Inspection on 21/09/06 for Eastlands

This inspection was carried out on 21st September 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Eastlands 10/07/07

Eastlands 27/10/05

Eastlands 07/06/05

Eastlands 25/01/05

Eastlands 18/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Eastlands Beech Avenue Taverham Norwich Norfolk NR8 6HP Lead Inspector Ruth Hannent Key Unannounced 21st September 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eastlands Address Beech Avenue Taverham Norwich Norfolk NR8 6HP 01603 261281 01603 869995 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) None provided County Healthcare Ltd, a wholly owned subsidiary of Four Seasons Health Care Ltd Claire Corrigan Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Thirty-five (35) Older People, not falling into any other category, may be accommodated. 27th October 2005 Date of last inspection Brief Description of the Service: Eastlands is a care home providing personal care and accommodation for 35 older people. The home is a single storey detached building, situated in the village of Taverham. The accommodation consists of six double and twenty-three single bedrooms, twenty-five of which have en suite facility. Various communal areas are available for service users. A drive way leads to the property with car parking facilities and gardens to front and rear of the premises. Email eastlands@fshc.co.uk Fees £385 - £500 Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection report follows a visit to the Home by the Lead Inspector. The Home over the past few Inspections has rated well and this visit reflects the same findings. The Manager was able to escort the Inspector throughout the day to discuss and produce evidence that comply with the National Minimum Standards. Due to annual leave and the Manager only returning on the day of the visit none of the pre inspection paperwork was available and will be completed and sent as soon as it is completed. Throughout the time since the last inspection the Commission has not received any concerns or complaints only one complimentary letter giving lots of praise to the staff and Manager. At the visit residents, staff and families were spoken to. Care plans, personnel files, maintenance records and staff training were seen. A meal was taken with the residents and a tour of the building took place. What the service does well: What has improved since the last inspection? Care plans are beginning to hold more person centred details. The Home now has all the correct records within the personnel files for each staff member. The Kitchen are monitoring all residents food intake to ensure they are eating enough and receiving the balanced meal with any amounts returned recorded Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 6 and then followed up by ensuring the resident liked the food or required something else. 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. Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are assessed to ensure those needs can be met by the Home. EVIDENCE: A recently admitted resident was able to say how her assessment had been thorough on her needs and how the home assured her the needs could be met. The written document was seen and although the lady herself had not visited the Home she was able to reflect on the impression she was given by the family, when they visited. (Many other homes had been viewed by this family to ensure they found the most suitable for this lady). On walking the Home and talking to residents people who live their appear to be placed correctly and within the registration of the Home. Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and10 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. Residents care plans have improved and do reflect the needs of each resident. The residents are supported well for their health needs. The home is thorough and follows clear guidelines of the handling of medication. Residents are treated with respect and their privacy is upheld. EVIDENCE: Care plans have improved since the last inspection and have more detail on person centred care. Three care plans were looked at and one resident was able to say that although she did not want to read her care plan she was happy with how her care was offered. Other residents spoken to were able to state how happy they were with the care with the opportunity to discuss any changes if the care support is not correct or unsuitable. One comprehensive care plan of a Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 10 resident with high needs had regular updates on the care plan as needs altered and they were dated and signed. This person was seen by the inspector and although unable to communicate clearly the care offered and the time spent by staff to understand the signs and then be able to offer the correct care was evident. Two residents discussed the support they receive from the GP’s. The Manager stated that the Home has a good relationship with the GP’s and District Nurses (who visit daily). Clear records are available with evidence of continuity of care being carried out by the care staff team of the health support for individual residents. One person is in need of the speech therapist, Community Nurse and Mental Health Team. All these details were held in the persons care file and all effort was being sort to give this person the correct medical input. The Deputy Manager is responsible for all the medication within the building and on Inspection has everything in order. The storeroom was neat and all the store cupboards are holding only one month’s supply with all returns logged and signed out. The medication trolley is tidy and bottles and eye drops in order. (Dates of drops opened were dated at the time of opening on each box). All MAR charts were correct with one error seen that had been sent incorrectly by the Pharmacist and been picked up and addressed by the Home. (The Home is double-checking all medication received due to a recent medication being sent to the Home incorrectly which is now being investigated by the Pharmacy Company). The medication storeroom is a little hot with the recommendation temperature to not exceed 25 degrees. The thermometer readings were on or just above this temperature and need to be reduced. (Recommendation) The Home has a very happy feel to its atmosphere. Staff are smiling and interacting with residents in a positive, kindly manner. All residents spoken to were very happy with the way staff care for them and how they will knock on the door before entering. In the double rooms a curtain screen is available for privacy and during the visit overheard conversations between staff and residents were appropriate. Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 and 15 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. The Home still needs to develop the service to meet the social needs of the individual residents. Visitors, families and friends are welcomed and encouraged. Residents do receive a well balanced diet that is pleasing with choice offered. EVIDENCE: At the last inspection activities were beginning to happen more often and to be more personalised to meet the individual needs This has not been happening in the recent months and limited events were taking place. The Home still had Easter bonnets and an Easter display on the notice board and little evidence except bingo was available. Residents who are more able did have the newspaper to read or audio books to listen to but those less able to stimulate themselves without encouragement or support were noted to be just sitting around. Staff did find time to bring drinks and have passing conversations but the Home lacks a dedicated person to concentrate on the social care support that people need to aid stimulation. (Requirement) Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 12 Families were seen coming and going all day. They were greeted and offered a drink with lots of smiles and pleasant conversations heard between staff, families and residents. No comment cards had been received from family members or residents due to the Manager being on leave and therefore had not been distributed. Two family members were spoken to stated they were always welcomed. The Commission had also received a very complimentary letter on the way staff and especially the Manager had cared for their relative. Residents have a choice over the way they manage their own affairs. Many are supported by family members, some manage their own and the Manager will assist in and advocacy service if required. A meal was taken in the dining room with the residents who all stated they can always ask for an alternative if they do not like what is on offer. “We can ask for what ever we like and there is always choice”. “I can have a cooked breakfast or just cereal and toast, it is up to me”. “The meals are always good we enjoy the food”. The Home has a chart that records what and how much has been eaten so that all residents are seen to be eating a balanced diet and maintaining their health. (After a discussion the Manager is to change the milk to full fat and all the yoghurts to thick and creamy). Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives can be assured that their complaints are listen to, taken seriously and acted upon. The home is building the knowledge of staff to ensure they are aware of abuse or potential abuse. EVIDENCE: A recent complaint received at the Home was discussed fully with the Manager. The Deputy Manager had followed the correct procedures in the absence of the Manager and the Manager explained how she was going to investigate and carry on with the procedures as stated in the Homes complaints literature offered to all residents and their families. In the entrance it was also noted a folder for anyone to enter any concerns, compliments or complaints. The last inspection made a requirement for staff awareness in the protection of vulnerable adults. The original Four Seasons booklet used on this subject has been completed by staff and a more comprehensive training to be cascaded to all Managers is planned for the near future so although the requirement is partly met a recommendation will be made to ensure the more comprehensive training and understanding is available to staff as quickly as possible to ensure all residents are protected. (Recommendation) Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 14 Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24,25 and 26 The quality outcome for this group of standards is adequate. This judgement has been made using available evidence including a visit to this service. Residents do live in a safe environment but some records of maintenance need to be checked. Residents do have comfortable bedrooms. The environment is not safe due to poor lighting and uncontrolled hot water. The Home is clean pleasant and hygienic. EVIDENCE: Two requirements made on the last inspection report are still outstanding. The refurbishment of the dining room is ongoing and the lighting within the corridors and some bathrooms are inadequate and unsuitable. On the day of the unannounced site visit the Regional Maintenance Officer for Four Seasons arrived with a contractor to begin the lighting changes with a definite finish Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 16 date by the end of September. As this was evidenced to the Inspector the requirement on lighting will be removed. The dining room requirement remains. (Requirement) The building in general is in need of redecorating. It is dark, a little shabby in areas and some carpets are badly stained, especially in the lounge and bedroom 14. This room has only just become vacant and is yet to have the carpet cleaned to see if the stains can be removed but is at present in a very poor state. On walking the building it was evident that residents rooms were personalised with many pictures and small items of furniture that the person treasures in place. These bedrooms are light with nice sized windows for brightness but many in need of a lick of paint. The bathrooms are dim and uninviting with no natural light. On testing the water in the bath it did not produce any pressure and the water just trickled out with a staff member stating they have to run the bath for about 1 hour to fill it enough for the hoist to be lowered and someone to wash. The temperature of the water in four hand washbasins that were checked were too hot to hold a hand underneath. With the Regional Maintenance Officer being in the building the Inspector was able to draw his attention to the problem and who will immediately obtain quotes and get the work done and ensure temperature control valves are on all hot water taps. In the mean time risk assessments must be in place and a notices placed in all sink areas accessed by residents. (Requirement). The Home was clean and tidy and no unpleasant odours were detected. Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 and 30 The quality outcome for this group of standards is good. This judgement has been made using available evidence including a visit to this service. The numbers and level of dependency of residents means the staff allocation is suitable and needs can be met. The residents are supported by the Homes recruitment policy. Staff are trained to do their job but not as frequently as required. EVIDENCE: On the day of the visit 5 care staff were on duty plus the Manager. This was one more than usual as the rota for the rest of the week shows 4 staff in the morning, three staff in the evening and two staff over night. The Home has 26 residents at present and according to the Manager many of the residents need minimal help so this level of staff is adequate at the moment. If the dependency levels or occupancy goes up then the Manager will ensure the rota of staff is increased. The Home is short of cleaning staff at present and carers were not only caring but covering domestic chores as well which made any kind of one to one time difficult and a domestic staff member should be found as soon as possible. (Recommendation). At the last inspection not all personnel files were in place and CRB’s not available. This has now been corrected and files (two seen) had all the relevant paperwork as stated in schedule 2 of the National Minimum Standards. A Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 18 question on whether a staff member who is supervised can start without references was discussed and as stated in Standard 29.2 it is clear that staff should have two references in place before commencing employment. The Home has copies of all training obtained by each staff member and also a folder was seen of the dates of training completed and when the next dates were due. The Manager has a number of staff who are overdue there First Aid and a full fire training is required. (The manager does ensure when new staff arrive that the procedure required to take place if the alarm goes off is clear and will set the alarm off as practise for all staff as well as the new member). Four Seasons have just produced new manuals and procedures for personnel and training. Eastlands needs to ensure the training for all staff, especially the compulsory training is current. (Requirement). Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36 and 38 The quality outcome for this group of standards is adequate. This judgement has been made using available evidence including a visit to this service. Residents do live in a Home that is managed by a person fit to be in charge. The home needs to develop the way it achieves the quality assurance and continually develops the service as needs of the residents change. Staff do receive supervision but not in a timely fashion with long periods of time between one to one sessions but are monitored through observation on a day to day basis. Some areas of Management responsibility under health and safety do need to improve with more accurate monitoring of training within health and safety and maintenance. EVIDENCE: Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 20 No pre-inspection questionnaire or comment cards have been received due to the annual leave of the Manager. As she has just returned the form will be completed and sent to the Commission as soon as possible. The residents, stakeholders and professionals who are involved with Eastlands have in the past rated this Manager highly and as mentioned earlier a complimentary letter had been received at the Commission. This Manager is very involved in the lives of the residents and knows them all well along with the families and visitors. She makes a point of speaking to each one daily and is always up to date with their care needs. On talking to staff and residents this was evident. The whole Homes ethos is to “communicate and be involved so staff are aware of what is happening” is one comment made. The Manager does send out questionnaires to residents as part of a quality check but has not included any other people involved within Eastlands. There is no evident action plan, or review based on the views and outcomes given by residents and stakeholders and no forward planning to keep developing and improving the service. The Home has not returned regulation 26’s which should have been carried out at least monthly by someone from the company who is responsible for the management of the service and is also part of the quality assurance checks. (Requirement). Supervision for all staff is offered and records of sessions were seen. The need to carry them out at least six times a year was not evident. The dates for the last supervision was December 2005 and others were overdue by a few months. (Requirement) The Manager does ensure that new staff are inducted according to the Four Seasons procedures. Training on all health and safety areas do take place but as previously mentioned sometimes not kept up to date. Maintenance records were seen and it was noted that water temperatures had been recorded too high with most records showing 50 . This had not been brought to the attention of the Manager, which also highlighted a need to ensure that regular supervision is in place for the Maintenance Officer and that checks on maintenance records are accurate. No records had been signed off by the Manager and unless the Maintenance Officer had told her, the records were not checked. (Requirement) Accident records were seen and completed correctly for both residents and visitors. (The home holds two books). Regulation 37 notification of accidents or deaths had not been received at the Commission and were immediately made available on the inspection. (There had been problems with emailing). One that had been received and discussed Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 21 was the concern over the medication error (mentioned previously), which was very detailed and clear to what is to happen and when with the investigation will take place. Overall the management of the Home needs to be improved in the record keeping areas within health and safety. The management of staff and the care or residents is good. Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x 3 1 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x 2 x 2 Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP20 Regulation 23.2 Requirement It is a requirement that the dining room is refurbished with flooring and curtains are in place at the windows. (Repeat Requirement) It is a requirement that residents are consulted and arrangements are made to enable them to be engaged in activities and interests that suit the individual. It is a requirement that all taps available to residents are regulated to a temperature that is safe for them to use. It is a requirement that all staff are up to date with all training that is compulsory to ensure they are suitably qualified to offer the appropriate care. It is a requirement that reviewing and improving the quality of care is in place with regulation 26 visits used as part of that improvement. It is a requirement that all staff are appropriately supervised to ensure they are carrying out their duties appropriately. It is a requirement that the DS0000027462.V313195.R01.S.doc Timescale for action 01/12/06 2 OP12 16.2 m&n 01/12/06 3 OP25 13.4 01/11/06 4 OP30 18.1a 01/12/06 5 OP33 24 & 26 01/12/06 6 OP36 18.2 01/12/06 7 Eastlands OP38 23.2c 01/12/06 Page 24 Version 5.2 home is well maintained to ensure health and safety for all people in the Home and records reflect this. 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 OP9 OP18 OP27 Good Practice Recommendations It is recommended that the room temperature in the medication storeroom is reduced to below 25 degrees. It is recommended that the programme for a more comprehensive training on the Protection Of Vulnerable Adults be implemented as soon as possible. It is recommended that the vacancies in domestic staff are filled as soon as possible to allow time for residents from the care staff and for them not to be doing domestic chores. Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Eastlands DS0000027462.V313195.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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