Inspection on 13/07/05 for Easthill Home For The Deaf

This inspection was carried out on 13th July 2005.

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

Easthill Home For The Deaf 29/10/08

Easthill Home For The Deaf 16/01/07

Easthill Home For The Deaf 31/01/06

Easthill Home For The Deaf 12/01/05

Easthill Home For The Deaf 08/09/04

Easthill Home For The Deaf 10/12/03

Similar services:

Heather House Nursing Home

Fairways

Fir Tree Lodge

Randell House Care Home

Cherwood House Care Centre

Madley Park House

Kilmory

The Oaks

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

CARE HOMES FOR OLDER PEOPLE Easthill Home for the Deaf Ashey Road Ryde Isle of Wight PO33 3EB Lead Inspector Mark Sims Unannounced 13th July 2005 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 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. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Easthill Home for the Deaf Address Ashey Road, Ryde, Isle of Wight, PO33 3EB 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) 01983 564068 01983 811857 The Hampshire, Isle of Wight and Channel Islands Association for the Deaf People Mr Gerard Lawrence Naggs Care Home 15 Category(ies) of Sensory Impairment (15) registration, with number of places Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12/1/2005 Brief Description of the Service: Easthill is a specialist home providing care and accommodation to 15 people with specific hearing difficulties under the category of sensory impairment. The home is a two storey detached property offering dining space, two lounges and an activities room. Access to all parts of the building is possible via a passenger lift and stairlift, although most service users are mobile independent individuals. The property is situated at the junction of Pitt Street and Ashey Road and is within half a mile of the towns shops and facilities, whilst the distance might prevent most service users from walking into the town, the provision of a minibus means that the home is able to facilitate regular trips and outings for people. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and undertaken without the support of an interpreter, so all contacts or communications with service users were translated by members of the staff team. The inspection lasted three and a half hours and focused on general outcomes for service users with regards to activities and alterations to the environment, as well as issues around the home’s documentation identified at the last inspection. What the service does well: What has improved since the last inspection? One of the bathrooms has been completely refurbished and now provides a walk-in shower facility, as opposed to an assisted bath, which was less popular and less frequently used. Alterations have also been made to an upstairs toilet, where the removal of an old shower cubicle has created far more space for people wishing to use the toilet. Great effort has been put into updating and revising the service users’ plans and assessment documentation, which previously had been an issue of concern Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 6 for the inspector. It was pleasing to note the huge improvement, which now sees all service users with an up to date and accurate care planning package, which includes relevant information about the person’s needs, wishes and desires. The home has also introduced both induction and foundation training programmes for staff, which from the evidence seen are useful tools, which should assist new care staff to settle into the home, whilst developing the fundamental skills required to care for people. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 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 standard(s) St 3. Significant improvements had been made in the home’s pre-admission / continuous assessment recording practice. EVIDENCE: At the previous inspection of 12 January 2005 the inspector identified areas of concern regarding the home’s approach to assessment and the documentation of those assessments undertaken. Whilst it is acknowledged that it can often be difficult to assess or meet all new residents prior to admission, as a large number of referrals are from mainland authorities, the inspector felt that on-admission assessments and revisions of the initial assessments should still be occurring, although at the time the documented evidence suggested that this was not taking place appropriately. At this visit it was pleasing to note the improvements that had been made in the home’s general approach to care planning and especially the assessment sheets, which had been reviewed and updated for all service users. Having made such significant improvements the challenge for the management team will now be to keep on top of the service users’ care planning records, Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 9 including ongoing assessments and to ensure they are regularly reviewed and updated. However, given the level of improvement witnessed the inspector is confident the team will rise to this challenge and maintain the records accordingly. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 7, St 8 The home’s care planning process has been reviewed and improvements in recording and updating initiated. Service users are well supported by staff when accessing health and social care agencies/professionals. EVIDENCE: As with the assessment records discussed above, the home’s care-planning process was also criticised at the January 2005 inspection for not being up to date or appropriately reflecting the needs and abilities of the service users. Yet again it was pleasing to note the improvements in the home’s approach to care planning, with those files inspected having clearly been reviewed and updated. In addition to the improved assessments and more detailed and informative care plans, the files also contained evidence of daily recording and interactions with staff, health and social care contacts and included up to date photos of each service user currently accommodated at Easthill. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 11 One immediate effect of the improvements in the home’s approach to record keeping was the ease with which the inspector could identify areas of good practice within the staff team. Areas such as the supportive nature of the team, who have documented with some clarity their sensitivity towards a service user who recently suffered a bereavement, acknowledging that the person should be given time to grieve, that they should be encouraged if they wish to talk about their loss and be given understanding and support if their mood or behaviour, etc. fluctuates. On another occasion staff have documented the support they provided to a service user requiring hospital treatment following a fall, the person’s visit to A & E occurring late into the evening and the follow-up visit to the fracture clinic taking place the next day, both visits accompanied by a staff member throughout. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 12, St 15. The service users are offered and enjoy extensive social and recreational opportunities. The meals provided to service users at Easthill continue to be well balanced, well presented and offer variety and choice. EVIDENCE: The staff and management of Easthill have always demonstrated a commitment to providing service users with extensive social and recreational opportunities, which was again found to be the case at this visit. Within the main dining area of the home it was noted that a chalkboard is used to advertise daily activities, listing opportunities such as hairdressing, cooking, bingo sessions or scrabble etc., as well as documenting short trips out, shopping or to collect items or people. Posters also on display within the dining room advertise opportunities to participate in activities such as exercise programmes with Diane, an external events organiser, who visits the home regularly and a more extensive programme of outings that have been planned by the staff and service users in unison. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 13 This programme documents the requests and wishes of service users to visit local attractions, attend local events and participate in annual celebrations, such as Halloween and bonfire night. In discussions with staff it was clear that this plan was drafted following a service user meeting, when in addition to agreeing the schedule people also demonstrated a desire to participate in this year’s Ryde carnival, as opposed to organising a fete. Whilst at the home the inspector caught sight of the costumes being created for the carnival and observed one of the service users, with seamstress skills, aiding staff in making the outfits to be worn. The inspector would not wish to divulge details of the costumes being created nor give details of the float being entered, however once complete it should make for a colourful and fun addition to Ryde’s festivities. Another popular event within the home appears to be mealtimes, which serves both a functional and social role within the home, people witnessed arriving in the dining room upwards of half an hour before tea-time to socialise. The food being prepared and the served also confirming that meals are presented nicely, that choice is of paramount concern, with several meals / teas prepared in response to service users’ requests and food stores reflecting the individual preferences of the service users, who often accompany staff when shopping, selecting food items they like whilst negotiating the supermarket. In conversation with people it was clear that this particular activity (shopping) is greatly enjoyed, with the opportunity to choose and try new produce, etc. seen as a very valuable and pleasing exercise. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 18 Improvements to the home’s induction and foundation training programmes should ensure new staff are better equipped to manage and identify issues of abusive practice. EVIDENCE: The home’s induction and foundation training programmes were again issues that raised concern at the 12 January 2005 inspection, where both programmes were found to be less than adequate. At this visit however it was evident that not only had the induction and foundation programmes been revised but also that efforts were underway to ensure all appropriate staff complete both programmes. One benefit of the approach adopted by the management is that by ensuring all staff receive basic instructions around care delivery and how to monitor / identify that care is being inappropriately delivered, a consistency in reporting of concerns etc. should be generated. By making staff aware of issues, such as adult protection, one of the key elements addressed within the programmes, the home is equipping staff with the skills necessary to respond appropriately to adult protection concerns. The programmes identify for staff what constitutes abuse, how to access information around abuse, where to locate policies and procedures and the expectations of the Hampshire Deaf Association, Local Authority and Commission for Social Care Inspection on how allegations of abuse should be managed. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 15 This initial introduction to the sensitive issues of adult abuse / protection are further addressed within National Vocational Qualification courses and specific training events around adult protection and the use of the various policies and procedures. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 16 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 standard(s) St 19, St 20, St 21, St 24. The premises is well maintained and does not lack from inward investment. A range of well maintained and comfortable communal facilities is provided both internally and externally. Recent refurbishment work has been completed on two bathrooms, ensuring that the toileting and bathing facilities within the home meet the needs of the service users. The accommodation provided to service users is well maintained, individually decorated and designed to meet the needs and wishes of the occupying service user. EVIDENCE: It became clear during the tour of the premises that the home is well maintained and that the reinvestment of monies into the property, in order to improve services for residents is not an issue, with the refurbishment of two bathrooms having recently been completed. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 17 During the tour of the home the manager discussed some possible development opportunities, for both the home and association generally, although the discussions were very preliminary, and any long term plans etc. would need consideration as part of a wider registration application process, or in preparation for the submission of such an application. Whilst touring the premises the inspector was introduced to several service users, who were mainly resting within their bedrooms or entertaining themselves post lunch. Whilst the inspector had no interpretation support at this visit, it was relatively easy to gauge how people felt about their personal space, given the amount of effort they had put into creating very individual and unique environments, every room within the home being completely different from any other and sometimes decorated and furnished using fascinating combinations of colour. In addition to the internal areas of the property visited, the inspector, accompanied by the manager, also inspected the gardens / grounds, which evidenced further the efforts made in creating and maintaining a pleasant and inviting environment for the service users. The flower beds had been nicely planted out, the grassed area well kempt, the patio clean, tidy and freely accessible to all residents and visitors and the greenhouse and vegetable plot full of seasonal plants and vegetables. Much of the praise for such a well kempt and tidy garden goes to one of the service users, who in conjunction with the gardener tends all plants and flowerbeds and waters all borders and greenhouses, as witnessed during the tour. As recorded earlier within the report the home has recently completed the upgrading or refurbishment of two bathrooms / toilets, resulting in one bathroom being altered to create a walk-in shower and the second seeing an unused shower removed from a toilet area to increase the accessible space for service users. These alterations, whilst not hugely affecting the amenities of the home, have greatly increased the accessibility and suitability, given the changing needs of the service users,of these areas and have met with praise from the residents. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 28, St 30. Staff are accessing training events, which should equip them with the skills and abilities required when caring for service users and maintaining their safety and wellbeing. The improved induction and foundation training programmes should equip staff with the essential skills and knowledge required to support service users. EVIDENCE: The management, supported by the Hampshire Deaf Association, is making National Vocational Qualifications (NVQ) far more accessible to staff, as evidenced by five staff having completed their NVQ level 2, with a further three staff due to complete their courses shortly and two staff having completed level 3, with a further one staff member due to complete her NVQ level 3 programme soon. Once these individuals have successfully achieved their NVQ qualifications the home will have eleven out of twenty care staff trained to NVQ level 2 and above, which is 5 above the 50 target indicated within the National Minimum Standards. In addition to providing staff with access to NVQ training courses the management continue to ensure staff have access to key training opportunities, such as sign language, which is a core educational need for anyone working within the home and perhaps should be viewed as slightly more important than NVQ training in the first instance. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 19 Another important aspect of the staff’s development is the induction and foundation programme, which for new staff entering into the caring profession for the first time and/or those returning to work after a lengthy break etc. is a useful introduction into the role and responsibilities of a carer. In addition to providing basic care skills and knowledge of essential policies and procedures, the induction and foundation training programmes help equip staff with the skills and confidence required when undertaking further NVQ style training courses. In discussion with the deputy manager, it was clear that she is committing considerable time to the induction programme and is happy to support staff who she feels are making positive efforts to learn from the process. Staff were also happy with the training opportunities available and for the increased financial support provided by the management and Hampshire Deaf Association and the encouragement and assistance of the deputy manager. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 34, St 37 & St 38. Changes to the Hampshire Deaf Association’s financial management structure have further enhanced the safety aspects for service users. Improvements in the home’s approach to record keeping and the storage of records should ensure service users’ rights and best interests are safeguarded. Issues directly affecting the health, safety and welfare of all parties involved with Easthill are addressed in accordance with health and safety guidance. EVIDENCE: In discussion with the manager and one of the deputy managers it was ascertained that changes within the Hampshire Deaf Association’s financial management structure, namely the appointment of a new finance director, has seen considerable changes in how monies are used. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 21 Some of the main changes being introduced involve far more accounting and auditing of financial transactions from the centre, i.e. the financial directorate has introduced more comprehensive records for the home to maintain, hand written accounts are being phased out and replaced with more modern computerised data bases and the financial director is far more hands-on and maintains contact with the home on all matters relating to finances. For the service users these changes should ensure far safer financial procedures, which are less open to mistakes or errors caused through human error. Although in fairness to the deputy manager, who oversees the home’s accounting, no issues of concern with regards to her record keeping have ever been raised. Another area of the home’s practice which has changed significantly, as mentioned earlier within the report, is the improvements in record keeping. At the 12 January 2005 inspection the inspector raised a number of concerns with regards to not just how the records were being maintained but how they were being stored, as the office appeared chaotic with large numbers of papers and documents littered around and no sense of direction or structure noticeable. At this inspection not only have huge improvements been seen in the home’s record keeping, as discussed throughout this report, but the issues surrounding the chaotic and haphazard way the office was set out and maintained have been addressed. Large amounts of the paperwork, previously spread around the desks and piled up on work surfaces, has been cleared or filed, sensitive information relating to service users and staff is now being filed and held in accordance with Data Protection requirements, access issues to up to date data for staff is being explored through a computerised system, which should enable different levels of access depending on seniority within the Association etc. The Hampshire Deaf Association and management of Easthill evidence that they take issues of health and safety seriously through the two pronged approach to managing health and safety they utilise. Within the last 12 to 18 months the Association paid for an external health and safety consultant to visit the home and undertake a full health and safety audit, providing a report to the manager and Association and providing environmental risk assessments, with the purpose of reducing the likelihood of injury from and perceived harm or danger. In addition to the external consultant’s role the management has also delegated to a senior staff member responsibility for reviewing health and safety around the home and for ensuring that the practices of staff and the Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 22 wishes of service users, where in conflict with health and safety guidance, is appropriately managed. The home also makes available to staff copies of health and safety guidance documents, although it is important from time to time to ensure these documents are updated, or at least reviewed, as current advice and guidance changes rapidly. From a service user’s perspective the deputy manager, most heavily involved in the care planning process, has introduced personal risk assessments, which as with the larger environmental risk assessments, set out to identify particular risks to people and produce plans on how these dangers might be limited / reduced. Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 23 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 3 x x STAFFING Standard No Score 27 x 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x 3 x 3 3 Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Easthill Home for the Deaf H55 H04_S12483_Easthill_V218170_130705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Mill Court Furrlongs Newport, Isle of Wight PO30 2AA 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. 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