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Inspection on 02/08/07 for Christopher Grange (Rhona House)

Also see our care home review for Christopher Grange (Rhona House) for more information

This inspection was carried out on 2nd August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a strong management structure within the home to promote a high level of care. The manager and staff work well with other healthcare professionals to promote good health. Records are well maintained and contain all information necessary to enable staff to meet service users needs and preferences. A good selection of meals are offered from which service users can choose. The home is clean and fresh throughout.

What has improved since the last inspection?

The reviewed pre-admission assessment has enabled staff to complete a detailed plan of care prior to admission. The environment has improved to provide service users with a pleasant place to live. Medications management is clear and accurate.

What the care home could do better:

The home should continue to improve the services and facilities offered to service users.

CARE HOMES FOR OLDER PEOPLE Christopher Grange (Rhona House) Youens Way East Prescot Road Liverpool Merseyside L14 2EW Lead Inspector Jeanette Fielding Unannounced Inspection 2nd August 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Christopher Grange (Rhona House) DS0000025095.V337407.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. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Christopher Grange (Rhona House) Address Youens Way East Prescot Road Liverpool Merseyside L14 2EW 0151 220 25 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) The Catholic Blind Institute Tina Marie Clair Care Home 28 Category(ies) of Sensory impairment (28) registration, with number of places Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may accommodate five persons aged over 50 years for nursing care. The home may accommodate one named person aged over 50 years for nursing care. The home may accommodate one named person aged under 50 years for nursing care. 30th January 2007 Date of last inspection Brief Description of the Service: Rhona House is part of the main Christopher Grange Home, but is registered separately. Rhona House is currently registered with the National Care Standards Commission for nursing care for elderly persons. A total of 28 beds are available, with five of these being available for the care of terminal illness. The home forms part of the Christopher Grange Home that was purpose built for providing services to visually handicapped people and provides all facilities on the ground floor thereby providing full access to all areas. It is situated in Liverpool 14, close to local shops and amenities. The home is set within a residential area, close to shops and major transport routes. The home is owned by the Catholic Blind Institute and has its own chapel in which a daily mass is held. However, residents are accepted from any faith and local ministers of other religions visit to provide pastoral support. Weekly fees at the home have been identified as £524. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted in one day over a period of five hours. This was the key unannounced inspection and was carried out as part of the regulatory process. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Discussion took place with a representative of the owner, the registered manager, nurses, care staff, service users and visitors to the home. Questionnaires were issued to service users to obtain further information. What the service does well: What has improved since the last inspection? 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. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 6 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 Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 7 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): 1 and 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Detailed pre admission assessments are undertaken to ensure that the home can meet the individual needs of service users. EVIDENCE: The home has produced a detailed statement of purpose and service user guide. The document identifies the value base for the work that is undertaken at Christopher Grange and contains information about how care is provided. The statement of purpose encompasses the work of both Rhona House and residential care units run by the Catholic Blind Institute that are located on the same site. These documents will be reviewed later in the year when planned changes within the home are completed. The care files of service users recently admitted to the home were inspected to evaluate the information recorded in the pre-admission assessment. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 8 The registered manager or one of the qualified nurses undertakes the preadmission assessment. Information is gathered from the service user, their relatives and any other person involved in their care. The assessments inspected were detailed and provided sufficient information to enable a plan of care to be prepared. The need for specialist equipment is identified at this time to enable the home to provide this in preparation for the admission of the service user. The home also provides specialist nursing care to service users who require care due to their terminal illness. Some of these service users have their assessment undertaken by the District Nurse, District Nurse Liaison, Marie Curie or Macmillan nurses. The home does not offer intermediate care. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans are prepared to enable the staff to provide the appropriate level of care to each individual service user. EVIDENCE: Individual care plans are prepared for all service users. These are detailed and informative and provide staff with sufficient information to enable them to meet the service users care needs. Individual preferences are recorded such as time of going to bed and rising. The standard of care planning has continued to improve with additional information on service users needs being identified to further ensure that all their needs and preferences can be met. People using the service make their own informed decisions and have the right to take risks in their daily lives. The service has a positive attitude to abilities and risks are managed positively to help people using the service lead the life they want. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 10 Detailed plans are prepared and comprehensive risk assessments are undertaken. These include falls, the use of bed rails, the use of wheelchairs, moving and handling, health and safety, nutrition and any other need appropriate to the service users health needs. Care plans are prepared for all these and provide the staff with detailed information on the care to be given. Records are held of visits made to and by other healthcare professionals including GP’s, dietician, chiropodist and dentist. The services of the Tissue Viability Nurse Specialists are sought where necessary and all recommendations made by these professionals are duly recorded and care plans changed as required. The nurses complete daily reports, and the care staff complete a record of the actual care given to service users on a daily basis. The care records are therefore comprehensive and informative and provide evidence that the service users’ health care needs are fully met. Medications within the home are well managed. Regular audits are undertaken to ensure that accuracy is maintained. The audits are undertaken by the manager and detailed records maintained. Inspection of medications showed that all nurses follow the comprehensive medication procedure. Medication Administration Record sheets were found to be up to date and completed as required. All medications were found to be ordered, stored, administered and disposed of appropriately. The home holds a small supply of specific medications for service users who are accommodated due to their terminal illness on behalf of the GP. Specific procedures have to be followed before these medications can be administered and inspection of these showed that the procedure is robust and is followed by all nurses. A new lock has been fitted to the medications room door to ensure that access is restricted to designated personnel. The manager has recently arranged a change of dispensing pharmacist and is working closely with the new pharmacist to ensure that a smooth transition takes place. Personal care is given to service users in their own bedroom or in the bathroom to ensure that privacy and dignity are respected at all times. Staff were observed to knock on bedroom doors and to wait for a response prior to entering. Service users spoken to said that staff were ‘wonderful’ and ‘so caring’. Some of the nuns who live on site provide a pastoral care service to service users and their visitors. The service is an integral part of the care and support offered at Christopher Grange and is particularly valued when service users are nearing the end of their life. Staff will assist with funeral arrangements and will prepare “Order of Service” booklets if requested to do so. Service users and their families can choose to hold their funeral in the home’s chapel with ministers of their own religion officiating. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 11 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Dietary needs of service users are well catered for with a balanced and extensive selection of food available to meet service users tastes and choices. EVIDENCE: Although the Catholic Blind Institute manages Christopher Grange, service users of any faith are accepted into the home. A mass is held daily in the chapel and is open to all service users who wish to attend. Ministers of other religions visit individual service users and hold their own services. Service users confirmed that the routines in the home were flexible and suited their individual preferences. An activities co-ordinator provides activities and social stimulation with the service user on an individual basis as well as in small groups or with service users from other service users within the Christopher Grange complex. A list of planned activities is displayed on the notice board to give service users the opportunity to choose which activities would suit their individual preferences. Two members of staff have attended Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 12 training courses and study days on activities and reminiscence and are actively involved in providing stimulation for service users. The home has a bingo machine and a karaoke machine which the service users have enjoyed using. Board games and activities are provided which are suited to the service users. Visitors are welcome to visit the home at any time and may meet with service users in the privacy of their service users bedroom or in one of the communal areas. The home also provides a designated room ‘Kelly’s Room’ where visitors may spend time within a private area for periods of reflection during difficult times. Service users can choose the time that they go to bed and rise and this information is recorded in their plan of care. Records are held of the name that the service user wishes to be called and of the lifestyle they choose. The meals at the home are good with an extensive range of choices available. A menu is provided and service users are asked to select their choice the day before. Meals were seen to be attractively presented and smelled appetising. Service users are encouraged to take their meals in the dining rooms, however arrangements are made for those who are unwell to eat in the lounge or in their bedroom. Ethnic and special diets can be provided on request or following the recommendations of the dietician or GP. Comments received from service users in the questionnaires were extremely positive with only one comment being received that a service user sometimes found the meals less hot than they would have preferred. Meals are prepared in the main kitchen within Christopher Grange and are delivered to Rhona House in heated trolleys. The main kitchen has recently been refurbished and was found to be maintained to a very high standard. Meal are prepared from fresh goods with a supply of frozen foods being held to provide greater choice and a supply of goods that are not in season. There is a small kitchen within Rhona House for the provision of snack and drink making. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 13 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have excellent knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a comprehensive complaints procedure which is included in the statement of purpose and is displayed within the home. The procedure indicates that upon receipt of a complaint to the manager an acknowledgement of the complaint will made within 24 hours and a response within seven days. The procedure states that matters remaining unresolved may be further pursued with the home’s governing body or the Commission for Social Care Inspection. Staff spoken to, during the inspection, were able to confirm that they were aware of the procedure to be followed. Service users spoken to confirmed that they knew whom they could complain to. All respondents to the questionnaires issued to service users were fully aware of the complaints procedure and one respondent said that ‘there was never any need to complain’. The home provides ‘Listening to You’ leaflets in the foyer to give service users and visitors to the home the opportunity to make comments about the home and the service provided. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 14 The home has a robust policy on adult protection and staff spoken to were fully aware of the action to be taken in the event of abuse being suspected. Training on Adult Abuse, and the different types of abuse has been given to all staff. The home has a copy of Liverpool City Council’s adult protection procedure. The home has a detailed ‘whistle blowing’ policy and all staff have been made aware of this. Christopher Grange (Rhona House) DS0000025095.V337407.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, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continued investment has resulted in further improvements within the home to create a comfortable and safe environment for those living there and visiting. EVIDENCE: The home is located on ground floor level and all areas are fully accessible to those who have mobility difficulties or require using a wheelchair. Handrails are fitted to assist service users. On the day of the inspection, the lounge was being recarpetted. The corridors have been redecorated and fitted with new flooring. New pictures have been purchased and fitted in the corridors to provide a pleasant environment. Twelve bedrooms have been fitted with new carpet since the last inspection Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 16 and all bedrooms are decorated to a good standard. New furniture has been ordered for the dining room and delivery is awaited. Four new profiling beds have been purchased for service users who require these. New crockery and towels have been purchased and are in use. Specialist equipment is provided for all service users as necessary and is ordered following identification of need at the pre-admission assessment. Aids and adaptations are provided to promote independence. Bedrooms are pleasant and service users are encouraged to personalise them with pictures, photographs and items of memorabilia. All areas of the home are extremely clean and no unpleasant odours were present. Appropriate arrangements are in place for waste disposal. Policies and procedures relating to the control of infection were in place and were seen to be followed by staff. The home provides a pleasant garden which has been provided with seating. Service users are free to use the gardens at any time. Christopher Grange (Rhona House) DS0000025095.V337407.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home employs a highly trained and experienced staff team to ensure that a high quality of care is given to service users. EVIDENCE: The home provides two qualified nurses on duty during the day supported by six care staff during the morning and four care staff in the afternoon. At night, one qualified nurse is supported by three care staff. The staff rota provides evidence that the home is fully staffed at all times provide care to the service users. Many of the staff team are extremely experienced and have worked at the home for a number of years. Staff turnover within Rhona House is extremely low and therefore provides a continuity of care for the service users. A high level of training continues to be provided for the staff team. External training services are provided by John Moores University and Marie Curie with specific training needs being identified and provided for all individual staff. Training on care for service users who have terminal illnesses has been given to all nurses and many of the care staff. All staff have been trained in moving Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 18 and handling and training opportunities are also offered to the ‘bank’ staff who work at the home to cover sickness and annual leave. The home employs both qualified nurses and care assistants on the ‘bank’ of staff. The home has a robust recruitment procedure which involves all prospective staff completing an application form prior to being called for interview. CRB and POVA checks are made on prospective staff together with the taking of two references. Evidence of qualifications is required to be produced and these are verified by the home. A full induction training programme is followed by all new staff. The content of the induction and probationary periods are seen to be very robust, detailed and service specific. The service only confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their high standards. Staff meetings are used for consultation, training and the involvement of staff in the development of the service this includes night staff. Agendas are developed, minutes are taken and relevant information is made available to staff. All staff have the opportunity to attend meetings and to be kept fully informed and able to contribute to meetings. Individual supervision sessions take place regularly and staff say that they find them useful. Christopher Grange (Rhona House) DS0000025095.V337407.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, 32, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a strong management structure which is effective in ensuring the health and safety of service users and visitors. EVIDENCE: The registered manager of the home is an RGN who has extensive management experience. She has undertaken considerable training, and achieved qualifications, to provide a high level of care to elderly people and those service users who have a terminal illness. She is highly competent to run the home and meets its stated aims and objectives. Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 20 There is a strong ethos of being open and transparent in all areas of running of the home. The manager is person centred in her approach, and leads and supports a strong staff team who have been recruited and trained to a high standard. The manager is aware of current developments both nationally and by CSCI and plans the service accordingly. Unfortunately, the manager is due to leave the home at the end of August 2007 as she is moving to another area. She has been proactive in promoting a high level of care and improving the service. She will be missed by colleagues, service users, visitors and other professionals with whom she has worked. The home is now currently recruiting a replacement manager. The registered manager is well supported within the organisation and has access to senior management at all times. Staff meetings are held on a regular basis and specific meetings are held for nurses, day staff, night staff and general assistants. Comments and suggestion leaflets are available throughout the home providing opportunities for people to comment on the facilities, care and services provided. Verbal feedback is also obtained from service users, relatives and other visitors to the home. The manager speaks with service users on a one to one basis to obtain their views and has a good rapport with all relatives. Some service users deal with their own finances and several have their finances dealt with by family members or advocates. Where the home is banking larger amounts of money detailed transactions are maintained and interest is allocated according to the level of savings for each resident. The accounts are audited on a regular basis by the finance director. The organisations annual report confirms that the home remains financially viable. All records inspected were found to be well maintained and up to date. Fire equipment checks are made on a regular basis as required and duly recorded. Records are also held of fire drills and of the staff involved. Risk assessments are undertaken on equipment, staff and service users and risk management strategies were seen to be in place as appropriate. Safety certificates are held and all were found to be up to date. The home has a consistent record of meeting relevant health and safety requirements and legislation, and closely monitoring its own practice. Christopher Grange (Rhona House) DS0000025095.V337407.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 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 X X 4 Christopher Grange (Rhona House) DS0000025095.V337407.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. Standard Regulation Requirement Timescale for action 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 Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Christopher Grange (Rhona House) DS0000025095.V337407.R01.S.doc Version 5.2 Page 24 - 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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