that fire alarms, extinguishers and emergency lighting had all been tested by outside contractors within the last year. The home had a valid gas certificate dated November 2006 and health and safety policies had been revised to take account of the building work. Hoists had been serviced less than a year ago but the contractor advised they were serviced every six months and that deadline had passed. When drawn to the attention of the administrator they took immediate action to rectify the omission. An immediate requirement was left in respect of some fire doors that were wedged open. They were in the new extension and had self-closure devices fitted but they were faulty so staff had used wedges to keep them open. Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 1 Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 22 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 (1) Requirement Care plans must reflect all the assessed needs of residents to ensure that residents receive the support they require. The medication policy must be expanded to include guidance on covert administration of medication and altering medicines from the format licensed by the manufacturers to make sure residents receive their medicines correctly and safely. Procedures must be put in place to ensure medication recording allows an audit trail to ensure residents have received their correct dosage. Provision must be made to give staff updates on mandatory training subjects to ensure residents are supported by knowledgeable staff. Fire doors that need to be open during the day must be fitted with self-closure devices and not wedged to protect residents and staff. Food that has been opened and stored must be labelled and DS0000066661.V340964.R01.S.doc Timescale for action 30/05/07 2. OP9 13 (2) 30/06/07 3. OP9 13 (2) 30/06/07 4. OP30 18 (1) (c) (i) 30/09/07 5. OP38 23 (4) (c) (i) 30/05/07 6. OP38 13 (4) (c) 30/05/07 Care-a-lot Ltd Trading As The Old Rectory Nursing Home Version 5.2 Page 23 dated to prevent unsuitable food being used for residents. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Care-a-lot Ltd Trading As The Old Rectory Nursing Home DS0000066661.V340964.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. 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