Inspection on 11/08/05 for David Lewis Centre Frederick Harwood House

This inspection was carried out on 11th August 2005.

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

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

Other inspections for this house

David Lewis Centre Frederick... 28/09/06

David Lewis Centre Frederick... 06/03/06

David Lewis Centre Frederick... 02/02/05

David Lewis Centre Frederick... 15/06/04

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

CARE HOME ADULTS 18-65 David Lewis Centre (Frederick Harwood House) Mill Lane Warford Alderley Edge Cheshire, SK9 7UD Lead Inspector Helena Dennett Unannounced 11 August 2005 09:30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service David Lewis Centre (Frederick Harwood House) Address Mill Lane Warford Alderley Edge Cheshire SK9 7UD 01565 640012 01565 640101 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) David Lewis Organisation Mrs Gillian Dyson Care Home 31 Category(ies) of Physical disability over 65 years of age (6) registration, with number of places Physical disability (25) David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 31 service users to include: * * * up to 6 adult service users over the age of 65 years, suffering from epilepsy for long term care. up to 21 service users between the ages of 18 and 64 years, with chronic physical disabilities suffering from epilepsy and require long term care. 4 service users aged 19 years and above suffering from epilepsy who require nursing care with an acute illness. 2. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3. The registered manager must obtain a nationally recognised qualification, at Level 4 NVQ or equivalent, in management before 1st March 2005. Date of last inspection 2nd February 2005 Brief Description of the Service: The David Lewis Centre for Epilepsy opened in 1904. Its benefactor was the department store pioneer, david Lewis (1822-1885). The centre is set in 170 acres of land and has a village atmosphere. The facilities on site consist of a swimming pool, gumnasium, worshops, school college and social club. Frederick Harwood House which is a single storey unit comprises of four wings, is one of the original buildings of the centre. There are 28 single rooms with shared toilet facilities between each pair of rooms, and one double room with an en-suite. There is an observation bay with two double rooms and two single rooms with wash hand basins fitted. The area has its own lounge. there is a large dining room and kitchenette, three separate lounges, one which is designated for residents who smoke. There is an enclosed garden and patio area. The residents primary needs are due to epilepsy and physical disability. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours. The inspector spoke with two residents and four staff. Their comments are incorporated into this report. What the service does well: What has improved since the last inspection? What they could do better: Whilst redecoration of some residents’ rooms has taken place further work on the building must be done to make sure the home is safe and more comfortable for the residents. The systems in place for cleaning of the unit needs to be revised to make sure that all parts of the unit are kept clean and free from dust and dirt. Staff must be employed correctly so that people living in the home are protected from people who should not be working there. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 6 A more robust fire risk assessment must be undertaken to make sure that residents are not placed at risk if a fire breaks out. 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. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Senior staff visit prospective residents wherever possible before admission to ensure that staff can meet the residents’ needs once they move in. EVIDENCE: The residents on this unit have complex health care needs. Senior staff visit residents before they come into the home to make sure that staff can meet their needs in full. An assessment by the doctor and nurse is also carried out on admission. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7, & 9 The care plans include information on all patients care needs and how these are to be met so they are safe and well at all times. Residents’ health care needs are monitored closely so that any deterioration in condition is recognised and addressed quickly. Residents confirmed that they make decisions about their lives. EVIDENCE: Residents spoken with said that they are consulted on their care and are enabled to make decisions about their lives. One resident discussed her likes and dislikes and felt that she was supported by staff. Individual care plans are in place for the residents. There is evidence that staff discuss the care plans with residents and their relatives. The daily records contained detailed information on the health and well being of residents and of any changes that may have occurred. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 10 Some of the care plans had not been evaluated for some time, for example the last evaluation recorded on one resident care plan was dated March 2005. Care must be taken to make sure that the change to the resident’s condition recorded under the evaluation is transferred into a new plan of care. Risk assessments are documented in the care plans and these are discussed with the residents and/or their representatives. Advocacy services are available, there was evidence that one resident had been enabled to use this service recently. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16 There are plenty of activities offered around the centre to meet the needs of the residents and to keep them stimulated. Residents can choose how they spend their time, which enables them to keep control over their lives. EVIDENCE: There is a range of activities at the David Lewis Centre that residents can access . Several of the residents attend the day resource centre which provides a number of varied activities. The residents spoken with said that they can choose which activity they attend. One resident said that she enjoys going shopping to Macclesfield although she has to be accompanied by a member of staff. Another resident said he enjoys going out on site around the centre. One resident enjoys knitting and donates her items to good causes. Residents can visit their partners whenever they wish, staff respect their privacy. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 20 Residents on the unit are given the appropriate personal and healthcare support they need to make sure that their needs are met in full. Medicines are managed in a satisfactory manner so residents receive their medicines are prescribed. EVIDENCE: Residents on this unit have complex health needs and learning disability. A named nurse and key worker system is in place and this works well. Several of the residents required 1:1 observation on the day of the inspection. There were plenty of staff on duty to make sure that this could be carried out without putting other residents at risk. The residents spoken with said that the staff on the unit were very good. They felt their privacy and dignity and choice were maintained as far as possible within the constraints of their treatment. Staff were seen to treat residents with respect, promoting their privacy and independence. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 13 There is an on-site doctor that visits the unit regularly. The consultant does ‘ward rounds’ weekly and the professor and senior house officer visit twice weekly. A small observation bay is provided on the unit. The intention of staff was to accommodate residents with acute health care needs on a short term basis. However some of these rooms are now occupied by residents who require long term care. Records of residents seizure activity are maintained well which enable staff to monitor their condition. There was evidence in the plan of care that staff are meeting the physical and emotional needs of the residents. Medicine policies are in place on the unit. The David Lewis Centre has a pharmacy on site. A stock of drugs is kept in the clinical room. The lock on the clinical room had been repaired since the last inspection. Stocks of drugs were kept in locked cabinets. The Medicine Administration Record sheets were examined. These were found to be satisfactory. The stocks of controlled drugs were examined. These were satisfactory. When checking stocks of drugs it was difficult to account for the amount of Temazepam in stock as a regular stock check is not carried out. See Recommendation 1. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Information about the complaints process for the home is readily available so residents and their relatives know how to make complaints and who to make them to. Although there is a policy on adult protection ensuring that residents are protected from abuse, this needs to be updated, to make sure that staff have the most up to date information on the action to be taken if an allegation of abuse is made. EVIDENCE: There is a complaint policy for the centre. Information on the use of advocacy is included in the welcome pack. No complaints have been made to the CSCI since the last inspection. There is an adult protection policy in place. This is dated 2001 and should be updated. See Recommendation 2. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,& 30. Although some of the residents bedrooms appeared comfortable and well maintained, other areas of the home were in a poor condition and require attention. There were no blinds on one bedroom window or door which contained clear glass so the residents privacy is not protected. There were areas on the unit that were not clean and could put residents at risk. EVIDENCE: Some of the residents bedrooms were seen to be comfortable, containing many of their own possessions. New catches have been placed on the dining room windows since the last inspection. A number of other areas require attention, in particular: • The woodwork on the doors in the corridor areas is badly chipped. This creates a poor first impression of the home. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 16 • The wallpaper in room 2, Wing 2 was peeling. There were no blinds on the windows and doors and therefore resident’s privacy could be compromised, the carpet was worn and needs replacement. In room 3, Wing 2, the furniture didn’t match. The chest of drawers was old and in poor condition, stickers were left on the wardrobe and a bottle of hibiscrub was seen on the floor by the sink. Room 406 (unoccupied), the wallpaper was peeling and there was an unpleasant odour in the room. Part of the floor covering in the kitchenette has been removed and the concrete floor exposed. Staff confirmed that this has happened about two weeks ago. As residents use this area to bring their used dishes through this could be a trip hazard. It is also an infection control hazard and must be addressed. The paintwork on the walls of the cleaners cupboard’s paintwork was chipped. • • • • There are shared toilet facilities between two rooms. Some residents doors can not be locked from the inside, therefore the person in the adjoining room using the shared toilet facility might be able to access their room. The nurse in charge said that for some residents it may not be appropriate for them to be able to lock their rooms, due to their physical and mental health needs, however she agreed to explore what action could be taken to try and make sure that unauthorised persons do not enter residents rooms. Cleaning systems on the unit need to be improved. The floor of the cleaners cupboard was dirty and in need of cleaning. Several mops were stored head down in the buckets in the cleaning cupboard. This is an infection control hazard. The extractor fan in the staff toilet was dirty and needed cleaning. The floor of the laundry room on the unit was very dirty and in need of a thorough cleaning. This is again an infection control hazard. Cot sides and the base to a commode were stored in this room. Residents clean laundry are also stored in this room before staff distribute them to the rooms. There were several cigarette ends scattered along the path at the back of the laundry as the designated bin outside was overflowing. The microwave in the kitchenette was dirty and in need of cleaning. A bench situated at the back of the laundry – close to where residents were sitting was broken and required disposal. See Requirements 1-11 David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 &35 There were plenty of staff to meet the needs of the residents. Staff felt supported in their role. EVIDENCE: There were 28 residents living at Frederick Harwood House on the day of the inspection. Several of the residents have complex health needs and required 1:1 intervention. As a result there were four qualified nurses on duty and thirteen carers up to 1600hrs, after that time there were two qualified nursing staff and fourteen carers rostered until 21.15 hrs and three qualified nursing staff and four carers overnight. The members of staff who spoken with knew the residents well. One member of staff (agency) said that she had worked on the unit for over a year and that the same agency staff are usually contracted to ensure continuity for the residents. She said she enjoyed working on the unit and felt supported in her role. Two personnel records were examined. These contained information on past employment and two references. Reference was made in one file regarding the receipt of enhanced CRB disclosure, the date of receipt of the disclosure was kept on computer. There was no evidence on file to suggest whether the disclosure was satisfactory. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 18 In the second personnel file there was no record of a CRB disclosure being requested or returned. Staff checked the computer record which stated ‘yes’ to the return of the disclosure however there was no date recorded on the receipt of this disclosure. See Requirement 12. The manager of the unit is in the process of implementing a system of supervision for all staff. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41 &42 The unit is well managed and run. Resident satisfaction surveys have been carried out so that staff can assess whether they are meeting the needs of the residents. Fire safety issues were identified on this inspection which could put residents at risk. EVIDENCE: The atmosphere of the home was relaxed and friendly. nursing staff and care staff are held regularly. Staff meetings for An audit on falls was due to be started in April 2005, the outcome of this audit was not available on the day of the inspection. After the inspection the manager submitted a copy of the resident satisfaction surveys and the audits that have been carried out at the home. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 20 Fire checks are done regularly by staff on the unit. A policy on privacy was in place in the three residents files examined by the inspector. This policy stated that residents doors must be left ajar at night and that should a resident wish to have their door closed that consent from the resident must be obtained. The health and safety officer confirmed that a fire safety inspection had taken place across the centre and that advice had been given regarding shutting residents doors at night or installing specialist devices approved by the fires safety department in order to maintain residents safety. See Requirement 14 Archived files containing details of past residents were stored in unlocked cupboards in the corridor areas. See Requirement 13 Some of the radiators in residents bedrooms were not covered. In one room the radiator was next to the bed, although it was turned off during the summer months, in the colder weather should it be switched on may pose a risk to residents. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 2 x x x 1 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 David Lewis Centre (Frederick Harwood House) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 2 2 x F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 24 26 26 Regulation 23 23 23 Requirement The doors in the communal areas and the bedroom doors must be repainted. The bedrooms identified in the report must be refurbished. Blinds must be provided to internal windows and doors with clear glass to protect residents privacy The kitchenette flooring must be replaced The cleaners store room must be repainted The cleaners store room must be cleaned thoroughly The laundry room must be cleaned thoroughly and systems put in place to make sure that all areas of the laundry is cleaned on a regular basis. The paths at the back of the home must be kept clean and free from cigarette ends Systems for cleaning the kitchenette must be reviewed to ensure that all areas of the kitchenette - tiles, floor, fridges, cupboards and microwave are cleaned on a regular basis. The extractor fan in the staff toilet area must be cleaned. F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Timescale for action 11/11/05 11/10/05 at all times 4. 5. 6. 7. 24 24 24 30 23 23 23 23 11/9/05 11/9/05 11/9/05 1/9/05 8. 9. 24 24 23 23 11/9/05 11/9/05 10. 24 23 11/9/05 Page 23 David Lewis Centre (Frederick Harwood House) Version 1.30 11. 24 23 12. 34 19 13. 14. 41 42 17 23 Outside furniture must be maintained to an acceptable condition and any broken items repaired or disposed of. All the necessary checks identified under this regulation must be carried out before a member of staff is employed to work at the home. Previous timescale not met. Residents records must be kept securely. The registered person must make sure that robust systems are in place for the prevention of spread of fire on the unit and that a fire risk assessment is carried out identifying all aspects of risk to residents on the unit, with appropriate action identified to minimise risks to residents in line with any advice given by the fire safety officer. 11/09/05 at all times at all times 11\9\05 15. 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. 3. Refer to Standard 20 23 Good Practice Recommendations Staff should carry out regular stock checks on Temazepam tablets. The policy on adult protection should be reviewed. David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire CW9 7LT 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 David Lewis Centre (Frederick Harwood House) F51 F01 S18770 DLC Frederick Harwood V228138 110805 Stage 4.doc Version 1.30 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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