CARE HOMES FOR OLDER PEOPLE
ERNELESTHORPE MANOR & LODGE Cow House Lane Armthorpe Doncaster DN3 3EE Lead Inspector
Ramchand Samachetty Unannounced 19 April 2005 09:30. 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. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Ernelesthorpe Manor & Lodge Address Cow House Lane, Armthorpe, Doncaster, South Yorkshire, DN3 3EE 01302 834643 01302 830800 None Yorkshire Property Investment Fund Ltd 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) Mrs. Irene widdowson Care home with nursing 65 Category(ies) of Old age, not falling within any other category registration, with number (65), Physical disability over 65 years of age of places (65) ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: One specific service user under the age of 65, named on the variation dated 25 th May 2004, may reside at the home. Date of last inspection 24th February 2005 Brief Description of the Service: Ernelesthorpe Manor and Lodge is a 65 bedded Home offering social and nursing care for older people ( 65 years & over), including those with a physical disability. The Home is designed as a bungalow and offers all its accomodation on the ground floor. Within the Home, there are two areas, the Manor and the Lodge, but there is no physical division between them and residents share all communal areas and are well integrated. The Home is situated in a residential area in the village of Armthorpe in Doncaster. It is accessible by public transport and to local shops and other community facilities. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out on 19 April 2005, starting at 09.30 hours and finished for the day at 17.00 hours. Two more hours were spent the following day. The inspection included a tour of the premises, conversations with ten residents and six relatives. Four members of staff were also spoken to, and issues were discussed with the Home management. Care documentation and other records were also checked. Representatives of the local Commissioning Authority (Doncaster Metropolitan Borough council) were at the Home, undertaking a contract compliance visit. What the service does well: What has improved since the last inspection?
The registered manager confirms that the new owners of the Home are more supportive of her role and responsibilities as a manager. She is now able to manage the Home more effectively, as more of her time is devoted to management. Staff have developed good care documentation records and the manager is encouraging staff to improve their standard of record keeping. New policies and procedures are being developed to improve the service that is provided. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 6 What they could do better: 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. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3 Currently residents including potential ones have only basic and limited information regarding the Home. This affects their choice of a Home. However, residents have their care needs assessed on admission, to ensure that such needs can be met by the Home. The assessment of care needs was not always consistent or comprehensive, which on occassions led to needs not being met. Residents and their representatives were not always given details of care assessments and were therefore unaware whether their expectations would be met. More work should be undertaken to improve the statement of purpose and service user guide. These documents should be made available to residents and their representatives. EVIDENCE: A few relatives stated that they had not been offered the statement of purpose and its service users’ guide. They got their information from a brief visit to the Home. One relative said ‘ the hospital social worker gave us the names of three homes, but we only had time to see one home as they were in a hurry to discharge mum’. Relatives stated that they would have liked to receive more information before choosing the Home. Residents who spoke to the inspector stated that they were generally satisfied
ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 9 with the care they were receiving. They commented’ they look after people well’. Staff have developed good documentation to assist in the assessment of care needs. The care files of three residents were checked. Some areas of need were not assessed. These refer mostly to communication, sensory impairments, nutritional and social care needs. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 10 Individual plans of care for residents were based on their assessed care needs to ensure that they were receiving the care and support they need. However, actions to be taken to meet identified needs were rather vague and on occassions have led to inadequate care being given and to inadequate review of care plans and risk assessment. Overall improvement is required in using the existing care planning system. The interactions between staff and residents were based on respect for the individual. However, not enough attention was given to protecting and promoting residents’ privacy and dignity. This is an infringement on their rights. There is a need to train staff in observing the privacy, dignity and confidentiality of residents at all times, in order to enhance their rights. EVIDENCE: Residents and relatives, who spoke to the inspector, confirmed that staff were ‘caring and friendly’. Some relatives felt that newer members of staff were often ‘ too inexperienced’ to care for older people. The interactions between staff and residents were noted to be courteous. However, on two occasions during the inspection, it was noted that bedroom and bathroom doors were left open whilst residents were receiving personal care and were in a state of undress. This compromised their privacy and dignity.
ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 11 Care plans which were checked, did not address the protection and promotion of residents’ privacy and dignity. Staff therefore did not appear to have any guidance on this issue. A few relatives commented that they had difficulty with making private telephone calls from the home, although a payphone was available. During case tracking, a sample of care plans, were checked. In two instances where residents had communication needs and sensory impairments, no actions on how to address those needs were specified. In another instance, the care plan did not address the specific needs of a resident who had a digestive tract disorder. Other care plans were adequately developed and implemented, but entries about care given were often too generalised. Risk assessments and care plan reviews were not consistently undertaken. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Although indoor recreational activities are organised on occasions, residents’ social care needs were not usually assessed and catered for. This has led to a lack of social and mental stimulation for residents. Care plans did not specifically address social care needs of residents. The Home was providing an adequate catering service and residents found to be satisfactory. However, difficulties with the seating arrangements for residents meant that meal times were rather unsociable. EVIDENCE: On the day of this inspection, a pre-planned session on ‘ movement to music’ took place for about one hour. Only a limited number of residents were able to join in. A few residents also talked about their participation in the weekly bingo night. However, most residents appeared to sit in the lounges for long periods, with piped music and television playing in the background. A relative commented’ except for the bingo night once a week, there is hardly anything else to keep them occupied’. One resident said ‘ I would like some help to walk outside the Home, for some fresh air, but I have never been able to do that’. Care plans did not specifically address social care needs of residents. Residents confirmed that they were asked for their food choices for the day. Staff were aware of the food and drink preferences of the residents. Residents commented that the food served at the Home was usually ‘ well cooked and
ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 13 tasty’. However, there was no assessment of nutritional needs of residents, in particular for those where such needs are of therapeutic importance. One of the dining rooms appeared ‘ overcrowded’ at lunchtime and this caused discomfort to a number of residents, especially those who were sitting in wheelchairs. In addition to the dining room furniture, two adjustable bedside tables were placed in this room for residents to dine at. The atmosphere in this dining room was rather tense as residents felt frustrated with the cramped conditions. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Management at the Home appear to take complaints and concerns seriously. This is felt to be reassuring, by residents and their relatives. Residents and relatives, who spoke to the inspector, stated that they could always raise their concerns to the manager with the knowledge that ‘ she would look into the matter’. However, the management of complaints itself was less satisfactory and gave rise to unclear outcomes. Care practices and procedures seemed in general, to protect residents from abuse, thereby creating a safe environment for residents. Whilst care staff showed an understanding of adult abuse, they were less clear on the management of alleged abuse, with particular reference to the local multiagency’s approach, which is in operation in Doncaster. The complaint and adult protection procedures used at the Home must be improved to ensure that more robust protection systems are in place for the benefit of residents. EVIDENCE: The complaint procedure and two complaints that had been dealt with by the manager, were checked. The complaints appeared to have been dealt with in a prompt manner. However, there was no timescale for a response, in the procedure to guide either staff or complainants. The main issues relating to a complaint and their investigations were not clearly recorded. Outcomes were not specified and therefore feedback to complainant appeared unclear. The Home has an adult protection procedure, including ‘ Whistle blowing’, which provides general guidance to staff. This procedure advises staff to undertake investigations into alleged abuse. Reporting such allegation to the local Social Services Department is left to the discretion of the staff. The procedure was not in line with guidance contained in the ‘ No Secrets’
ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 15 document from the Department of Health. In discussion, staff were unclear what the actual procedure was. On recruitment, staff were appropriately checked against the’ Protection of Vulnerable Adults Register’. Although care staff have received some training on adult protection issues, this appeared to have been limited in scope. Further training on adult protection issues must be provided to all care staff, to ensure that residents are protected from all forms of abuse. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 22 The building and its surroundings were generally well maintained, thereby enhancing its appearance and facilities. However, a programme of repair and refurbishment is needed to ensure it continues to maintain its good conditions. It offers a comfortable standard of accommodation. The design of the Home, as a bungalow, allows for good wheelchair access within its communal areas. Residents have appropriate use of mobility aids to assist in the provision of personal care and in maintaining their independence and wellbeing. EVIDENCE: A tour of the home was undertaken by the inspector, accompanied by the manager. The communal areas and some residents’ private rooms which were viewed (the latter with residents’ permission) appeared to be in good decorative state. The home was found to be clean and had no malodours. However, minor repairs were identified as needed in a bathroom. Some floor coverings were lifting up from the floor and appeared damaged. There was an apparent difficulty with the safe storage of equipment. Mobile hoists and other items were stored along corridors and in toilets and bathrooms. This caused obstruction and a potential hazard.
ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 17 A number of residents were seen to move about with the aid of walking frames, rollators and wheelchairs. Toilets and bathrooms were equipped with grab rails. Fixed and mobile hoists were available. They were in working order and were adequately maintained. Residents who were nursed mostly in bed had use of special mattresses to help them avoid pressure sores. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 The number of cares staff and qualified nurses appeared adequate to meet the needs of residents. However, the actual supervision of staff whilst on duty, was rather inadequate and on occasions appeared to affect the time it took for residents’ call for assistance to be answered. An effort should be made to ensure that staff respond to residents’ calls for assistance in a more timely fashion. The staff recruitment and selection procedures of the Home appeared to be in line with good employment practice, including the promotion of equal opportunities and the required safety checks. This approach helps to ensure the protection and welfare of the residents. EVIDENCE: There were ten care assistants and two first level nurses on duty during the daytime hours. Five care assistants and one first level nurse were scheduled to work during the night. On the current number of residents at the Home, this number of staff appeared to meet their care needs. A number of care staff have worked at the Home for a long time and have a good rapport with the residents. Besides the manager, there was other support and administration staff, who all formed a good team. However, a few relatives and residents commented negatively on the time they sometimes have to wait before they receive assistance from care staff. This was evidenced on a few occasions during the inspection. Relatives and residents also added that the delay in answering calls for assistance was more evident during weekends. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 19 The recruitment and selection procedures were checked. Care staff started their employment only after the safety checks and references were obtained and were judged satisfactory. This included checks against the ‘ Protection of Vulnerable Adult’ and the Nursing and Midwifery Council’ registers. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The overall management of the home has improved, thus allowing the registered manager to spend more of her time in organising care provision, the necessary documentation and policies and procedures. Some areas relating to health and safety issues require further attention, in order to enhance the welfare of both residents and staff. EVIDENCE: The registered manager stated that she now receives more support from the Home’s owners to manage the Home. Staff commented that they feel more satisfied in their work. Residents and relatives who spoke to the inspector stated that they were happy with the way the Home was run. The residents’ safety and welfare were safeguarded by providing staff with training on a range of topics including ‘moving and handling’ fire safety, and food hygiene. However, accidents and incidents at the Home, involving residents were not adequately recorded. There was insufficient detail of the action taken in
ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 21 individual cases. The issue of inappropriate storage of equipment and other items as commented upon in standard 19, must be remedied. A risk assessment regarding the physical environment and for all safe working practices was not available. However, a monthly and a six monthly audit tools were used to monitor health and safety issues. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 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. 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 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 2 x x 3 x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 x 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 x x x x x 2 ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4, 5 Requirement The Homes statement of purpose and service user guide must be improved to meet the Regulation. Copies of these documents must be made available to all interested parties. Assessment of care needs must be improved to ensure all health, personal and social care needs are considered. the registered person must confirm to residents/ relatives that the Home is able to meet the assessed needs of the resident in question. Individual care plans must be improved to indicate details of the action to be taken to meet identified needs. Care given to individual residents must also be appropriately recorded in their care plan. Care plans, including risk assessments must be reviewed at least once a month. The registered manager must ensure that all appropriate actions are taken to ensure that the privacy, dignity and Timescale for action 20 June 2005. 2. 3 12,14 20 June 2005 3. 7 15 4 July 2005 4. 5. 7 10 15 12 20 june 2005 20 June 2005 ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 24 6. 10 12,16 7. 12 12, 16 8. 16 12, 22 9. 16 12, 22 10. 18 12, 13 11. 18 13, 18 12. 13. 14. 15. 19 19 19 38 23 23 23 12, 13 confidentiality of residents are protected and promoted at all times. An appropriate telephone facility must be provided to residents to enable them to make or receive telephone calls in private and allowing for their confidentiality. The social care needs of all residents must be appropriately assessed, developed in care plans and catered for, to meet the preferences and capabilities of individual residents. The complaint procedure must be improved to include the appropriate timescale for responding to complaints. Complaints and their investigations and outcomes must be appropriately recorded and communicated to complainants as necessary. The adult protection policy and procedures used at the Home, must be improved to reflect guidance from the No Secrets document. Further training on adult protection issues, including the local multi-agency approach, must be provided to all care staff. The necessary repair must be carried out in the identified bathroom. Areas of floor covering that damaged must be replaced. Appropriate storage of equipment and other items must be provided at the Home. The recording of accidents and incidents must be improved to include more information of the action taken by staff at the home. All accidents and incidents must be reported to the local office of CSCI. 20 July 2005 20 June 2005. 20 June 2005 20June 2005 20 June 2005 4 July 2005 4 July 2005 4 July 2005 4 July 2005 2 June 2005 ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 25 16. 38 12,13 A comprehensive risk assessment for the environment and for all safe working practices must be developed and implemented. 20 June 2005 17. 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. 4. Refer to Standard 10 15 27 Good Practice Recommendations All staff should be trained on issues dealing with the protection and promotion of residents rights, including their privacy, dignity and confidentiality. The seating arrangements for residents at meal times should be improved. Care staff should be appropriately supervised in their dayto-day provision of care and support to residents. ERNELESTHORPE MANOR & LODGE J55 J07 S55879 Ernelsthorpe Manor and Lodge V215394 190405 Stage 4.doc Version 1.20 Page 26 Commission for Social Care Inspection 1st Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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