Inspection on 02/05/06 for Elmsdene Care Home

This inspection was carried out on 2nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Elmsdene Care Home 27/08/09

Elmsdene Care Home 04/09/07

Elmsdene Care Home 13/12/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Elmsdene Care Home 37-41 Dean Street South Shore Blackpool Lancashire FY4 1BP Lead Inspector Mrs Ruth Edgington Unannounced Inspection 2nd May 2006 8.30am 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 Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Elmsdene Care Home Address 37-41 Dean Street South Shore Blackpool Lancashire FY4 1BP 01253 349617 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) Sheridan Care Limited Mrs Hazel Linley Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 33 service users in the category OP (older persons 65 and over) The work required by the pre-registration agreement will be met within the stated timescales. 12th December 2005 Date of last inspection Brief Description of the Service: Elmsdene is an adapted property, situated in an area of Blackpool, which is predominantly holiday accommodation. The availability of local shops and facilities could be seen as an advantage for those able to continue to maintain links with the community. The home is registered to accommodate a maximum of thirty-three persons over the age of 65 years. The accommodation, which is on the ground and first floor, consists of twenty-five single bedrooms, nine of which have en-suite facilities and four double bedrooms, two of which have en-suite facilities. Each room is furnished to a good standard. There are four communal areas that provide the residents with the choice of where to sit and where to have their meals. There is a passenger lift, which enables easy access between the ground and first floor. A variety of aids are provided around the home to meet the needs of the residents. There is a Statement of Purpose/Service User Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are, and what the resident can expect if he or she decides to live at the home. All residents receive a copy of the most recent inspection report and a copy is available in the information given to prospective residents. Information received prior to this visit (02/5/06) showed that the fees for care at the home are from £280.0 to £324.10 per week, with added expenses for hairdressing, chiropody and newspapers. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit, which commenced at 8.30am and took place over seven hours. Prior to the visit the deputy completed a pre-inspection questionnaire and comments cards were received from nineteen residents and four relatives. The homeowner, deputy, senior care, three care staff, a laundry /care assistant; a domestic and the cook were spoken to. Five residents and three visitors were spoken to individually and a number of residents who were sitting in the communal areas were also spoken to. Conversation with residents was very much dependent on their ability or wishes to speak to the Inspector. A tour of the home was carried out and a selection of staff, residents and administrative records were examined. From the observations made, comments received and written documentation seen, the information has been put together to from this the report produced. Everyone was very friendly and co-operative throughout the visit. What the service does well: The residents in this home are well cared for. Staff were seen to be very caring in the way in which they looked after the residents and all personal tasks were carried out sensitively. Residents are encouraged to be individual and their personal routines and lifestyles are respected. Relatives are encouraged to play a part in the home and to voice their views in order that the needs of the residents are met. Observations of care practices showed that there is good interaction between carer and resident. Residents spoken to said that “things have improved”, although one resident felt that the homeowner was trying to do too much at once and was concerned about her. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 6 Visitors were also complementary, saying that the staff were very kind, polite and that they were kept informed at all times. One visitor said that their relative was very happy and the staff were very caring and supportive, What has improved since the last inspection? There have been a large number of improvements made to this home since the previous visit (12/012/05) and this is in due to the commitment and hard work of the homeowner and staff. The changes identified in the previous report to commence in January 2006 are now in operation. Induction and supervision have become more formalised ensuring that staff work in accordance with safe practices for the benefit of the residents. Staff training and individual development is seen as a priority and time is put aside each week to allow training about specific areas identified to meet the needs of the residents. One area that has developed since the last inspection is that of care planning. The home operates a Key-Worker system, which ensures that each resident has at least one identified carer at all times over the twenty-four hour period. The system of reviewing the agreed care plan has improved, which has resulted in areas of staff training and development being identified and the provision of any aids or adaptations required by the individual resident to improve the care provided. A number of bedrooms have been redecorated and recarpeted taking into consideration the individual residents choice. Other areas of the home have had new carpets laid. Locks have been fitted to bedrooms doors and those residents who wish and are capable have been given their own key. A new emergency call system has replaced the previous system that was considered to be an invasion of privacy and so loud that it disturbed other residents. Areas of heath and safety have been improved, which includes all radiators are now fitted with appropriate guards and the fire alarm system has been upgraded to ensure that all doors close in the event of a fire Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 7 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. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 the following standard(s): 1&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives have the information needed to choose a home, which will meet their needs. The admission and assessment procedures are clear to ensure the care needs of residents are met. EVIDENCE: The home has an admission policy, which includes providing all prospective residents with a copy of the Statement of Purpose /Service User Guide and the need for a formal assessment to be carried out prior to any resident being admitted. Through discussions with the relative of a prospective resident it was confirmed that they had been given a copy of all the necessary information to assist them in making up their mind about the home. The relative said that Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 10 they had made several visits to the home and at the time of this visit the deputy was undertaking a full assessment of the residents needs with the persons concerned. The relative could not praise highly enough the attention that they had been shown and said that they wished that they had found this home sooner. The records were examined of the last three residents to be admitted. The files contained a full assessment of needs, which had been carried out prior to admission, therefore ensuring that the home could meet these needs. The staff spoken to confirmed that they had access to the residents’ information and could describe in detail the care needs of individual residents. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored to ensure health needs are met. EVIDENCE: On the previous visit the procedures for recording individual care plans were being developed further. A Key worker system is now in operation and ensures that there are individual records kept for each resident. These contain a plan of care setting out in detail the action that needs to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents are met. Significant events had been recorded and daily entries made setting out the care given. Evidence was seen that confirmed that the care plans are regularly reviewed. The records of three residents were looked at and these clearly described their healthcare needs. Discussions with staff members confirmed they were fully aware of the healthcare needs of residents. Entries made on care plans showed good communication between the home and healthcare professionals. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 12 At the time of the visit a district nurse was visiting one resident and from observations and discussions it was clear that the staff were following the instructions given. Information seen confirmed that there were two residents at that time receiving treatment by the district nursing service. From discussions with the management it was concluded that the five residents that they had identified on the PIQ as having mental heath problems where never formally diagnosed as such and would be suitably cared for in the present environment and also remain in the home if the proposals to care for residents with Dementia are accepted by the Commission for Social Care Inspection (CSCI) The homeowner confirmed that they were in the process of having all residents re-assessed in respect of the proposed changes to the category for which the home is registered. Observations were made throughout the visit of the caring approach of the staff towards the residents and the practices in the home ensured that residents were treated with respect and their right to privacy was upheld. Residents spoken to said that they could stay in their bedrooms if they wished and that staff were always polite and made sure that they were never embarrassed in any way. Medication practices observed were safe and good records had been maintained. The home uses a monitored dosage system and the storage of the medication was seen to be satisfactory. All staff who administered medication have undertaken training. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14 & 15, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social, cultural and recreational activities meet resident’s expectation. Residents receive a healthy, varied diet according to their assessed requirements and choice. EVIDENCE: Observations were made of residents having breakfast and lunch. Attention was being given to those requiring assistance. Residents spoken to said that they can have their meals either in their bedroom, the dining room or the lounge areas. The new Cook was spoken to and was found to be aware of the individual resident’s needs and any special diets required. There were two residents who had diabetes and the cook was able to explain how this affected their diet. A monthly nutritional assessment is undertaken for each resident. The cook confirmed that all meals are home made The soup being provided at lunchtime was sampled and found to be excellent. Residents confirmed that the food had improved. One said” I never leave anything on my plate”. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 14 One resident refuses to have the meals prepared by the home, which has been the situation for a number of years. They prefer to buy food from a wellknown store because they had done this before coming into the home. Whilst accepting individuals right of choice, the cook is working hard to encourage this person to try the home’s meals. Discussions with the management in regard to persons, whose first language was not English, revealed that this had been a mistake when completing the PIQ. All residents spoke and understood English. Residents who were able to communicate explained how they spent their time and all were satisfied. Observations made during the visit confirmed that they are able to choose how they spend their time and with whom. Activities are carried out each afternoon and resident confirmed that they are free to join in should they choose to. Relatives are being encouraged to be more involved and an entertainments committee has been set up and are to meet bi-monthly. The homeowner discussed plans to develop appropriate activities for the residents should the home change category to allow admission of persons with Dementia. During the visit one resident was going out shopping with a friend, which they said was a regular occurrence. Information was available to confirm that other residents attend local churches, clubs and have regular contact with family and friends. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements in place for handling complaints ensure that people feel confident that their complaints will be listened to and taken seriously. Procedures for dealing with and reporting abuse were in place to ensure that people are adequately protected. EVIDENCE: The homeowner has implemented a new system since she took over the home for the recording of any complaints, which ensures that full information is recorded about the complaint, the action taken and the outcome. A detailed complaint procedure is made available to all residents on admission to the home. Comments received from residents confirmed that they knew who to complain to if they had any concerns. Staff spoken to confirmed that they felt confident that any concerns that they had would be taken seriously and acted upon by the homeowner. The PIQ stated that there had been one complaint received by the home since the last visit. The record of this was seen and was found to be about food and that the appropriate action had been taken to resolve the matter. The home has a procedure in place for dealing with allegations of abuse. The management and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 16 Evidence was seen that staff had received training and documentation on the Abuse procedures. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 the following standard(s): All the above standards were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: A tour of the home showed that the general environment was good. Furnishings were very comfortable and aids and adaptations were in place to help the residents’ mobility, personal toilet and bathing needs. Bedrooms are personalised and those residents spoken to said that they were happy with their room. One relative spoken to was busy sorting clothing out in the resident’s bedroom and said that they liked the involvement that they had. Confirmation was seen that now all radiators are fitted with a guard. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 18 A member of the management systematically checks the home and any work required. This is recorded in a maintenance book to be attended to by the handyman. Certificates re all work required pre registration have been produced and a recent Environmental Heath report has been complied with. There were no obvious concerns noted during the visit. Standards within the home are improving and steps are being taken to ensure the safety and comfort of all the residents should the future proposals for the home go ahead. The previously invasive call system as been replaced and the effect is that the home is calmer and more peaceful. The laundry was clean and hygienic and staff said that the new equipment had made great improvements to the overall laundry service . Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 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): All the above standards were looked at. Quality in this area is good. This judgement has been made using available evidence including a visit to the service. The policies and procedures for the recruitment of staff are robust and provide safeguards for the protection of residents. Staff in the home are trained, skilled and in sufficient numbers to meet the aims of the home and the changing needs of the residents. EVIDENCE: The files of the last three members of staff to be employed were examined and found to contain all the information required by regulation before new staff members commence working in the home. All appropriate checks had been undertaken. Through examination of the files and discussions with the staff evidence was found that staff had gone through a formal recruitment and induction process. Evidence was also seen that indicated that staff training , supervision and contact with outside agencies had improved. This was confirmed through discussions with staff on duty. The home has achieved 50 of care staff with a level 2 NVQ. The remaining care staff have all agreed to undertake this training. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 20 The home operates an equal opportunities policy for all staff. The staff rota has been devised to provide adequate cover when required and stability for the residents, as they know who is working at anyone time. All the staff spoken to said that they enjoyed their work, could easily describe the needs of individual residents and felt supported. They felt that improvements in the home were for the best. One staff said “ I love working here” and another said that they would not have stayed if the residents were not cared for properly”. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 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, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed and run in the best interests of the residents. EVIDENCE: Since the homeowner took over the registered manager has been off sick and she has made the decision not to return. A copy of the manager’s resignation was provided during the visit. The homeowner is a qualified nurse and is very experienced in the care of the elderly. She is presently on the second year of a Diploma in Management course. Training in Health and Safety practices is provided and at the time of the visit a training course was in progress in the home for those staff who had not completed this. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 22 All health and safety checks are carried out in line with requirements and evidence was seen that the hoists had been serviced recently. Systems are in place for quality assurance. Residents questionnaires are completed three monthly and questionnaires are made available for visitors to complete. All comments are collated and areas for improvement or development are then addressed. The questionnaires received by CSCI prior to the visit raised questions in regard to how much assistance had been given to the residents in completing the form given the capabilities of the majority of the residents to undertake such an exercise. The homeowner was advised that if residents are not capable of answering such questions and there is no relative or advocate available to assist them, this should be identified in any outcome recorded. However from the comments by residents and staff during the visit it would appear that the feelings of the residents were reflected adequately and also there are other ways in which residents can make their feelings known. There are regular staff and residents meetings, which enable people to voice their opinions and make suggestions that will benefit everyone. The homeowner regularly contacts the Inspector to discuss any concerns that arise, however CSCI is not always notified in writing of any incidents of death or accidents. that occur in the home. The homeowner was reminded of this requirement. Information recorded on the Pre-inspection identified that there had been few such occurrences since the homeowner took over the home. All policies and procedures are in the process of being reviewed and evidence was seen that the National Minimum Standards (NMS) are being worked through to ensure that the home complies fully. Records for money being handled by the home on behalf of the residents are kept and receipts of all expenditures and moneys are securely locked away. The Annual Development Plan is due in September 2006. The homeowner is in the process of compiling evidence in support of the proposed changes to the category of residents accommodated. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x x 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 2 Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP38 Regulation 37 Requirement The registered person must notify the Commission in writing of any accidents, injuries, illness, communicable disease or other event that adversely affect the well being and safety of the residents. Timescale for action 02/05/06 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 OP31 Good Practice Recommendations The registered provider should ensure that they gain a management qualification. Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Elmsdene Care Home DS0000065303.V286126.R01.S.doc Version 5.1 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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