CARE HOME ADULTS 18-65
Ferndale 6 - 10 Church Road Brownhills Walsall West Midlands WS8 6AA Lead Inspector
Lesley Webb Unannounced Inspection 28th November 2005 09:00 Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 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 Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 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. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Ferndale Address 6 - 10 Church Road Brownhills Walsall West Midlands WS8 6AA 01543 454 689 01543 372 308 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) Mrs Angela Lane Mr Peter David French Ms Jeanette Anne Witton Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home must comply with any requirements requested by West Midlands Fire Service and Walsal MBC Environmental Health Department. 14 June 2005. Date of last inspection Brief Description of the Service: Ferndale is a ten bedded residential home which offers specialised care for adults with autism and associated conditions. The building is designed to be domestic in nature with two lounges, two kitchens, a dining room, laundry and ten single bedrooms all of which have en-suite facilities. There is a small garden to the rear of the premises that also offers day care facilities to residents of Chase Community Homes and parking facilities to the front of the building. It is located very near to the centre of Brownhills, close to shops, public transport, markets, theatres and public houses. There is local provision for riding for the disabled and Cannock Chase is close by for walks etc. Ferndale is one of a number of homes that form Chase Community Homes, a private company that is owned by two teachers, both of whom have over twelve years experience of teaching in residential schools for complex and delayed developmental disorders including autism. Chase Community Homes are a group of small residential homes aiming at providing an environment where adults with autism and allied conditions can feel safe and secure. They believe people with such conditions have the right to live like others in the community, but that they also have the right to continued specialist help and support within a sheltered setting, to enable their lives to be more meaningful and fulfilling. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector arrived unannounced at 9am and stayed until 5.20pm. Due to the communication difficulties of the people who live at the home the inspector was unable to have meaningful conversations with them so spent additional time formally interviewing all staff on duty to find out views and opinions of service provision. In addition to this time was also spent observing care practices, looking at records and talking to the manager. As this is the second inspection to take place this year both this report and the one published in June should be read when looking at how the home is meeting national minimum standards. Building work is presently being undertaken at the home to add another bedroom and improve kitchen and laundry facilities. The inspector could find no evidence of this having a detrimental effect on the people living at the home and by the end of the visit was satisfied that as in previous inspections the home provides a high quality of care. The inspector would like to thank everyone for his or her co-operation and assistance during the visit, where she was made to feel very welcome. What the service does well:
The home employs a very knowledgeable staff group. When interviewing people everyone demonstrated knowledge of risk assessment processes and their responsibilities in relation to monitoring the healthcare needs of service users. As staff explained, “we are here to reduce any risks but not to stop people having opportunities to try things. As a support worker I have a responsibility to feedback to management any changes that will effect an assessment and a responsibility to read and implement them” and “because of communication difficulties some people cannot always tell us they are in pain so we have a responsibility to watch closely and make the necessary appointments”. Methods of communication are also very good in this home. For example picture cards are used at mealtimes in order that service users can make choices. In addition to this makaton is also used, again to aid communication and involve service users in decision-making processes. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 6 The home is also good at investigating and promoting an atmosphere where people feel issues can be raised. All complaints have been thoroughly investigated and the home has worked in an open and transparent way with other organisations including CSCI and relevant social work teams. Management of maintenance relating to the safety of the building is another area that the home completes in a more than satisfactory way. Servicing of gas, electric, water and other aspects of the building takes place on a regular basis ensuring the environment is safe for people to live in. What has improved since the last inspection? What they could do better:
To further enhance the care planning systems already in place at the home work must be undertaken to ensure risk assessments are completed for all identified needs and self-medicating assessments completed based on individual capabilities. The inspector recognises that no-one may be able to fully self medicate but staff confirmed that many who require prescribed creams and lotions could be supported to apply this themselves if the appropriate assessment and care plan was introduced. As one member of staff explained, “I encourage service users to apply creams if in areas such as the groin so thinking about it shouldn’t we be supporting them to do this regardless of where it is needed and if they are capable”. The home must also introduce nutritional assessments and arrange for chiropody and hearing tests for everyone. These will promote the healthcare needs of service users. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 7 Clarification must also be sought from the fire department with regards to the amount of fire drills that must take place at the home. Once this is obtained the home must amend its policies and procedures. 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. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 8 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 Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 9 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): Standards not assessed at this inspection. EVIDENCE: Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 10 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 and 9. Care planning is good, providing staff with the information they need to satisfactorily meet service users needs. Risk assessments are in place but not for all of the risks that are posed in delivery of care; an improved system would offer more protection to service users. EVIDENCE: Since the last inspection the likes and dislikes of service users have been included in their plans of care and staff attend 3 weekly in-house training sessions where care plans are discussed. Staff that were interviewed informed the inspector that these training sessions ensure everyone is aware of the aims and goals contained in care plans. The inspector sampled 3 service users files and found they all contained comprehensive risk assessments that identified hazards, who might be harmed and action to be taken to minimise the risk. In the main most assessments were linked to identified needs contained within plans of care however, some gaps were found for example 1 service users identified needs were challenging behaviour, communication/social integration and epilepsy but there was only a
Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 11 risk assessment in place for epilepsy. All assessments were found to be reviewed by the manager on a yearly basis. The inspector recommended that time spans for review be included in the assessment and that these be based on the level of identified risk. When interviewing staff the inspector asked if service users are allowed to take risks and for the risk assessment process to be explained. Generally everyone demonstrated understanding in this area. For example one person stated, “the people who live here should be allowed to go anywhere and do anything but with support from staff. Its our responsibility to reduce and manage any risk”. The majority of staff confirmed they had received training in risk assessment but some felt further training relating to practice issues would be of benefit. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 12 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): 17. The meals in this home are good offering both choice and variety. Further work must be undertaken to ensure nutritional needs of service users are met in full. EVIDENCE: The home employs a cook and operates a 4 weekly menu. Menus detail choices of hot and cold meals, one of which is also a ‘healthy option’. When looking at the individual records for meals taken by service users the inspector could find little evidence that the dietary needs of a particular service user being met despite this person being on a reduced calorie diet. This was discussed with the manager who agreed that staff might need further guidance in this area. The inspector recommended that advice be sought from a dietician with regards to this persons eating habits and support required by staff. Manager also confirmed that at present nutritional assessments are not undertaken for people as part of the care planning process. Staff when interviewed confirmed the lack of nutritional assessing. For example one person stated, “everyone is weighed monthly, what they eat gets recorded, that’s about it”. Staff were however able to explain how service users are offered choices at mealtimes despite communication barriers. As one person
Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 13 stated, “we have picture cards that the cook shows people, with others we use sign language”. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 14 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): 19 and 20. Generally the health needs of service users are well met with evidence of good multi-disciplinary working taking place. Medication practices although adequate do not promote independence within a risk managed framework. EVIDENCE: The health records for 3 service users were inspected. All confirmed that service users attend appointments for epilepsy, flu vaccination, medication reviews and dentistry. Evidence was also supplied that everyone at the home will be undertaking an optician’s appointment in January 2006. Not all service users have been receiving treatment from a chiropodist with staff at the home undertaking this task. The inspector discussed this practice with the manager raising concerns in relation to qualifications and undiagnosed conditions. The manager agreed to alter this practice with arrangements for service users to receive private care if required. The manager also explained that the home was having difficulty obtaining hearing tests for people due to the G.P. practice service users are registered with not offering this service. Health action plans were shown to the inspector that are being introduced at the home. The manager agreed to prioritise their completion to aid healthcare monitoring. All the staff that were interviewed demonstrated very good knowledge and understanding of their roles in relation to promoting good healthcare. For
Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 15 example one person stated, “if someone is in pain we must do something about it, because of communication difficulties they cannot always tell us we have a responsibility to watch closely for changes and investigate these” and another “by making sure they have regular checks with dentists and other specialists such as the asthma clinic. If we see any changes or are concerned in anyway we make appointments for investigations”. Medication practices were scrutinised. All records relating to the receipt, administration and disposal of medication were found to be in good order. The inspector did however recommend that if a medication was PRN (as and when required) that this be recorded on the medication administration recording sheets and that larger medication cabinets be purchased. When looking at the medication the inspector found 3 items that were not recorded on the MAR sheets. It was unclear if these had been discontinued or if they were still required but not included on the sheets. When asking staff if any service users self medicate everyone stated this was not possible due to their disabilities affecting their understanding. However when discussing this further many staff felt that some service users would be able to assist applying prescribed creams with support from staff. The inspector explained that this would be self-medicating based on each person’s capabilities and that care plans and assessments should be implemented for this that could be used as tools to monitor progress. Staff also recognised that although only a small task if achieved would promote further choice and control for people living at the home. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 16 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 and 23 partly assessed. Generally the home has a satisfactory complaints system with evidence that issues are listened to and acted upon. EVIDENCE: A previous requirement to amend the complaints procedure has been met. This now includes stages of, and timescales for this process ensuring everyone is fully informed. 3 other requirements relating to complaint records were found to be partly met. These were discussed with the manager who assured the inspector they would be fully addressed before the next inspection. Although staff have yet to undertake adult protection training the inspector was shown evidence that this has been arranged for January 2006. There have been 4 complaints regarding differing aspects of the home in the last twelve months, 2 of which were sent direct to CSCI. The home is very proactive in encouraging people to raise issues and the inspector has found an abundance of evidence over the twelve-month period that indicates to an open and inviting atmosphere where complaints are viewed as positive tools to improving service within the home. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 17 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): Not assessed at this inspection. EVIDENCE: Although not assessed at this visit the inspector noted that 6 of the 7 requirements identified in the previous inspection relating to the environment have been met, with the remaining requirement forming part of the building work currently being undertaken at the home. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 18 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): 32, 33, 34, 35 and 36. Training specific to the needs of people who access the service is now provided, resulting in a knowledgeable workforce who have the appropriate skills to meet the needs of service users. Improvements to recruitment documentation provide safeguards and protection to people living in the home. Although improved further work is required to ensure staff receive the appropriate supervision. This will support them to carry out their roles and responsibilities effectively. EVIDENCE: Since the last inspection staff have undertaken communication and epilepsy training, requirements identified in the previous inspection, however no certificates were available to verify this on the day of inspection. Arrangements are still required so that challenging behaviour training is undertaken. Of the twenty-one staff employed at the home 7 hold a NVQ level 2 or 3, 7 are in the process of completing this qualification and 7 are still to enrol. A training co-ordinator has been employed by the organisation. The inspector was impressed that training is now more organised, with staff undertaking autism, makaton and care planning on a regular basis to ensure they have the skills and knowledge to care for the people living at the home. As yet staff are to undertake equal opportunities training, with this booked for December this year. The inspector was also pleased to find that 7 staff have
Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 19 undertaken learning disability accredited framework training. Many positive comments were made by staff that were interviewed in relation to training. For example one person stated, “training here is fantastic, every week have in house training as well as the home arranging for me to do courses, they are always providing training”. 3 requirements identified in previous inspections relating to staff meetings, covering shifts and the on call system have all now been fully met. Previous requirements for staff recruitment documentation and supervision sessions are partly met, with improvements in both of these areas. Further work is still required to address these in full. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 20 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): 41 and 42. Improvements relating to records have ensured service users are safeguarded by the homes policies and procedures. Generally health and safety is well managed in this home, creating a safe place for service users to live. EVIDENCE: 3 requirements identified in previous requirements relating to staff rotas, the homes restraint policies and safe working risk assessments have now been fully met. The inspector viewed fire safety records. The homes policy states that fire drills should take place monthly, with their fire risk assessment stating ‘regularly’ however records confirmed that the last drill occurred in July 2005. The manager stated that the fire officer had advised that only 3 drills should occur every year. The inspector explained that either this advice must be obtained in writing with the homes policies amended or the home should follow its written guidance as it stands presently. The inspector also explained that
Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 21 when deciding how often drills occur an assessment of the needs of the people living at the home and the staffing ratios should also be taken into consideration. All other records relating to fire, gas and water were found to be in order. Records also demonstrated that the majority of staff either hold or are about to undertake training in health and safety, infection control, food hygiene and moving and handling. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 2 X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 2 3 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Ferndale Score X 2 2 X Standard No 37 38 39 40 41 42 43 Score X X X X 3 2 X DS0000020852.V268584.R01.S.doc Version 5.0 Page 23 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 YA9 Regulation 13(4) Requirement Risk assessments must be completed for any identified needs/goals contained within service users plans of care. Nutritional assessments must be completed for all service users. The home must be able to demonstrate that any specific dietary needs are being met. Arrangements must be made for all service users to receive treatment from a qualified chiropodist. All service users must have the opportunity to access hearing tests. Any discontinued medication must be returned to the pharmacy. Any prescribed medication in use must be recorded on the MAR sheets. 5 YA20 13(2) Self-medication assessments 28/02/06 must be completed for all service users based on individual capabilities with plans of care
DS0000020852.V268584.R01.S.doc Version 5.0 Page 24 Timescale for action 28/02/06 2 YA17 16(1) 28/02/06 3 YA19 12(1) 28/02/06 4 YA20 13(2) 28/11/05 Ferndale implemented as necessary. 6 YA22 22(1) The manager must maintain a record of all complaints that includes details of any investigation, action taken and outcome – Part met. Requirement originally made June 2005. Full and comprehensive investigations must be completed for all complaints – Part met. Requirement originally made June 2005. The Commission for Social Care Inspection must be notified of any allegations of misconduct against anyone working at the home - Part met. Requirement originally made June 2005. All staff must undertaken adult protection training Requirement originally made June 2005. The laundry room requires refurbishment – Requirement originally made November 2004. All staff must undertake communication training specific to meeting the needs of the people living at the home - Part met. Requirement originally made June 2005. All staff must undertake challenging behaviour training Requirement originally made June 2005. All staff must undertake epilepsy training - Part met. Requirement originally made June 2005. The home must demonstrate that arrangements are being made for all staff to undertake a NVQ qualification. All staff files must contain the
DS0000020852.V268584.R01.S.doc 31/12/05 7 YA22 22(1) 31/12/05 8 YA22 37 28/11/05 9 YA23 10(1) 31/01/06 10 YA30 13(3) 31/03/06 11 YA32 18(1) 31/01/06 12 YA32 18(1) 31/01/06 13 YA32 18(1) 31/01/06 14 YA32 18(1) 28/02/06 15
Ferndale YA34 4, 6 31/01/06
Page 25 Version 5.0 19 YA36 18(2) 20 YA42 13(3-6) required documents and information as set out in Schedules 4 and 6 of the Care Homes Regulations 2001- Part met. Requirement originally made November 2004. All staff must receive a minimum of six supervision sessions per year – Part met. Requirement originally made November 2004. The home must either: Supply written evidence regarding the fire officers advice in relation to fire drills and then amend its written policies to reflect this advise or, Comply with its own policies and procedures in relation to fire drills. 31/01/06 31/01/06 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 2 3 4 5 Refer to Standard YA9 YA9 YA17 YA19 YA43 Good Practice Recommendations It is recommended that the time spans for review be included in risk assessments and that these be based on the level of identified risk. It is recommended that risk assessment practices be included in the in-house training schedule. It is recommended that advice be sought from a dietician with regards to the service user who is attempting to lose weight It is strongly recommended that priority be given to completing health action plans It is strongly recommended that the manager be given an annual appraisal in order that the opportunity to discuss development be available – Recommendation originally made 2004. Ferndale DS0000020852.V268584.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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