Inspection on 01/10/08 for Doublegates Green (47)

This inspection was carried out on 1st October 2008.

CSCI found this care home to be providing an Good service.

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

Doublegates Green (47) 04/10/06

Doublegates Green (47) 24/01/06

Doublegates Green (47) 26/07/05

Doublegates Green (47) 17/02/05

Doublegates Green (47) 01/09/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Doublegates Green (47) 47 Doublegates Green Ripon North Yorkshire HG4 2TS two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Diane Wilkinson Date: 0 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Doublegates Green (47) 47 Doublegates Green Ripon North Yorkshire HG4 2TS 01765607381 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Doublegates.Green@unitedresponce.org.uk United Response care home 5 Number of places (if applicable): Under 65 Over 65 5 0 learning disability Additional conditions: Registered for 5 Service Users with Learning Disabilities some or all of whom may also have Physical Disabilities. Date of last inspection A bit about the care home 47 Doublegates Green is registered to provide residential, personal and social care for 5 people under 65 years of age who have learning disabilities and may also have physical disabilities. The home is a purpose built bungalow with five single bedrooms. Communal accommodation consists of a newly extended living room, a dining room and a kitchen, as well as two specially adapted bathrooms. There is good access to and from the property, including access for wheelchair users. The home is situated close to the centre of Ripon in North Yorkshire and provides good access to local amenities. The home is part of the United Response organisation and the manager is Gary Biddlecombe. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home on the 4th October 2006, including information gathered during a site visit to the home. The unannounced site visit was undertaken by one inspector over one day. It began at 10.15 am and ended at 3.15 pm. On the day of the site visit the inspector spoke on a one to one basis with residents and staff, and spoke to the manager over the telephone a few days later. Inspection of the premises and close examination of a range of documentation, including three care plans, were also undertaken. The manager submitted information about the service in advance of the site visit by completing and returning the Annual Quality Assurance Assessment (AQAA) form. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. In order to improve the way the Commission involves and engages with people who use services, someone with knowledge about residential care provision known as an Expert by Experience assisted with this inspection visit. This person, Victoria Bowman, spoke to one of the people living in the home and staff working in the home, and looked around the home with the inspector. In addition to this, she had lunch with the residents. Following her visit to the home, the Expert by Experience prepared a short report for the Commission and information from the report was used in the preparation of this key inspection report. Surveys were not sent out as part of this inspection process but anonymised comments from discussions with people on the day of the site visit will be included throughout the report. At the end of this site visit, feedback was given to staff on our findings, including requirements and recommendations that would be made in the key inspection report. What the care home does well New residents are only offered a place at the home following a thorough assessment of their needs and if it is felt that their assessed needs can be met. People are supported to live their chosen lifestyle and to take part in activities and learning experiences chosen by them. People are encouraged to make their own decisions about daily routines, including personal care tasks, and this helps them to maintain their independence. Support plans are very detailed and are reviewed on a regular basis; this helps to ensure that a persons current care needs are met. Staff receive training that gives them the skills needed to carry out their role effectively. There is good communication between residents, staff and the manager. Support plans record a persons responsibility for daily living tasks, such as shopping and meal preparation; this encourages independence and choice. The home is well managed and the quality assurance systems give people the opportunity to affect the way that the home is operated. The health and safety systems in place are audited on a regular basis to ensure that they are effective. What has got better from the last inspection What the care home could do better A bedroom door was being held open by unauthorised means; this created a trip hazard and compromised fire safety at the home. The manager should apply to the Commission for Social Care Inspection for registration. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Diane Wilkinson 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People have a thorough needs assessment prior to their admission to the home and are only offered a place at the home if it is considered that their individual needs can be met. Evidence: New service users are only admitted to the home following a full needs assessment that is undertaken by people that are competent to do so. Information is obtained from the service user, their relatives and friends if appropriate and from health and social care professionals. This information is collated and forms the basis of an individual support plan. The plan is written in the first person, i.e. the support I need to be provided is, and is very detailed. Any restrictions on freedom of choice are recorded and included in the support plan, and agreed by the resident, where appropriate. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents have an individual support plan in place that describes how they like to be assisted with personal care tasks and how they like to spend their day. Details about decision making and responsible risk taking are included in support plans. Residents are involved in the development of these plans, and they are reviewed on a regular basis. Evidence: Each resident has a thorough and very detailed individual support plan. This includes information on how people undertake personal care tasks and any support needed by staff, relationships with family and friends, current prescribed medication, health care needs, bedtime routines, assistance needed with finances and emotional support. Residents are involved in the development of their individual support plan. This is not yet available in a format that residents can understand but the manager told us that work is taking place to enable this to happen. Residents and others, such as relatives and health care professionals, are involved in the regular review of support plans. The resident that we spoke to was aware of the involvement of other professionals in their care, and had requested some of this involvement themselves. We saw information in care plans that evidenced that advocates are used to support residents when this is felt to be necessary or when requested. The expert by experience told us that residents go shopping with staff to the local supermarket and have a choice over which food is bought. Residents are encouraged to help staff prepare meals and are supported to help themselves to food and drink from the kitchen. On the day of the site visit we observed that residents were supported to make decisions throughout the day, such as what they would like to eat or drink, where they Evidence: would like to spend their day and how they would like to spend their day. Residents were asked if they would like to speak to us and to the expert by experience, and were left in private to do so. Care plans evidenced that staff work with residents to promote their independence and to enable them to access services in the local community such as banks, shops, pubs and leisure activities. Residents are supported to take responsible risks as part of this process. There is evidence that any risk assessments in place for residents have been read and understood by all staff. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents are supported to take part in leisure and learning activities throughout the week, including at day centres and within the local community. People are supported to remain in contact with family and friends and visitors to the home are made welcome. Meal provision at the home is good and residents are involved in menu planning, shopping and the preparation of meals. Evidence: Support plans evidence that residents are supported to take part in fulfilling activities. Two residents attend a local day centre but other residents have chosen to take part in leisure activities in the local community, such as visiting the library, attending a drama group, visiting family and friends, going out for meals and shopping. One resident told us that they like to go to the pub with the manager of the home. The expert by experience was concerned that there was no activity plan displayed in the home. However, we noted that there was an individual activity plan for the week in each persons support plan, and that this changed from week to week depending on the wishes of the resident concerned. These recorded such activities as weekly shop at Morrisons, visit place of interest, baking, set and clear tables, drama group, TV and music with Matt. There was some supporting information about the specific activities that the individual resident had expressed an interest in. Some residents have a learning log as part of their support plan, and this includes information such as, went to chiropodist - coped very well with the experience. Care plans included a lot of information about how residents remain in contact with family and friends and it is evident that a persons wishes regarding contact are Evidence: listened to. We observed on the day of the site visit that visitors were made welcome at the home, and that residents were able to choose whether to remain in their own rooms and whether to interact with staff or with each other. The expert by experience told us that staff were seen to knock on doors before entering and to ask residents if they were happy to meet with visitors. We saw people assisting staff with the preparation of food at lunchtime and dealing with their laundry, and care plans record a persons responsibility for household chores. Residents told us that the meals at the home are good and the expert by experience supported this view. Residents assist staff to prepare a weekly menu and this is based on the likes of the five residents living in the home. Because two of the residents attend a day centre on a regular basis, those remaining at the home have a snack lunch and all residents have a cooked evening meal. Staff told us that they have brunch on a Saturday so that residents can have a lie in if they wish to do so, and that the main meal on a Sunday is at lunchtime. We saw one of the residents accompany a member of staff to the vegetable van and that they helped to choose the fruit and vegetables needed for the coming week. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples health care needs are met in a way that respects their privacy and dignity. Medication is held securely and is administered by staff in a safe way to promote the well-being of residents. Evidence: Support plans evidence that people are assisted with personal care tasks in a sensitive manner that maximises their dignity, privacy and independence. People told us that they are able to get up and go to bed at a time chosen by them and that this is flexible. Care plans also record information about how people are supported to go out shopping to buy their own clothes whenever this is possible, as well as being encouraged to decide what to wear each day; this is usually with the support of a persons key worker. We saw in records that health and social care professionals provide additional support or services for residents, including independent advocates. Care plans include information about contacts that have been made with health care professionals on behalf of residents, including appointments for any specialist health care needs. The manager told us in the AQAA that they would like to make information about appointments more accessible to residents and that they hope to make improvements in this area. We examined the records held in respect of the administration of medication and viewed the storage arrangements. There is a medication policy in place and this was last reviewed in January 2008. In addition to this, the home has obtained information that is used by community pharmacists providing advice to residential homes. Thirteen staff have undertaken medications training; evidence of this was seen on the day of the site visit. Medication administration records are very thorough and include a photograph of each resident and a medication profile, including information on any side effects of prescribed medication. We noted that there were no gaps in recording on medication administration records. Medication is stored in a locked cupboard within Evidence: a locked cupboard; none of the current residents have been prescribed controlled drugs, but there are storage facilities available should these be needed in the future. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents are supported to make complaints and there is evidence that these are listened to and acted upon by staff. There are appropriate policies and procedures in place on safeguarding adults from abuse and staff have had training on this topic; this promotes the safety and well being of residents. Evidence: There is a complaints procedure in place; a copy of this has been produced in a clear format using symbols to aid understanding. However, the manager told us in the AQAA form that they hope to make further improvements to the documentation in place to improve accessibility for residents. Care plans evidence that residents are encouraged to express their views and that these are listened to and acted upon by staff. There have been no formal complaints made to the home or to the Commission for Social Care Inspection since the last key inspection. There are policies and procedures in place that are designed to protect people from all types of abuse. The manager told us that staff have training on safeguarding adults as part of their induction training and records evidence that all but two staff have now undertaken training on this topic. The manager told us in the AQAA that they have reviewed the policy on whistle blowing and that this was discussed at a staff meeting. There have been no recorded allegations or incidents of abuse at the home since the last key inspection. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is maintained in a safe, bright and hygienic condition and provides the specialist equipment needed by residents. Furniture, fittings and decoration are domestic in nature and of good quality. Evidence: The property is purpose built and includes two bathrooms, both with a ceiling hoist and a different style of adapted bath; this gives residents a choice about which best suits their needs. Although purpose built, the home is on a residential estate and is in keeping with other properties in the area. The home was seen to be safe, bright, cheerful and clean on the day of the site visit and we noted that good hygiene practices were promoted for both residents and staff. There is an easily accessible sink close to the back door so that people can wash their hands when entering the kitchen and disinfectant gel was available throughout the home. The manager recorded in the AQAA that the living room has been extended and we noted that this now includes patio doors; there are also patio doors in the dining room and both allow easy access into the garden. The manager told us that they would like to make improvements to the outdoor space by creating a sensory garden. We were told that the residents helped to choose the decor in the extended lounge as well as in their own bedrooms. Furniture, fittings and equipment are of good quality and domestic in nature, whenever possible. We noted that one bedroom door was held open using unauthorised means. This posed a trip hazard and a fire risk and staff acknowledged that this created a risk of harm. The manager must investigate the provision of a system that allows the door to remain open but that would ensure that it closes automatically in the event of a fire. We also noticed that one of the doors on a bathroom cupboard was missing, leaving the personal care products on display. Staff told us that this had only recently happened and that the door was to be refitted shortly. Laundry facilities are good. On the day of this site visit the organisations own health and safety representative visited the home to undertake an audit of the premises and the systems in place. Evidence: The expert by experience pointed out that the layout of the dining room meant that people had to move on occasions when residents using a wheelchair wanted to leave the room. The repositioning of the table and settee should be considered by the manager and staff. The expert by experience also said that the home was homely, well decorated and spacious. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is staffed by skilled and well trained staff that have been recruited in a safe way; this protects residents from the risk of harm. Evidence: Staff told us that support workers have either achieved National Vocational Qualification (NVQ) Level 2 in Care or are working towards this award. Records evidence that staff undertake training on core topics as part of their induction training and then on an on-going basis; this equips them with the competencies and skills needed to carry out their role. The expert by experience told us, I observed the staff chatting to the residents, and sharing jokes and laughing together. The staff were friendly and welcoming, and I liked the way they were interacting with the residents. The manager told us that they use a new matching tool as part of the recruitment process; this identifies the personality characteristics, skills, shared interests etc. that are needed to enable staff to meet the needs of the residents currently living in the home. There have been no new staff employed since the last key inspection, but the home is currently in the process of recruiting new staff. We discussed this with the manager, who told us that one of the residents is involved at the interview stage and then again at the end of the probationary period for the new employee. Two written references are obtained for prospective employees and these are followed up in person. They intend to obtain satisfactory Criminal Records Bureau (CRB) checks for people prior to them commencing work, as they understand that people employed via a Protection of Vulnerable Adults (POVA) first check can only work under supervision until a satisfactory CRB check has been obtained. The manager told us that they would only use a POVA first check if they were very short staffed. All new staff undertake a two week shadowing period before working with people on a one to one basis. There is a training and development plan in place and this evidences that staff undertake training on such topics as infection control, moving and handling, first aid and safeguarding adults. Staff told us that they attend training programmes with other Evidence: people from the organisation and that they are offered refresher training every three years. Staff records included an individual record of training needs and requirements, and copies are retained of training certificates for training achievements. We saw the minutes of the most recent staff meeting and noted that staff practised Makaton signs and discussed manual handling and health and safety issues. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is well managed and people are given the opportunity to affect the quality of the service provided. People are protected from the risk of harm by the health and safety procedures that are in place and by staff training on health and safety topics. Evidence: The manager has the skills and competencies needed to run the home and has achieved a qualification at NVQ Level 4. He intends to apply to the Commission for Social Care Inspection for registration. Staff told us that the manager is approachable and supportive with both staff and residents, and that he gives praise when they have done well. There are quality assurance systems in place that offer residents, staff and others the opportunity to affect the way in which the home is operated. Surveys are sent out and the returned information is collated and fed into the Doublegates Green plan - this is a three year plan but it is reviewed every year. Information from this plan feeds into the organisations Area Plan. This information is shared with residents and others as far as is possible. Residents meetings are held, support plan reviews are held every six months and residents spend one to one time with staff; all of these situations give residents the opportunity to share their views with staff and with others. Records evidence that there have been occasions when independent advocates have worked with residents. We looked at health and safety policies, procedures and practices on the day of the site visit to the home; the organisations health and safety representative also visited on the same day to check the systems in place, policies and procedures and associated records. We noted that there were appropriate measures in place to protect people from the risk of fire and to promote good hygiene practices and good manual handling practices; this is supported by regular training for staff on health and safety topics. All Evidence: appliances and equipment had been serviced on a regular basis and there is a gas safety certificate in place. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 24 23 Advice must be sought from 20/03/2009 the Fire Department about alternative means for holding open bedroom doors. This is needed to protect residents and staff from a trip hazard and from the risk of fire. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 37 The manager should apply to the Commission for Social Care Inspection for registration. Helpline: 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 We want people to be able to access this information. 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