Inspection on 30/08/05 for Self Unlimited North East

This inspection was carried out on 30th August 2005.

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

Other inspections for this house

Self Unlimited North East 03/10/06

Self Unlimited North East 11/05/06

Self Unlimited North East 01/11/05

Self Unlimited North East 01/06/05

Self Unlimited North East 14/10/04

Self Unlimited North East 13/07/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Care Ponteland North Road Ponteland Newcastle upon Tyne NE20 0BW Lead Inspector Elaine Wright Unannounced 30 August 2005 09:00 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Care Ponteland Address North Road Ponteland Newcastle upon Tyne NE20 0BW 01661 860333 01661 821830 careponteland@btconnect.com CARE (Cottage and Rural Enterprises Ltd) Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Vacant CRH 42 Category(ies) of LD - Learning Disability (42) registration, with number of places Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Two service users only are accommodated in Crastor Cottage. Nine service users only are accommodated in Kielder Cottage, two of whom live in self contained flats within the cottage. Fifteen service users only are accommodated in Cheviot Cottage, one of whom lives in a self contained flat within the cottage. Sixteen service users only are accommodated in Burnside Cottage, two of whom live in self contained flats within the cottage. Date of last inspection 1 June 2005 Brief Description of the Service: CARE Ponteland is located on the outskirts of Ponteland village, in open countryside, close to local amenities which include shops, public houses, restaurants, health centre, churches and swimming pool. Accommodation comprises four purpose built residential units, 5 independent flats, workshops, central kitchen, dining room and administrative offices. A maximum of 42 younger adults with a learning disability live at CARE and access employment and educational opportunities both on and off site. Nursing care is not provided. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 30 August 2005, at 09:00, by Elaine Wright and Deborah Haugh, and lasted until 17:00. This second unannounced inspection was as a result of a serious Protection of Vulnerable Adults notification, concerns expressed by local authority care managers and a complaint received by the Commission for Social Care Inspection regarding staffing levels and the quality of care provision. As part of the assessment process service users care records and daily recordings by staff were checked in Cheviot Cottage and discussed with the managers in Burnside and Kielder. Communal areas of each of the cottages were seen, a random sample of policies/procedures, medication recording systems and staff rotas were examined. Andrea Fox, Community Manager, who had just started work with CARE on the day of the inspection accompanied the Inspectors throughout the day. Three cottage managers and 4 members of staff were spoken to during the inspection. Eleven service users were also spoken to either in their cottage or as they were going about their daily activities on site. What the service does well: What has improved since the last inspection? Contact with care managers has been re-established for two service users. Staffing levels in Kielder Cottage have been increased. Efforts are being made to access more purposeful placements for service users living in Kielder Cottage. Two service users have had to move to nursing care to enable their needs to be met. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 6 PCP’s have commenced in Burnside Cottage. New furnishings have been purchased for Burnside Cottage. What they could do better: An application needs to be made to register the new residential services manager. Complete the implementation of Person Centred Planning (PCP) and increase the range of outcome based care plans. Introduce a comprehensive range of risk assessments appropriate to the need of/and for the protection of service users. Provide staff with clear aims and objectives for CARE Ponteland. Implement a programme of supervision for Cottage Managers. Ensure line managers employ a robust approach to providing support to Cottage Managers. Promote the recruitment and retention of staff. Establish clear staffing levels and teams based on service user needs. Increase links with Lead Care Managers and/or Team Managers to promote care managers involvement with service users. Improve the quality and style of daily recordings. Ensure an effective programme of maintenance, decoration and cleanliness is implemented on all units, prioritising Cheviot. Review the domestic programme. Provide CSCI with an action plan detailing implementation of the 5 year business programme and/or refurbishment of the existing premises. Produce guidance on the deployment of hours to support 1-1 packages of care. Review the medication policy with regard to “covert medication”. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 7 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. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5. The lack of care plans and PCP’s does not promote the health and welfare of service users and could place them at risk. The presence of contracts protects the welfare of service users. EVIDENCE: From record examined in Cheviot Cottage it is not clear whether the needs of service users are being met as there are limited care plans and no PCP’s in place. Staff allocations in terms of staff 1-1 with service users are not specific. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9. Poor care planning records places the health, safety and welfare of service users at risk. Service user needs and goals are not fully identified putting their health, safety and welfare at risk. EVIDENCE: Service user plans showed limited progress towards the implementation of PCP. Staff have completed PCP training but in one of the cottages the manager reported that 50 of the staff trained had now left the employment of CARE. Some parents of service users also undertook the original round of PCP facilitator training. Good progress in the introduction of PCPs was noted in Burnside Cottage. Daily recordings by staff were being made on “tick box sheets”, the reverse of the sheet also provided a space for additional information. Staff were not using these fully. Records should be explicit and informed. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 11 Care plans in place did not provide the evidence that outcomes were being met for service users. Activities for one service user in Cheviot Cottage were recorded as being “sat in hallway”, “sat in lounge”. Notes on a service users night time routine were incomplete, undated and not signed. Information contained in some care plans conflicted with daily recordings ie., no continence issues v recordings of incidents of double incontinence. There was limited evidence to support the regular review of care plans. Original assessments are not available in all service users files. Basic risk assessments are in place in terms of using a microwave but lifestyle choices and behaviours which challenge the home are not in place. Recorded incidents of verbal and physical aggression were noted but plans to deal with incidents are not in place. A recent incident between two service users had resulted in the admission of one to hospital with burns. The Behavioural Assessment and Intervention Team (BAIT) have been consulted but their advice is not evidenced as a plan of action. In Kielder Cottage relationships have been re-established with care managers to the benefit of two service users. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17. The practice of transporting food on trays around the CARE site could place service users health and welfare at risk. EVIDENCE: Staff were seen carrying plated meals, covered with metal lids, over from the main hall. Three meals had previously been brought into the cottage dining room and left on a table, not being kept warm, and one was uncovered. An immediate requirement notification was issued in respect of this incident. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20. Care records do not support service user choice in the manner their personal care is provided. Policies and procedures do not detail the use of “covert medication” which could place service users at risk. EVIDENCE: It is not clear what care is provided to service users due to the lack of care planning. Evidence was seen of the involvement of health care professionals such as Psychiatrists, GP’s, Dieticians and the BAIT team with service users. Their advice is not evidenced as a plan of care. An examination of records relating to medication in Cheviot Cottage revealed a plan to conceal a service users medication in food. This was supported by a letter from a Consultant. The manager said that this practice had not been used. The medication policies and procedures should be reviewed against the contents of paragraph 6.2.2 “Refusal and Covert Administration” of the Royal Pharmaceutical Society of Great Britain guidance “The Administration and Control of Medicines in Care Homes and Children’s Services” dated June 2003. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23. Complaint and protection of vulnerable adult procedures (POVA) are confidently used to protect the welfare and wellbeing of service users. EVIDENCE: CARE has a comprehensive policy and procedure in place to support the acceptance, recording, investigation and reporting of complaints. Service user files contain evidence that they had had the complaints procedure explained to them. Staff have received training in POVA and are aware of the procedure to follow. Two recent referrals through the POVA procedure have resulted in questions being raised by care managers and other professionals regarding staffing levels and the ability of staff to meet service users needs. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27, 28, and 30. The standard of the premises, style of accommodation, level of maintenance and cleanliness do not promote service user lifestyle, privacy, health and welfare needs. Poor levels of cleanliness could place service users at risk. EVIDENCE: Cheviot Cottage is continuing to show the affects of wear and tear and concerns were raised about the cleanliness of the kitchen. Requirements remain outstanding with regard to the lounge laminate flooring which is damaged and a potential trip hazard, the kitchen units and surfaces are damaged and stained with food. The oven, refrigerator, freezer and floor (including in the food store) were also stained with food. The fluorescent lighting covers in the kitchen were full of dirt and flies. The fire exit path outside the kitchen is uneven and a potential trip hazard. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 16 The lounge carpet is badly stained, despite cleaning, and must be replaced. In the accommodation described as the “staff flat” a toilet was found to have been left in a “filthy” condition and staff were called to deal with it immediately. Attempts had been made to remedy the leak in the staff toilet area but staining had recurred. This leak needs to be further investigated. The manager of Cheviot Cottage said that she was still not aware of her budgets for the year 2005/06. Kielder Cottage was found to be clean in the communal areas but the kitchen is continuing to show the effects of wear and tear. The fluorescent lighting strips in the kitchen were uncovered and could pose a potential accident risk. Burnside Cottage was found to be clean and hygienic. The lounge is comfortably furnished and the manager said that service users had chosen the décor. New leather sofas had been purchased together with dining furniture and cabinets. Contract cleaners are employed on site for 2 hours per day, 5 days per week, they are responsible for maintaining bathroom, toilet, corridor and lounge areas of the cottages. Only service users living in the flats have access to private bathroom and toilet facilities. An action plan detailing upgrading/refurbishment of premises is not available. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 36. Continuing changes in the staff team and the deployment of agency staff could place service users at risk. Failure to provide staff with effective/programme supervision and support places both staff and service users at risk. EVIDENCE: Staff recruitment and retention is still causing problems. Although the Inspectors were told that agency staff were not now needed staffing rotas in Cheviot Cottage showed a high level of agency staff deployment. There was some confusion about staffing levels and numbers possibly being reduced as a result of service users leaving. The manager was asked to explore the cottage manager’s understanding of when and why levels were changed. An immediate requirement notice was issued requesting that each cottage be staffed to support the number of service users they are registered for. All three cottage managers said that they had not received personal supervision for more than 6 months. They were also experiencing varying degrees of success implementing programmed supervision for their staff. The Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 18 lack of supervision and robust support is affecting the ability of cottage managers to fulfil their roles. Guidance for staff deployed to deliver 1-1 support to service users was not available. Methods of maintaining staff rotas and recording sickness/time off varied between cottages. A programme of planned training for 2005/06 was not available on the day of the inspection. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 41, 42 and 43. Inconsistent management approach and support has placed staff and service users at risk. Absence of guidance and omissions from policies could place staff and service users at risk. The absence of an action plan regarding the refurbishment/upgrading of the premises is affecting the quality of service users lives. EVIDENCE: There have been three changes of staff at registered manager level in the last 9 months and an application to register the current residential services manager has not been made. The management structure is in a state of flux leaving cottage managers unsupported. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 20 Fluorescent tubes in the kitchen in Kielder Cottage were uncovered and could be a potential accident hazard. The fire exit outside Cheviot Cottage kitchen is uneven and unsafe posing a potential tripping hazard. Gaps were identified in the medication policy. The application for funding to building a dementia unit on site is being resubmitted. This has lead to a considerable delay in decisions being made about plans for the Ponteland site. Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 2 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 2 x 2 Standard No 11 12 13 14 15 16 17 x x x x x x 2 Standard No 31 32 33 34 35 36 Score x x x 2 x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Care Ponteland Score 2 2 2 x Standard No 37 38 39 40 41 42 43 Score 2 2 x 2 2 2 x B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? 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 6 Regulation 15 Requirement The introduction of person centred planning and service user care plans must be progressed. (Previous timescale of 30 March 2005, not met by 1 June inspection.) All care plans must be regularly reviewd and updated. Original assessments must be available on service users files. All records must be complete, dated and signed. Staff must receive training in record keeping. (Carried forward from 1 June 2005, inspection report.) Care plans must detail intended outcomes for service users. (Carried forward from 1 June 2005, inspection report.) The range of risk assessments must increase with the implementation of person centred planning. Timescale for action 30 September 2005 2. 3. 4. 5. 6 6 7 7 14/15 14 17 18 30 November 2005 30 March 2006 30 November 2005 30 September 2005 30 September 2005 30 September 2005 6. 7 15 7. 9 13(4) Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 23 8. 9. 17 24 13(4) 23(2) (Carried forward from 1 June 2005, inspection report.) Arrangements for the transportation of food must be reviewed. The floor in Cheviot dining room must be repaired or replaced. (Previous timescale of 30 July 2005, not met.) 30 August 2005 30 July 2005 10. 24 23(2) The kitchen in Cheviot must be repaired or replaced. (Carried forward from 1 June 2005, inspection report.) The failed repair to the staff bathroom and ground floor toilet in Cheviot must be corrected. Safes in the cottages must be secured in a manner to protect staff health and safety. (Previous timescale of 30 July 2005, not met.) Standard of cleanliness within the home must be addressed. Fluorescent light covers must be cleaned and replaced. All kitchen areas must be maintained in a clean and hygenic condition. The role and responsiblities of contract cleaners must be reviewed. The badly stained lounge carpet in Cheviot must be replaced. A copy of the 2005/06 training programme must be forwarded to CSCI. CSCI must be provided with details of the number of agency and bank staff used, by cottage, for the months of July and August 2005. Staffing in Kielder Cottage must be reviewed. 30 September 2005 30 September 2005 30 September 2005 11. 12. 24 24 23(2) 23 13. 14. 15. 16. 17. 18. 19. 30 30 30 30 30 32 33 23(2) 23(2) 13(4) and 23(2) 23(2) 23(2) 18 18 30 August 2005 30 October 2005 30 August 2005 30 December 2005 30 October 2005 30 September 2005 30 August 2005 20. 32/33/35 18 30 October 2005 Page 24 Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 21. 32/33/35 18 (Previous timescale of 30 July 2005, not met.) Staffing in Cheviot Cottage must be reviewed. (Previous timescale of 30 July 2005, not met.) Implementatiaon of a quality assurance system must be progressed. (Previous timescale of 30 March 2005, not met. Carried forward from 1 June 2005, inspection report.) The fire exit/pathway outside Cheviot cottage must be repaired and cleaned. CSCI must be provided with an action plan addressing the 5 year business plan and/or the refurbishment of the existing premises. The medication policy and guidance must be reviewed with regard to the covert administration of medication. 30 October 2005 22. 39 35 30 September 2005 23. 24. 42 43 23(2) and 23(4) 23 30 September 2005 30 October 2005 25. 20 13(2) 30 December 2005 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. Refer to Standard 6 21 Good Practice Recommendations Correction fluid should not be used in records. Review the service user information held regarding their wishes in the event of their death. (Previous recommendation not met.) Consideration to be given to the payment system for waking night and sleep-in staff. (Previous recommendation not met.) 3. 33 Care Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 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 Ponteland B53-B03 S598 CarePonteland V247642 300805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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