Inspection on 08/11/05 for Chaxhill Hall

This inspection was carried out on 8th November 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

Chaxhill Hall 24/02/09

Chaxhill Hall 04/08/08

Chaxhill Hall 03/08/07

Chaxhill Hall 10/01/07

Chaxhill Hall 03/08/05

Chaxhill Hall 17/02/05

Chaxhill Hall 19/08/04

Chaxhill Hall 17/02/04

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

CARE HOMES FOR OLDER PEOPLE Chaxhill Hall Chaxhill Nr Westbury-on-severn Glos GL14 1QR Lead Inspector Mrs Janet Griffiths Announced Inspection 8th November 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Chaxhill Hall Address Chaxhill Nr Westbury-on-severn Glos GL14 1QR 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) 01452 760717 01452 760717 Mr Peter Albert Whitehouse Mrs Francesca Beverley Whitehouse To be appointed Care Home 36 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (35) of places Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named service user under the age of 65 years of age. The home will revert to the original client category when this service user no longer resides at the home or reaches the age of 65. 3rd August 2005 Date of last inspection Brief Description of the Service: Chaxhill Hall Care Home is situated alongside the main A48 trunk road between Gloucester and Westbury upon Severn. It is a pleasantly adapted Victorian house offering comfortable rooms. The accommodation consists of thirty-two single and two double rooms, twenty-two of which have en suite facilities. Communal facilities consist of three large lounges, two on the ground floor and one on the first floor, and two dining rooms. The first floor is accessed by a shaft lift. There is a garden and patio area for residents to enjoy in the fine weather. Car parking is available at the front of the building. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over six and a half hours on one day in November 2005. It was brought forward and announced as the inspector had received no action plan from the last inspection in August and needed to ensure that the requirements made then had been/ were being addressed. The acting manager was present throughout the day and the responsible individual joined the inspection later in the morning and was there to receive feedback. In addition to a tour of the premises, the inspector spoke to a number of residents, one visitor, and several staff during the day and a selection of records were checked. What the service does well: What has improved since the last inspection? Assessments, care planning and medication administration have all improved over the last year and all service users now have an assessment completed, but there is still room for further improvements to ensure safe and consistent practice. Recruitment practices have also improved but still require some amendment to current documentation. There has been some maintenance work undertaken Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The admission process is managed fairly satisfactorily with a proper assessment being completed prior to people moving into the home to ensure that their needs can be fully met. EVIDENCE: There has only been one new admission since the last inspection, but the home has paperwork in place for the acting manager or a senor carer to complete a pre-admission assessment on each prospective service user. This had been completed for the newly admitted resident but was quite brief, completed in pencil and not signed and dated. All records, as legal documents, must be completed in ink, dated and signed (see requirement 37- schedule 4 of the Care Homes Regulations 2001). This resident was spoken with and appeared to have settled into the home quite well although because of some short-term memory loss was unable to remember the circumstances of admission. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 9 She was happy with her room and was able to pursue a favourite pastime of painting, evidence of which was seen. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 There is a consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. The health needs of service users are well met with evidence of multi disciplinary working taking place on a regular basis. The systems for the administration of medicines although improved still could potentially place service users at risk. Service users are treated with respect and their privacy respected. EVIDENCE: The records of three residents, to include the latest admission, were looked at in detail. Generally these are now much more consistent and include an assessment, care plans, a risk assessment and a moving and handling risk assessment. Individual daily records are also being completed now. There was evidence of review but no evidence of review with the service user or their relatives. Although some of the care plans reflected individuals needs, there were problems noted in daily records such as tendency to wander, fall, and degrees of confusion etcetera that did not have care plans. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 11 There was also some confusion on the inspectors’ part, over one of the risk assessments, which is completed. She was uncertain of what the scoring or even the risk assessment itself really told the reader and as it was photocopied it was also difficult to read. The use of this documentation must be reviewed. Speaking with residents and through records kept, multi-disciplinary input was confirmed. The district nurse currently visits two residents and one has been provided with a special bed and mattress, though not with a cushion, which would be expected for someone sat in a chair all day and at risk of pressure sores. Regular visit from the chiropodist, dentist and optician were noted and the community psychiatric nurse is available to call on, should the home feel it necessary for any resident to be assessed for increasing confusion or changes in behaviour. The home is not registered to accept any residents with a diagnosis of dementia. The acting manager explained that current residents have either become increasingly mentally frail over their years in the home or are admitted with varying confusional states but do not have a diagnosis of dementia. Medication storage has much improved over the last year, and all hand written transcriptions appeared to be accurate although not all the instructions on the medication itself or the charts was being followed accurately. The inspector was told that they were following doctors changed instructions, but if so these must be recorded and reflect what is written on the box/bottle. It was also noted that at least two courses of antibiotics did not appear to have been completed. In one instance, eye drops prescribed 2 hourly stopped at 10 pm and restarted in the morning. Again this instruction may need to be changed. Some gaps in administration were noted. From observations and speaking with service users it was confirmed that staff treat the service users with respect and their privacy is respected. It was clear that they are free to choose how and where they spend their days and several prefer to spend most of the day in their own rooms although the majority do meet in the dining rooms for lunch. Visitors are also able to see their relatives in private. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 Links with the community are satisfactory and support service users social opportunities where possible. Whilst recreational activities are provided , residents would benefit from having a structured and co-ordinated programme. The meals in the home are good offering variety and some choice and catering for special dietary needs. EVIDENCE: The home did have a weekly volunteer who would organise a variety of craft activities in the home but unfortunately she has now retired and it was reported that an organised programme of activities has been very ad hoc recently as staffing levels have been down. However the acting manager does her best to organise special outings a few times a year and 19 had recently been to Birmingham to an Ice show, which reportedly was thoroughly enjoyed by all who attended. A resident meeting was also held recently to discuss future social events. The next event is a Christmas meal on board a local boat sailing from Gloucester. Fundraising events are held throughout the year. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 13 Three entertainers have also been booked for December. One or two of the residents attend local day centres weekly/several days a week and others go out with their relatives. A few enjoy a walk around the garden and to the shop/garage next door and when the weather was warmer time in the garden. Others prefer to read, sew, watch television or listen to music in the privacy of their rooms and one gentleman has a fish tank with a few fish that he enjoys looking after. One lady has a pet cat that she keeps in her room. Lunch being prepared and served during the inspection was cottage pie, vegetables and gravy followed by lemon meringue pie. A cheese omelette was cooked for someone who is vegetarian. The cook was also busy making a birthday cake for someone’s 90th birthday that day. There were no menus visible on this occasion as the cook said they were about to be reviewed; there were records of the suppers provided each day but not of all the food provided for other meals, which is a requirement. The cook stated that there had been a visit by the EHO but she was unsure when and there was no report available. She reported that only minor work was required in the food storage area that had been addressed. The kitchen appeared clean and well organised during the inspection. Fridge and freezer temperatures were seen. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. Through staff induction and training and policies and procedures a safe environment is provided to protect service users from abuse. EVIDENCE: The home has a complaints procedure, a copy of which is displayed in most rooms and within the service users guide. Neither the Commission nor the Home had received any complaints that have had to be dealt with formally, since the last inspection. Two service users spoken with commented on a humming noise that disturbs them in their rooms especially at night. It was thought that it may be the heating system or water pipes but despite a thorough investigation and several visits from the plumber, they have been unable to locate/solve the problem. However, both did acknowledge that the acting manager has done her best to deal with the problem. The home has a policy on whistle blowing and the Department of Health guidance ‘No secrets’. Staff through induction and during NVQ training are all fully aware of adult protection issues and all new staff have had POVA checks prior to starting work in the home. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The standard of maintenance is slowly improving but has shown little evidence of future planning to date. However, the overall appearance is of a homely environment which will improve with a regular maintenance, redecoration and refurbishment programme. The standard of cleanliness is satisfactory. EVIDENCE: The home has not had anyone employed full-time to carry out maintenance work for a while now and consequently there are a large number of jobs to complete. A maintenance man was at the home during the inspection and had been immediately prior to the inspection trying to address the requirements from the last inspection. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 16 It was reported that all the extractor fans in the en suites had been checked and five need to be replaced; improved lighting had been fitted in one bathroom, but is still required in two others; one bathroom is now unusable because there had been a leak and the ceiling needs replacing; several carpets had been replaced; a worn armchair had been replaced’a bolt fixed on a store room door, and radiator guard fitting had just recommenced; new flooring was to be fitted in several en suites also but removing the old flooring had revealed further problems . From the inspection of the premises there are still a number of environmental issues to address and these will be detailed in a separate letter with timescales indicated. There is a need for the acting manager or responsible individual to do a regular inspection of the premises to identify all the work to be undertaken, which can then be prioritised and passed to the maintenance man to deal with. This must include a rolling programme of redecoration and refurbishment, replacing furniture as it becomes old and worn. The standard of cleanliness was satisfactory on this occasion with no malodours noted. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 Service users needs are not completely met by the numbers and skill mix of staff. The procedures for the recruitment of staff have become more robust and provide better safeguards to offer protection to people living in the home, although some improvements are still necessary. EVIDENCE: On the day of inspection there were four staff on during the morning and three in the afternoon to include the acting manager. There were to be three staff on also during the evening. In addition to care staff there was a cook and two cleaners but no laundry assistant on this occasion, so care staff were responsible for doing the laundry. There were 24 residents. From observations and conversations with service users it appeared that their needs were being met quite well. However, a number of staff had left since the last inspection and as a result of this there were no staff available to provide a daily activity programme. It was also noted that there had been 23 accidents recorded since from August 2005 to date and an audit of these accidents against staffing levels has been requested to see if lower staffing levels had any significance to this. The home has interviewed and hopes to appoint two new care staff as soon as CRB disclosures have been completed. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 18 There had been some gaps in the recruitment procedure at the last inspection and an immediate requirement notice was given, which was followed up on 9th September and was being met. Again new staff files were checked. POVA is now checked prior to appointment and CRB checks sent for and were seen on file. The proprietor has reported that the length of time in returning these continues to be inconsistent and they have experienced great difficulty in having one CRB returned. All new staff complete an application form and health questionnaire but these still need amendment to ensure that staff are able to confirm their mental and physical fitness in writing and to make it clear on the designation of who is providing references to ensure that the former employer is named as one of the referees. Interview records are completed but not every form has a complete career history and do not contain a written explanation of any gaps. The reference from the last employer is still outstanding for one carer who is waiting to start. This must be obtained prior to appointment. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38. There is leadership, guidance and direction to staff but no permanent manager to provide consistent quality care. The systems for service user consultation in the home are fair but need to be developed upon and accessible to all service users/their representatives. The accounting and financial procedures of the home, although satisfactory, could be improved upon. Some practices in the home do not promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The former manager continues to manage the home in the absence of a new manager being appointed and approved by the CSCI. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 20 It was reported that nine candidates have been interviewed, only two are being considered as possibilities and the position continues to be advertised. It is the aim of the provider to appoint someone as soon as possible but with past bad experiences he needs to be sure that whoever is appointed is entirely satisfactory. There are four senior care staff in the home and one is currently completing NVQ 4 registered managers award. There was evidence that the acting manager does consult with service users about certain aspects of the running of the home, for example social events but with the provider now living some distance away he is no longer part of the day to day running of the home and several service users commented that they had not seen him for some time. It was again discussed that he is required to complete a regulation 26 report and submit it to CSCI each month. Records are in place to record any financial transactions undertaken on behalf of service users and of any money/valuables held in safe keeping at their/ their relatives requests. Historically, the acting (former) manager has agreed to be appointee for several residents’ pensions and does hold sums of money for a large number of service users. Good records are in place that are accessible to service users/their families and are audited regularly by two senior members of staff. However, it was advised that these procedures are reviewed so that service users/their families are encouraged to take back the responsibility to manage residents’ monies. Not all of the required records are being well maintained. Although accident records are kept it was noted that the CCSCI had not been notified of three serious accidents that had occurred since the last inspection. The acting manager apologised and explained that this had been an oversight; although there have been photographs of all the service users in the past, these are currently absent and need to be renewed and there is no record kept of all the food served. Some amendments to service user and staff files are also required (see standards 7 and 26). Since the last inspection the acting manager has commenced moving and handling assessments where necessary and one completed was provided to check that it was satisfactory. One resident who requires a hoist is still in an upstairs bedroom accessed up a step and staff on-duty demonstrated how this service user is transferred by wheelchair from her room. The family have been asked if they can move this service user to another room but they have not yet consented to this. It is the manager’s responsibility to safeguard the safety of her staff as well as the service users and a solution to this problem must be found. The radiator guard programme has recommenced and it was discussed that this needs to be prioritised to ensure that hot unguarded radiators in occupied Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 21 rooms are fitted first; hot water temperatures are now checked randomly every two weeks and the proprietor has made some enquiries into tests for Legionella and has been reportedly told that the home does not require these. Written confirmation of this is necessary. Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 X X 3 X X 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 2 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X 2 2 Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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 OP7 Regulation 15 Requirement Ensure that each care plan reflects the needs of the service users and is reviewed with the service user/ their relatives where possible. The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Provide facilities for recreation for the service users Ensure that the premises are of sound construction, kept in a good state of repair internally and externally and kept reasonably decorated ( timescale of 30/10/05 not met in full). Ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. All required documentation as identified in Schedule 4; Regulation 17(2) of the Care DS0000016402.V264037.R01.S.doc Timescale for action 08/12/05 2 OP9 13 08/12/05 3 4 OP12 OP19 16(n) 23 08/12/05 08/02/06 5 OP27 18 08/12/05 6 OP29 19 08/12/05 Chaxhill Hall Version 5.0 Page 24 7 8 OP31 OP33 8 26 9 OP37 17 10 OP38 13 Homes Regulations be held in staff files ( timescale of 30/9/05 not met in full) A manager must be appointed and seek registration with the Commission. The provider shall visit the home at least monthly unannounced, interview service users, their representatives and staff, inspect the premises and prepare and submit a written report to CSCI. The registered person shall maintain in the care home all the records specified in Schedule 4 of the care homes regulations 2001 The registered`person shall ensure that all parts of the home to which service users have access are so far as is reasonably practicable, free from hazards to their safety (timescale of 13/9/05 not met in full) 31/12/05 08/12/05 08/12/05 08/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP35 Good Practice Recommendations The registered manager ensures that service users control their own money except where they state they do not wish to or lack capacity and that safeguards are in place to protect the interest of the service user. Ensure that regulation of water temperatures and design solution to control risk of Legionella. 2 OP38 Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Chaxhill Hall DS0000016402.V264037.R01.S.doc Version 5.0 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. 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