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Inspection on 10/01/06 for Colonia Court

Also see our care home review for Colonia Court for more information

This inspection was carried out on 10th January 2006.

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.

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

A resident said "The staff are all pretty good here. I`m well looked after. I feel safe here". One resident describe the staff as "friendly, kind and helpful", and another said "The staff are all good, I`m happy her". One relative described the staff as "very human, warm, affectionate and sympathetic" towards residents. The home is to be commended for the fact that residents and relatives remained very happy with the care on Blomfield House, despite the recent high sickness rate amongst staff.

What has improved since the last inspection?

Two relatives considered that overall standards on Blomfield House had improved since the last inspection.

What the care home could do better:

Although care plans were more resident focused than in the past, staff needed to actively involve residents and their representatives more in their development and review. Rehabilitation of residents with mobility problems needed to be given a higher priority, and be linked more directly to the prevention of falls. One relative was happy with standards of care, but still considered that communication with them about health issues "could to be improved". The home did not provide activities throughout the week, and didnot cover the role of the activity coordinator when they were absent. Verbal concerns and complaints were generally not being documented, so senior staff might not be aware of any problems occurring on Blomfield House. Odour control in a couple of areas needed to be improved. Some training needs were identified during the inspection, but staff had not always been able to be released from Blomfield House due to recent high sickness rates on the house.

CARE HOMES FOR OLDER PEOPLE Colonia Court St Andrews Avenue Colchester Essex CO4 3AN Lead Inspector Francesca Halliday Unannounced Inspection Blomfield House 10th – 20th January 2006 09:00 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 Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 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. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Colonia Court Address St Andrews Avenue Colchester Essex CO4 3AN 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) 01206 791952 01206 794230 www.bupa.com BUPA Care Homes (CFHCare) Limited Harvey Newman Care Home 110 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number disorder, excluding learning disability or of places dementia (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (30), Physical disability (3), Physical disability over 65 years of age (30) Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. Amber Lodge Persons of either sex, under the age of 65 years, who require nursing care by reason of Huntington’s Disease (not to exceed 20 persons) Persons of either sex, under the age of 65 years, who require care by reason of Huntington’s Disease (not to exceed 20 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of Huntington’s Disease (not to exceed 3 persons) Blomfield House Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 30 persons) Mumford House Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 30 persons) Paxman House Persons of either sex, aged 50 years and over, who require nursing care by reason of a physical disability (not to exceed 3 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 30 persons) The total number of service users accommodated not to exceed 110 persons 30th August 2005 Date of last inspection Brief Description of the Service: Blomfield House is registered to provide care for up to 30 residents over the age of 65. Care is provided in 30 single rooms, all with en-suite toilet and basin. The home has wide range of communal rooms and is all on one level. Blomfield House is one of four houses at Colonia Court Residential and Nursing Home. Each house is staffed on an individual basis and the central services include administration, laundry and kitchen. The home has a spacious car park and a guest flat available. Colonia Court is set in a residential area and is approximately one mile from Colchester town centre and two miles from the railway station. Buses run along St Andrews Avenue outside the home. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit was to Blomfield House only. The inspection visit took place on 10th January 2006 and lasted 8 hours 15 minutes. The inspection process included discussions with 4 residents, and 7 members of staff including the general manager. The premises and a sample of records were inspected. 3 relatives were contacted on 16th January. The head of care was not present at the time of inspection and was spoken with on 20th January, and this concluded the inspection process. 14 of the 38 standards were inspected: 2 met the standards, 11 standards had minor shortfalls and 1 standard was not met. The judgements made within the report are based on the observations and evidence gathered during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Although care plans were more resident focused than in the past, staff needed to actively involve residents and their representatives more in their development and review. Rehabilitation of residents with mobility problems needed to be given a higher priority, and be linked more directly to the prevention of falls. One relative was happy with standards of care, but still considered that communication with them about health issues “could to be improved”. The home did not provide activities throughout the week, and did Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 6 not cover the role of the activity coordinator when they were absent. Verbal concerns and complaints were generally not being documented, so senior staff might not be aware of any problems occurring on Blomfield House. Odour control in a couple of areas needed to be improved. Some training needs were identified during the inspection, but staff had not always been able to be released from Blomfield House due to recent high sickness rates on the house. 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. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 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 Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 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 (6 not applicable) Staff do not have access to preadmission assessment information to assist them in developing care plans. EVIDENCE: The preadmission assessment process could not be assessed, as staff did not know where the preadmission documentation was filed. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Care plans are more resident focused, but this is still an area that needs further development. Some residents and relatives would like to be more involved in review of care and care plans. Residents consider their health needs are met, but some would like more emphasis on rehabilitation. Residents are protected by the homes policies and procedures for dealing with medicines. EVIDENCE: The standard of care plans sampled was generally good, and the documentation was more resident focused than at the last inspection. The standard of evaluations had improved, but some were instructions for care staff rather than an evaluation of the care and care needs from the residents’ point of view. A relative said that they had been involved in some care planning, and had been told that they would be invited to monthly reviews, but that this had not happened. Two residents with mobility problems said that they would like to go for walks more frequently, but said that staff were too busy to take them. One resident considered that staff were “over protective” of them, and added “they’re too busy to take me, but won’t let me go alone”. A discussion was held with staff about the need to agree specific goals and Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 10 objectives with residents, as part of their rehabilitation and to reduce the likelihood of falls. Falls charts were seen, but they had not always been completed following falls. Blomfield House had systems in place to monitor residents’ health, and residents reported that concerns about their health were addressed promptly and appropriately. The home had a range of risk assessments, and there was evidence that risks for residents were regularly assessed. The BASOLL assessment (Behaviour Assessment Scale of Later Life) was being used to monitor residents’ psychological health, however, there was evidence that staff were not always carrying out the full assessment. Staff considered that the problems concerning communication with relatives, identified at the last inspection, had been resolved. However, one relative said that they were not always kept informed about health issues or notified when the resident saw their GP. Medicines management was generally sound, and staff who administered medicines had received training. Stock balances of Controlled Drugs (CDs) and homely remedies were checked and found to be correct. However, staff had not always recorded the administration of homely remedies on the medicine administration chart. Staff were reminded that money or valuables must not be stored in the CD cupboard. This was raised at the last inspection. There was evidence that staff were carrying out risk assessments for residents who handled their own medicines. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 15 Activities provide some stimulation and interest for residents, but are not provided throughout the week or in the absence of the activity coordinators. This is an area that needs developing in the home. Residents are generally happy with the variety and choices on the menu, but food is not always served at the correct temperatures. EVIDENCE: Residents were aware of the activities on offer on Blomfield House, and joined in when the activities interested them. There were only activities on three and a half days, and the role was not covered when the activity coordinators were absent. Care staff said that they were usually too busy to provide activities during the rest of the week. There was very little documentation about individual resident’s activities and social interaction. There was evidence, from discussions with residents and staff, that residents who declined to join in the games or crafts had limited input from the activity coordinators. One relative of a resident who remained in their room said, “None of the staff ever have time to go beyond talking for a very short time”. Staff had not received training in the range of therapeutic activities for older people. One resident described the food as “excellent”. Another resident said that the food was generally good, but that “very occasionally” the standards were Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 12 lower. The manager said that he would try to obtain some hot curries for a resident who was finding the food rather bland. Two relatives said that as residents in the communal lounge were usually served first, the hot food was often served cold to residents who ate in their rooms. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Lack of documentation could potentially result in concerns and complaints being inadequately assessed and addressed by senior staff in the home. Some staff need further training in the different types of abuse that can occur. EVIDENCE: A resident said that staff “sorted things out” when they had any concerns. One verbal concern had been recorded (since the last inspection) with the action taken to resolve the issue. However, discussions with residents and relatives identified some concerns/verbal complaints that had not been documented. The majority of staff had received training in the protection of vulnerable adults (POVA). One member of staff spoken had not received training. They had some awareness of the issues surrounding abuse, and said that they felt confident about reporting poor practice, but were not fully aware of the different types of abuse that could occur. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 14 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): 24 and 26 Residents’ rooms are safe and comfortable. The home is generally clean but odour control needs to be improved. EVIDENCE: Residents’ rooms were generally well personalised to their tastes and preferences. Residents said that there was generally a good response to call bells. Replacement keys to the drawers in residents’ rooms had been ordered and were due to be delivered soon after the inspection. The home was generally clean on the day of inspection, however, there were two areas where there was a problem with odour control. One relative considered that cleaning could be improved in some residents’ rooms and said, “bed changes could be more frequent and they run out of loo rolls (in residents’ en-suite)”. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 15 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 and 30 Shortage of staff at some times in the day has a direct impact on the speed of response to residents’ care needs. High sickness rates are impacting on staff morale and staff training. EVIDENCE: One resident said “ the carers are wonderful and the night staff are excellent”. However, a number of residents mentioned that Blomfield House had recently been very short of staff. One resident said that residents were brought to the dining tables an hour to an hour and a half before meals, “because of the lack of staff”. The duty rota indicated that there had been a very high sickness rate amongst care staff, in the weeks preceding the inspection. On one week six members of staff had been sick. This problem had been exacerbated by the fact that some staff were not informing the unit that they were unable to work, until the shift was about to begin. The manager said that the staffing had been maintained at the agreed levels, as other members of staff had usually covered their duties. However, a number of staff commented that this was resulting in very low staff morale. The issues about lack of staff cover of the unit at handover periods were raised by residents at the last inspection and had still not been resolved. Staff were not always receiving a full handover at the beginning of each shift. Staff said that it was difficult to do a proper induction and supervise new staff as well as they would like, because of the problems identified above. They said that senior staff were sometimes “signing off” a new carer as having completed part Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 16 of an induction, when they had not worked with them or assessed competence. Staff said that it had not always been possible to release staff for training due to the recent high sickness levels. The manager said that he was hoping to provide training on a modular basis during the night shift, to make it easier for night staff to attend. The manager said that he was in the process of recruiting more staff for Blomfield House. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 17 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): 36 and 38 Systems of supervision have improved. Some training in safe working practices is neded. EVIDENCE: There was evidence that formal supervision had been introduced since the last inspection. Staff were advised that supervision records should be kept securely in order to maintain staff confidentiality. The manager said that wheelchairs were regularly serviced, the maintenance man carried out regular checks, and night staff cleaned them, but this was not always recorded. All staff had received fire training. Two new staff needed moving and handling training and other staff were due an update. The manager said that there was now a moving and handling trainer on Blomfield House, who would be responsible for regular staff training and ongoing assessment of competence. The majority of staff had completed food hygiene and infection control training, Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 18 or were due to start updates. A number of staff needed to do health and safety and COSHH (Control of Substances Hazardous to Health) training. Blomfield House did not have a member of staff with a first aid certificate on every shift. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 19 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 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 X X X X X 3 X 2 STAFFING Standard No Score 27 2 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X 2 Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 20 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 OP3 Regulation 14(1) Requirement Timescale for action 10/01/06 2 OP7 15(1)(2) 3 OP7 15(1)(2) 4 OP8 12(1) The registered person must ensure that staff on Blomfield House have access to preadmission assessments. Informed at the time of inspection. The registered person must 10/01/06 ensure that residents, and their re presentatives where appropriate, are involved in the development and review of care plans and care needs. Informed at the time of inspection. Requirement in previous reports - timescales of 7.07.04, 9.12.04 and 30.09.05 not met. The registered person must 10/01/06 ensure that, whenever possible, staff provide active and systematic rehabilitation for residents with a mobility problem, and ensure that specific goals are agreed with residents as part of their care plan. Informed at the time of inspection. Requirement in previous report - timescale of 30.08.05 not met. The registered person must 10/01/06 DS0000015331.V277292.R01.S.doc Version 5.1 Colonia Court Page 21 5 OP8 15(2) 6 OP9 13(2) 7 OP9 13(2) 8 OP12 18(1)(c) 9 OP12 16(2)(m) (n) ensure that residents psychological health is regularly monitored when this has been identified as a need, and that an actual assessment has been carried out by the member of staff completing the form. Informed at the time of inspection. Requirement in previous reports - timescales of 9.12.04 and 30.08.05 not met. The registered person must ensure that residents representatives are informed of changes in care and treatment, and that a record is made of any important discussions with them. Informed at the time of inspection. Requirement in previous report - timescale of 30.09.05 not met. The registered person must ensure that staff record the administration of homely remedies on the medicine administration chart. Informed at the time of inspection. The registered person must ensure that staff do not store money or valuables in the Controlled Drugs cupboard. Informed at the time of inspection. The registered person must ensure that care staff and activity coordinators receive training in the range of therapeutic activities suitable for older people. Requirement in previous report - timescale of 1.01.06 not met. The registered person must ensure that social activities are provided on a daily basis, that all residents have regular input from the activity coordinators and ensure that the role of the activity coordinator is covered at DS0000015331.V277292.R01.S.doc 10/01/06 10/01/06 10/01/06 01/05/06 01/03/06 Colonia Court Version 5.1 Page 22 10 OP12 15(1)(2) 11 OP15 16(2)(i) 12 OP16 22 13 OP18 13(6) 14 OP26 16(2)(k) 15 OP27 18(1)(a) times of annual leave or sickness. Requirement in previous report - timescale of 30.08.05 not met. The registered person must ensure, and that records about residents’ social activities are maintained for individual residents, and are linked to their social care plan and monthly evaluation. Informed at the time of inspection. The registered person must review the systems of meals distribution, and ensure that food is given to residents at the appropriate temperature. The registered person must ensure that all verbal concerns and complaints are documented, along with the actions taken to address the issues raised. Informed at the time of inspection. Requirement in previous reports – timescale 30.08.05 not met. The registered person must ensure that all staff receive training in the the protection of vulnerable adults (POVA) and that this includes an assessment of understanding and competence. Requirement in previous reports - timescales of 1.10.04, 1.03 05 and 1.10.05 not met. The registered person must ensure that carpet cleaning is of sufficient frequency for control of unpleasant odours. Informed at the time of inspection. The registered person must ensure that the issues surrounding staff cover and staff communication at handover periods are resolved, so that they do not impact on resident care. DS0000015331.V277292.R01.S.doc 10/01/06 01/02/06 10/01/06 01/03/06 10/01/06 01/02/06 Colonia Court Version 5.1 Page 23 16 OP30 18(1)(c) 17 OP38 13(4) 18 OP38 13(4) The registered person must ensure that there are clear systems and standards for the completion of induction on Blomfield House. The registered person must ensure that all staff receive health and safety and COSHH training. Requirement in previous report - timescale of 1.06.05 not met. The registered person must ensure that there is a member of staff with a first aid certificate on each shift. 01/03/06 01/05/06 01/06/06 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 OP7 OP38 Good Practice Recommendations The registered person should ensure that falls charts are completed each time a resident has a fall. The registered person should ensure that wheelchair maintenance checks are documented. Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Colonia Court DS0000015331.V277292.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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