Inspection on 11/05/05 for Edensor Nursing and Residential Home

This inspection was carried out on 11th May 2005.

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

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

Other inspections for this house

Edensor Nursing and Residential... 04/06/08

Edensor Nursing and Residential... 03/05/07

Edensor Nursing and Residential... 23/06/06

Edensor Nursing and Residential... 22/11/05

Edensor Nursing and Residential... 17/11/04

Edensor Nursing and Residential... 11/05/04

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Claremont House

Chesham House

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Firstlings

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

CARE HOMES FOR OLDER PEOPLE Edensor 3-9 Orwell Road Clacton on Sea Essex CO15 1PR Lead Inspector Diana Green Unannounced 11 May 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. Edensor Version 1.10 Page 3 SERVICE INFORMATION Name of service Edensor Nursing and Residential Home Address 3-9 Orwell Road Clacton-on-Sea Essex CO15 1PR 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) 01255 423317 01255 423317 Elder (UK) Limited Mrs Kim Crosskey Care Home 66 Category(ies) of Dementia (26), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (4), Physical disability over 65 years of age (26) Edensor Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Persons of either sex aged 40 years and over, who require nursing care by reason of dementia (not to exceed 26 persons). Persons of either sex, aged 65 years and over, who require care by reason of a mental disorder, excluding learning disability or dementia (not to exceed 46 persons)Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 26 persons) Date of last inspection 17 11 04 Brief Description of the Service: Edensor provides nursing and personal care with accommodation for younger people with dementia and older people with mental illness and/or physical disabilities. Edensor is owned by a private organisation named Elder (UK) Ltd. The home is located in a residential area within walking distance from the centre of Clacton upon Sea.The home was opened in 2002 and consists of a three-storey building.There are 34 single bedrooms and 16 double bedrooms. There is a passenger lift. The home has gardens to the front of the property and a secure courtyard garden that is accessible to wheelchair users. Edensor is accessible by road and rail and the nearest station is in Clacton on Sea. Parking is available in the small car park and adjacent road. Edensor Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 11 May 2005, beginning at 10.15 and ending at 15.45 hours. The inspection process included: discussions with the manager, the deputy manager, five staff, eight service users and two relatives; a partial tour of premises, observation of lunch and the inspection of a number of records kept by the home. Twenty-one standards were inspected, of which 7 were met and the remainder consisted of minor shortfalls, resulting in 18 requirements and 2 recommendations. Residents and their relatives were generally satisfied with the care at the home and said that staff were friendly and caring. One resident said “they look after us well. The food is always good here”. However the standards of care planning and monitoring of health needs need to be raised to ensure that care staff are fully informed and able to provide care appropriately for individual residents. What the service does well: Edensor was providing a comfortable and homely place to live, with a range of pleasant communal areas and bedrooms with individual character. Residents and relatives spoken with said that staff were caring and looked after them well and they felt safe at he home. Residents who commented upon the food, said it was good and there was plenty to eat and drink. Residents with dementia were supported in participating in the programme of therapeutic activities and others were enabled to pursue their own interests and to keep in contact with their friends outside the home. Edensor Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Care plans did not cover all needs comprehensively so that care staff were not fully informed on residents’ individual needs when providing care. The manager should ensure that responsibility for developing care plans is delegated to senior care staff in her absence to ensure that no resident is without a care plan. Improved monitoring of some health care needs is necessary to demonstrate that appropriate action is taken where a need is identified. Time taken to address premises issues identified at inspection could be improved upon and would enhance the environment for residents. The processes for recruiting new staff could be improved to ensure that all the necessary documents have been obtained and are in order, including documents translated in English for staff employed from overseas. Staff need to take care to uphold the privacy and dignity of all residents when providing personal care. The home had the Essex Guidelines for the protection of vulnerable adults available but had yet to formalise procedures for the home to ensure staff were clear of how to make referrals. The management of complaints could be improved to ensure issues are fully investigated which would give residents and their relatives confidence that their concerns are taken seriously and acted upon. Systems for consulting service users and other interested parties about their experience of the home had been implemented but required further development to enable an action plan, based on these views, to be developed. Edensor Version 1.10 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Edensor Version 1.10 Page 8 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 Edensor Version 1.10 Page 9 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) 3, & 5 The admission procedure is inadequate and does not ensure all residents are assessed on admission. Without this there is no assurance that care needs can be met. Prospective residents and their representatives are given the opportunity to visit prior to making a decision to move in. EVIDENCE: The manager and deputy manager, both registered nurses, undertook assessment of prospective residents prior to admission. Information on the person’s needs was recorded, but details were brief and incomplete. There was no assessment for foot-care, manual dexterity or religious and cultural needs. Evidence of pre-admission assessments was present on two of the three files inspected. One resident had been admitted as an emergency on 3/05/05 and the local authority had provided the care management assessment but there was no evidence of an assessment having been undertaken since admission Edensor Version 1.10 Page 10 and no care plan had been developed. There was evidence from discussion with the manager and feedback received from relatives that they had the opportunity to visit the home and meet the manager and staff prior to admission. Edensor Version 1.10 Page 11 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) 7, 8 & 10 Residents health and personal care needs are generally well met within the home. The care planning process does not consistently provide adequate information for care staff to satisfactorily meet residents’ needs. Staff have a caring approach towards residents, but privacy and dignity are not always upheld. EVIDENCE: Three care files were inspected. Two contained care plans that covered the majority of key needs (physical and social), but the details of the action required of staff to meet residents’ needs were brief and required further development. Both care plans had been regularly reviewed. The third file contained a care management assessment and mental health assessment but there had been no assessment of needs undertaken or care plan developed in the eight days since admission. Assessments for moving and handling/mobility, pressure areas and continence needs were recorded in two of the files inspected. One file provided evidence that a risk assessment for falls had been undertaken but the mobility plan did not provide sufficient detail Edensor Version 1.10 Page 12 to demonstrate that the risk had been minimised. Care plans provided brief details of the action required to meet needs and required further development. The home had a contracted GP who attended weekly and as required. There were a further four GP practices who also attended to review residents. The standard of personal care was observed to be satisfactory, although one resident said they had to wait to see a hairdresser. There was one resident with a pressure sore who was in hospital. The home had appropriate pressure relief equipment available and records confirmed preventative action was taken. Staff were observed to encourage residents to walk with their assistance and to take part in physical activities. The records confirmed that residents were weighed on admission and regularly. However one resident’s weight was recorded in stones and pounds on admission and subsequently in kilos. A weight loss of seven kilos was recorded but there was no evidence of any action taken. Residents spoken to said that staff were caring and helpful. Staff spoken with said they were instructed at induction on how to treat residents with respect and this was generally evident from their care practice. However one resident was noted to be wheeled to the bathroom in a partial state of undress. Edensor Version 1.10 Page 13 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) 12, 13 & 15 The routines of daily living suit the majority of people living at Edensor but religious needs are not always met. Residents are enabled to maintain contact with the people important to them. The meals in the home are varied and nutritious and cater for special dietary needs. Alternative choices are provided based on residents’ preferences. EVIDENCE: The home operated an activities programme that included physical exercises and some therapeutic activities for residents. On the afternoon of the inspection, residents in one lounge were taking part in a word game and a ball game. The records detailed residents’ preferences but this could be further developed to provide a clear and comprehensive record of the residents preferred lifestyle. Residents were enabled a choice of where to eat and some flexibility of time of eating was facilitated for one service user. Several residents were observed to take their time in eating lunch with no pressure on them. Staff were observed to assist those residents who required assistance with eating in a sensitive and discreet manner. Edensor Version 1.10 Page 14 One resident said they found it disappointing that there was no regular religious service held at the home as they had received regular visits from a minister at their previous home. Residents’ visitors were observed to visit throughout the day and those spoken with said they were advised of the arrangements on admission and were welcomed into the home. Residents spoken with said they were able to go out with their families. The menu was displayed for residents’ information and their choice discussed daily with them. The records were being maintained appropriately and evidenced a balanced, nutritious diet with specialist needs catered for. All residents looked well nourished and those spoken with indicated the food was good and plentiful. The lunchtime meal of roast chicken, potatoes, gravy and fresh cauliflower and cabbage followed by a choice of desert was observed and was clearly enjoyed by residents. One resident said “they look after us well. The food is always good here.” Edensor Version 1.10 Page 15 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) 16 & 18 The home’s complaint procedures are generally satisfactory but there is evidence that some relatives do not feel their views are listened to and acted on. Appropriate practices were in place to protect residents from risk of harm or abuse. EVIDENCE: The home had a complaints procedure that included the timescales within which complainants can expect a response and advised them of their right to refer to the CSCI at any stage. One complaint was under investigation. The manager said there had been no other complaints since the previous inspection. Residents spoken with said they had no cause to complain and were satisfied with the care at the home. However two relatives provided feedback that indicated their complaints were not taken seriously. From discussion with them and inspection of the records the Commission has concerns that the management of complaints does not demonstrate residents and their relatives concerns are adequately addressed. Edensor had a whistle blowing procedure place for staff guidance. The Essex Guidelines on the Protection of Vulnerable Adults (POVA) was available but had not been incorporated into a procedure for the home. There had been no allegations of abuse. From discussion with the manager there was evidence that any allegations would be appropriately dealt with. Thirteen care staff had received training on understanding abuse in October 2003 and whilst all were currently employed, an updated training session would be of benefit. The Edensor Version 1.10 Page 16 home’s policies and practices regarding service users’ monies were not inspected. Edensor Version 1.10 Page 17 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) 19, 22, 25 &26 Recent investment has improved the appearance of parts of the home. The slow pace of refurbishment and failure to quickly address maintenance and safety hazards means that Edensor does not wholly present as safe for service users. EVIDENCE: Only a limited inspection of the premises was undertaken. The home was generally clean and well maintained, however some action required from previous inspections had been slow to be addressed (provision of mirrors, overhead and bedside lighting). Ceiling tiles damaged in a flood in one room were waiting for repair and a stair rail was loose. A veranda potentially accessed by residents had old furniture and gardening tools left that required disposal. A skip that had been used in the recent refurbishment was present to the front of the premises and the front gardens also required attention. A recent fire inspection had agreed the use of door wedges to prop doors open in Edensor Version 1.10 Page 18 the dining room. These must be removed at night to assure the safety of residents and staff. Edensor had two lifts that were well maintained and access to communal and individual accommodation was provided through grab rails and ramps fitted throughout the home. Call bells were not available in all rooms and additional alarms must be provided. There were no separate storage facilities and wheelchairs were stored in communal rooms in designated areas. The home was comfortably furnished and residents spoken with said they felt it was their home and they felt safe at Edensor. The home was centrally heated throughout but could not be controlled in all residents’ rooms. Action had now been taken to guard all radiators throughout the home. The home was generally clean with no odorous smells but standards of cleaning with attention to detail (cleaning of light switches and door handles) could be improved. The laundry was well organised with appropriate equipment in use to ensure the appropriate laundering of clothing and bedlinen. However there was some damage to the floor and gaps in tiles could present an infection control risk. Staff hand washing facilities did not include paper towels in all areas. Edensor Version 1.10 Page 19 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) 27, 29 &30 Staffing levels and skills are appropriate to meet the personal care and physical needs of service users. The recruitment processes are not sufficiently robust to protect service users, placing them at possible risk of harm or abuse. Staff are able to update their skills through regular training providing residents With confidence in their care. EVIDENCE: There were 61 residents comprising 41 residential and 20 nursing clients. The duty rota was inspected and complied with the levels previously agreed. From discussion with the manager, staff and residents there was evidence that staffing levels were sufficient to enable personal care needs to be appropriately met. Residents spoken with said that they were not kept waiting for long when they called staff. In addition to the manager, there were two registered nurses and eight care staff on duty. Ancillary staff included a secretary, two domestic staff, a laundry person, the cook and a kitchen assistant. The recruitment procedures were discussed with the manager who confirmed that staff were employed from overseas that had been arranged through an agency who undertook all checks. Three staff files were sampled. All were qualified nurses in their country of origin and were employed as care assistants. Proof of identity/recent photograph, passport and birth certificate were not available in two of the three files. Two written references were available in two of the three files but the police check was only available in Polish in two files. Edensor Version 1.10 Page 20 The induction checklist was inspected for the same three staff. This comprised a brief checklist only. The care staff confirmed that they had been informed of fire procedures, advised of moving and handling techniques and received a hoist demonstration. One had attended training in pressure ulcer identification. None of the care staff had received formal training in moving and handling or health and safety. There was evidence from the training records inspected that moving and handling training had last been provided in September 2004 and was planned for 16/05/05. Recent training had included falls prevention, advanced diabetes care, and infection control. Edensor Version 1.10 Page 21 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) 31, 33 & 38 Staff are well supervised but action is needed to ensure health and safety practices are improved and upheld to ensure the safety of residents. The systems for service user consultation need further development to ensure residents and their relatives are confidant their views are listened to and acted upon. EVIDENCE: The registered manager, who is a registered nurse, had managed the home for several years and was supported by a deputy manager, also a registered nurse. The proprietor was also in regular attendance at the home. Supervision was provided on a continuous basis and there was evidence of regular handover meetings held between shifts. A quality assurance system had been implemented since the previous inspection. Service user questionnaires had been circulated to those residents who were able to independently complete them. However the questionnaires were not anonymous and there were no results from the survey. Discussion took place on the methods available to consult fully with residents and their Edensor Version 1.10 Page 22 relatives. There was evidence from discussion with residents that their views on the home were sought through residents meetings and changes made as a result, for example by changes of menu. Policies were reviewed annually and the manager was advised to ensure these were dated to evidence the reviews. The home was in the process of refurbishment and some items requiring disposal remained in a skip and on the veranda detracting from the attractiveness of the building and posing a health and safety risk. Health and safety practices were generally adhered to, however the delays in maintenance issues being dealt with means that Edensor does not always present as safe. There was evidence from observation, inspection of the records and in discussion with staff and residents, that the manager made efforts to ensure the health and safety of staff and residents as far as reasonably practicable. Edensor Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x 2 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x 2 x x 2 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x 2 x x x x 2 Edensor Version 1.10 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2 Standard 5 7 Regulation 15(1) 13(5) Requirement The registered person must ensure that all residents have an assessment and plan of care. The registered person must ensure that residents’ mobility plans provide detailed instruction for care staff. The registered person must ensure that appropriate action is taken where residents’ unexplained weight loss is identified. The registered person must ensure that residents’ privacy and dignity is upheld at all times. The registered person must ensure that all complaints are fully investigated and appropriate action taken. The registered person must ensure that the home has a policy and procedures for the protection of vulnerable adults that are consistent with local Essex POVA Guidance. This is a repeat requirement from inspections of 11/05/04; 17/11/04 The registered person must ensure that external grounds Version 1.10 Timescale for action Immediate informed at inspection 30/06/05 3 8 12(1) Immediate informed at inspection Immediate informed at inspection 30/06/05 4 5 10 16 12(4)(a) 22(3) 6 18 12(1) & 13(6) 31/07/05 7 19 23(2) 30/06/05 Edensor Page 25 8 9 22 24 16 & 23(1)(a) 16(2) 10 24 16(2)(c) 11 26 13(3) & 16(2)(j) 7, 9, 19 Schedule 2 12 29 13 30 12(1) & 18(1) 14 33 24 15 36 18(2) and veranda are kept tidy and safe and do not present hazards for residents or others. The registered person must ensure that call bells are available in all rooms. The registered person must ensure that all residents’ rooms have overhead and bedside lighting. This requirement has been brought forward as the standard was not inspected. The registered person must ensure that all residents’ rooms have a mirror. This requirement has been brought forward as the standard was not inspected. The registered person must ensure that the laundry flooring is impermeable and wall tiles are repaired. The registered person must ensure that two satisfactory written references are obtained for all staff prior to appointment and work permits are available at inspection. The registered person must ensure that the induction programme is developed to NTO specification. This requirement has been brought forward as the standard was not inspected. The registered person must ensure the quality assurance system is further developed to include an internal annual audit and anonymous residents questionnaires. The registered person must ensure that supervision records are developed to fully meet the standard. This requirement has been brought forward as the Version 1.10 31/07/05 31/07/05 31/07/05 31/08/05 Immediate informed at inspection 31/08/05 31/08/05 31/07/05 Edensor Page 26 standard was not inspected. 16 37 26(4) The registered person must ensure that a monthly written report is forwarded to the Commission on the conduct of the care home. This requirement has been brought forward as the standard was not inspected. The registered person must ensure that the gas safety certificate is current, a copy to be forwarded to the Commission on receipt. The registered person must ensure that risk assessments of the premises are undertaken and recorded for safe working practices. 30/06/05 17 38 13(4) Immediate informed at inspection 31/08/05 18 38 13(4) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard 3 25 Good Practice Recommendations The registered person should ensure that assessments include foot-care, dexterity and religious and cultural needs. The registered person should ensure that heating can be controlled in all residents’ rooms. Edensor Version 1.10 Page 27 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Edensor Version 1.10 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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