Inspection on 29/06/06 for Esher House

This inspection was carried out on 29th June 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Esher House 11/02/09

Esher House 17/08/07

Esher House 26/09/05

Esher House 06/04/05

Esher House 09/11/04

Esher House 05/05/04

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

CARE HOME ADULTS 18-65 Esher House 16 Cabbell Road Cromer Norfolk NR27 9HU Lead Inspector Jenny Rose Unannounced Inspection 29th June 2006 09:50 Esher House DS0000027339.V302558.R01.S.doc Version 5.2 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 Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Esher House Address 16 Cabbell Road Cromer Norfolk NR27 9HU 01263 512533 F/P01263 512533 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) info@prime-life.co.ukwww.prime-life.co.uk Prime Life Limited Ms Sara Doherty Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2005 Brief Description of the Service: Esher House provides accommodation for up to 13 adults with mental health problems. The philosophy of the home is centred on helping service users to regain/develop social skills with a view to moving on if this is possible. All service users have their own room to which they can retire at any time. Communal accommodation is spacious and one lounge is designated a smoking room. Service users private rooms are located on the first, second and third floors.Service users are encouraged to participate in all aspects of the life of the home and to develop links with the local community if they wish. In this respect the home is well situated: both the town centre and the seafront are just a few minutes walk away. Maintaining and developing contacts with family and friends is seen to be an important aspect of the service users overall pattern of care and at their invitation family members and friends are welcome at all times. The home does not provide accommodation for highly dependent service users and all those in residence have to be fully ambulant as there is no lift. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection taking place over 7 hours. The manager was present throughout. A pre-inspection questionnaire had been completed by the home and preparation had taken place in the Commission office beforehand. Records and policies were examined and a tour of some of the building undertaken. There were eleven residents living in the home; on the day, four were out visiting relatives or friends. The care staff on duty were spoken to individually; five residents were spoken to in private, and all the residents present in the house on the day were spoken to during the activities in the communal rooms throughout the course of the inspection. Eight survey forms completed by residents had been returned to the Commission and these views were taken into account when writing the Report. No survey forms had been returned from visitors or healthcare professionals. What the service does well: * There is a friendly, relaxed atmosphere in the home and in addition to their individual accommodation, there are a variety of communal areas which provide a homely, comfortable environment for the residents. Residents feel well supported by staff and feel treated as individuals with their preferences respected. They enjoy their meals and flexible routines. There are weekly residents’ meetings enabling residents’ views to be heard and acted upon in the routines and activities of the home. There is good communication with health and social work professionals which further ensures residents’ care needs are met. Activities and opportunities for personal development, whether that is in employment or individual aspirations, have greatly improved. The manager has brought good leadership to the staff team, who are enthusiastic and keen to promote activities within and outside the home. Policies and records are well maintained and the manager has worked very hard on developing good care plans, involving residents where possible and delegating part of these to be the keyworkers’ responsibility. * * * * * * Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? * There is more cohesive information available on the organisation, together with local information on the home, which together with the assessment process ensures, as far as possible that the individual and the home can be sure the placement is appropriate. The recruitment process has improved, with all necessary checks carried out before staff are employed, which helps to protect residents. There has been some progress on opening a local bank account for the home, so that residents can manage their own accounts if appropriate. The procedure for administering medication has been changed to build in extra safeguards, as this is now being undertaken by two members of staff. There has also been progress in staff receiving outside training, particularly in the area of adult protection and all staff employed in the home at present have a national care qualification, which helps to ensure a good service to residents. * * * * What they could do better: * Progress should continue to be made, so that residents have control of their own finances, if possible, and receive interest on any monies in their accounts. Although there is on-going maintenance in the home, some areas are in need of repair, redecoration and refurbishment, particularly in the smoking lounge, the entrance hallway and other areas detailed in the report. * 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. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. People who use this service and/or their respresentatives have good information about the home in order to make an informed decision about whether the service is right for them. The assessment process means that peoples diverse needs are identified and planned for before they move to the home. EVIDENCE: The service user guide was seen to be a more cohesive document than on previous inspections. There was information regarding the organisation and also the local information on the home. There was evidence from the eight completed residents surveys that residents felt they had received sufficient information before deciding to move to the home and had received a contract Case tracking the latest resident to be admitted confirmed good practice. Information had been provided from the residents previous home on many areas of the residents needs and also comprehensive risk assessments. The resident had been gradually introduced to the home; first going to tea, then staying the day, for a weekend and then for a week. The care plan had been based on the initial assessment; the file also contained a copy of the contract and there was evidence this involved the resident. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. There is good practice in the involvement in recording the residents’ diverse needs and expectations, helping staff to support residents effectively as part of an independent lifestyle. EVIDENCE: In speaking to the manager about care plans, she reported that in the time she had been in post, she had reorganised all the plans and had reached the point of delegating them, under her supervision, to the keyworkers. This was confirmed by the keyworkers spoken to. One care plan was examined where the resident herself was writing her own plan, with staff support, which is good practice. Two care plans were case tracked. The residents were involved in this plans and their regular review and gave comprehensive information so that staff are able to give appropriate support. There was evidence of the involvement of the Community Psychiatric Nurse and the Psychiatrist. There was separate information regarding the keyworker involvement, over such issues as bereavement. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 10 Two residents, both of whom had requested in the returned surveys to speak to an inspector, reported that they felt they received personal care in a manner with which they were happy and that their privacy and dignity were respected. They both had specific healthcare needs, and were satisfied that these were always attended to. They also confirmed that they felt they were able to make decisions about their lives and were not pressured to do anything. One resident reported I am happier than I have been for a long time”. The requirement and recommendation from the previous inspection regarding residents having their own bank accounts locally and receiving interest on their accounts had been partially met, inasmuch as the Manager reported that she had returned the necessary documentation for the home to open a bank account locally, rather than through head office, following upon which, residents would be able to open accounts locally and be in control of their own finances. However, the requirement is repeated for interest to be paid on any savings deposited by a resident in a company account, similarly, the recommendation is repeated from the previous inspection that every effort is made to enable individual service users to open their own bank accounts and if necessary have independent advocates to help them. Risk assessments were seen to be in place covering a range of situations. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The home continues to make good progress in providing opportunities for personal development, education, employment and leisure activities. The residents enjoy their meals and there is more resident involvement in the choice of menus and preparation of meals. EVIDENCE: There are four residents in the home who are over 65 and in the main, residents are in a mature age range and therefore are not seeking employment. However, from case tracking two care plans, there was evidence that both residents had employment opportunities, although one was no longer employed, and that from speaking to three other residents, all were enjoying the activities offered in and outside the home and were involved in planning what they wanted to do. Three residents spoken to talked of regular visits to members of their family and one stays regularly with a relative. One keyworker spoke of supporting a resident in making contact with a family member after many years of lost Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 12 contact. The Manager reported that other residents maintain regular contact with family and friends and one was staying with a friend for a few days. One keyworker described how she supports residents to clean their rooms and change bedlinen and accompanies them on shopping trips if necessary. One resident was observed folding personal laundry and discussing which new clothes to buy. The menus provided for the inspection and on the day demonstrated that residents are offered a choice at the main meal and that the choices looked varied and nutritious. Staff were observed asking residents their choice for the day, which was between a chicken and vegetarian dish. Two residents make their own sandwich lunch, but for those residents in the home at lunch time, there was a choice between such dishes as cheese on toast, or egg on toast and it was evident that staff knew the preferences of individual residents. There is a pleasant dining room, but residents can choose to take their meals elsewhere. One resident prefers to have her meals on a tray in the lounge. Residents were observed doing their own washing up after lunch, although for the main meal the dishwasher is used. At weekly residents meetings menus are chosen and notes are taken of residents favourite meals. One resident, who has a food hygiene qualification, prepares a main meal on occasions for all the residents, which staff say is much enjoyed. The residents surveys and all the residents spoken to said the food was good and varied. There was evidence on the day that staff were aware of residents dietary requirements, including diabetic and weight reducing diets. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Residents are mobile and self caring, but their physical and mental health needs are well monitored and action taken to see that they are met. EVIDENCE: There was evidence from previous inspections, elsewhere in this report, from discussion and observation of residents, completed residents surveys and care plans that the health needs of the residents were attended to and there were regular reviews. In this regard, both staff members spoken to felt the keyworking system was helpful in monitoring residents personal and healthcare needs. From observation of the administration of medication, systems were in place and properly organised. A monitored dosage system is used and kept in a locked cupboard with a double lock for controlled drugs. The manager has recently introduced a system whereby medication is administered by two staff members. Both staff members on duty felt comfortable with this and felt it was a better system. Training in medication is available. Two residents were self medicating and there are guidelines for assessing this. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Residents feel safe and listened to. Staff have undertaken training with an outside agency in Adult Protection. EVIDENCE: The residents surveys and discussion with residents provided evidence that residents were aware of how to make a complaint or their concerns known. The complaints book contained two complaints, and the action taken to remedy them. One allegation, which had been notified to the Commission, was still being dealt with, but the manager had taken appropriate action, involving the Adult Protection Team, an investigation of which would be taking place on 10 July. Both the Manager and the Deputy Manager had completed a course in Adult Protection on 7 November 2005 following a recommendation in the last report. They would be cascading this information to other members of the staff team and the manager confirmed that adult protection issues are discussed at staff meetings and this was confirmed by a member of staff spoken to. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The quality outcome in this area was adequate. This judgement has been made using available evidence including a visit to this service. Although there is routine maintenance and redecoration, many areas of the home were in a poor state of decoration, which means that the home is not very welcoming for residents. EVIDENCE: The issue of the hot water has been resolved by the installation of a new boiler. A tour of the building was undertaken and invitations to view residents rooms accepted. On entering the home residents can choose the decoration in their rooms and bring what personal possessions they wish. Residents spoken to were very pleased with their bedrooms. One of the communal areas was decorated with England flags in support of the World Cup. However, in one bedroom there is a stale water smell and a damp carpet around the wash basin, there is therefore a recommendation that this should be replaced. In addition, in one bathroom there is a gap between the wash hand basin and the basin, which needs to be attended to as a matter of hygiene. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 16 Although it was evident from the maintenance schedule that the doors in the entrance hallway, the paintwork of which is scuffed, were due to be painted, there was no mention of the walls and ceiling, which are rather a strident colour. The smoking lounge is very dingey and there is torn wallpaper and the dado needs repair. It is therefore recommended that attention be given to all areas needing redecoration and repair and that the residents are involved in choosing the colour schemes more in keeping with the character of the house. All areas of the home seen were clean and cleaning was taking place during the inspection. The members of staff spoken to say that the keyworker system works well in supporting residents to keep their bedrooms clean. There had been an issue of hygiene noted on a management visit, in the managers absence, but the manager had devised a system of checklists for staff and the problem had been addressed. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The whole staff team continues to show improvement and the keyworker system continues to be developed for the benefit of the residents. EVIDENCE: The manager has worked hard to ensure that there are sufficient staff numbers on duty to allow residents to be taken out, sometimes on a one-to-one basis, always leaving two staff on duty in the home 4-5 days a week, which was shown on the rota. Three staff records were examined, including the newest members of staff. There was evidence that all the checks were made before a new recruit starts work, which was a requirement at the last inspection. Staff files also showed evidence of training, which has been carried out in house throughout the last two inspections. The staff now are 100 NVQ trained. Following a recommendation at the last inspection, the Manager and the Deputy completed a Protection of Vulnerable Adults course, as mentioned elsewhere in this report. The other member of staff spoken to on the day was aware of the issues surrounding the Protection of Vulnerable Adults and of the local procedures. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 18 Both members of staff spoken to were enthusiastic about the keyworker system and were looking forward to having some responsibility for part of the care plans, i.e. expanding life histories and supporting individual residents achieve their long term aspirations. They also spoke of the support there was amongst the staff team and particularly the Manager. The residents, both from the surveys and in discussion, were complimentary about the staff team, finding them supportive and kind. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. The residents are benefitting from the continuing strong leadership and management skills, both with the staff team and the organisation of training and record keeping. EVIDENCE: Staff and residents spoken to were appreciative of the management style, which was open and inclusive. The Manager said she has completed the work for her NVQ3 Award, but has been waiting several weeks for this to be finally assessed, before moving on to her NVQ4 qualifications, which she is anxious to complete. She has introduced a number of improvements in the organisation of the home, for example the administration of medication by two members of staff and the delegation of some parts of the care plan to keyworkers, and all the records are well kept and up to date. Staff spoken to felt there was sufficient time for handovers and that staff meetings and supervision sessions for staff provided opportunities for staff to Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 20 discuss their work, air their views, bring ideas and gel as a team for the benefit of the residents. There is a quality assurance system from head office, but the appraisal for 2005 is a work in progress. However, weekly residents meetings within the home are proving useful in ensuring residents views are taken into account in the running of the home, especially regarding meals and activities, this was confirmed by one resident spoken to and also from the Minutes of these meetings. The managers quality assurance book was also seen dated 12 June 2006. The monthly management visit from head office had been made on 6 June 2006 and the report seen. The home has a good record of organised procedures for keeping residents safe with appropriate checks and services on fire systems, gas and electrical appliances and water temperatures. Fire drills are held regularly for all residents and staff. The accident book was seen, four accidents had been recorded since 3 February 2006, three on the staff accident book and these were seen to be dealt with appropriately. There had been servicing of fire alarm and fire equipment on 13 June 2006. Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 X X 3 X Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 22 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. Standard YA7 Regulation 20(1) Requirement The registered person must ensure that interest is paid on any savings deposited in a company account by a service user. Repeated requirement Timescale for action 31/08/06 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 YA7 Good Practice Recommendations It is recommended that every effort is made to enable individual residents to open their own banks accounts and if necessary have independent advocates to help them. Repeated recommendation It is recommended that redecoration and repair is considered, especially in the entrance hallway and that carpets are replaced where necessary, particularly in one particular bedroom. 2. YA24 Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Esher House DS0000027339.V302558.R01.S.doc Version 5.2 Page 24 - 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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