Inspection on 01/03/06 for Glastonbury Court

This inspection was carried out on 1st March 2006.

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

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

Other inspections for this house

Glastonbury Court 30/07/07

Glastonbury Court 31/07/06

Glastonbury Court 08/11/05

Glastonbury Court 29/03/05

Glastonbury Court 01/12/04

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

CARE HOMES FOR OLDER PEOPLE Glastonbury Court Glastonbury Court Glastonbury Road Bury St Edmunds Suffolk IP33 2EX Lead Inspector Mary Jeffries Unannounced Inspection 1st March 2006 13:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Glastonbury Court Address Glastonbury Court Glastonbury Road Bury St Edmunds Suffolk IP33 2EX 01284352650 01284352645 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) Suffolk County Council Mrs Moira Elizabeth Clare Care Home 48 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (16) of places Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2005 Brief Description of the Service: Glastonbury Court is situated in a pleasant residential area of Bury St Edmunds. It is registered for the care of 16 older people and 32 older people with dementia. It is a modern two-storey building that was designed for its current use. All rooms are for single occupation and all have en-suite facilities. The rooms are grouped into units of 8, each with its own lounge, kitchen and dining area. Willow, Cherry and Elm, on the ground floor, are the individual units which make up the nurse led unit at Glastonbury Court. Two nurses work on the ground floor between 10 am and 6pm, one nurse at other times. The nurses manage the care on the units, supported by a team leader. These units provide care for older people with dementia. Beech, Cedar, and Maple do not provide nursing care, and are on the first floor of the home. Beech unit has recently been converted to provide care for older people with dementia. The Home is owned and managed by Suffolk County Council. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place one afternoon in March 2006. It was facilitated by the Registered Manager, assisted by the deputy. Time was spent mainly on the ground floor and Beech, although in order to follow up on requirements made at the previous inspection, the other upstairs mainstream units were also visited. Six service users were spoken with, as was a relative of a service user on the new dementia unit, Beech. Care staff and a nurse participated. The inspection took four hours. What the service does well: What has improved since the last inspection? The Service User Guide had been provided to service users, a contract for short-term care had been produced. Care Programme Approach reviews were on file in a timely way. A tripping hazard had been rectified. A training analysis had been drawn up. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 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 the following standard(s): 1,2,6 Service users can expect to have good information available to them to enable them to make an informed choice living at about the home. EVIDENCE: Standards 3,4 and 5 were found to be met at the previous inspection. A requirement was made at the previous inspection that all service users be supplied with a copy of the Service User’ Guide. The Registered Manager advised that the deputy manager had been tasked to ensure all had the guide. A service user spoken with confirmed that they had received a Service User’s Guide. The Registered Manager advised that respite care contracts had been drawn up. A copy was provided. The home is registered for 32 service users with dementia, and 16 who require care as a consequence of old age. On the day of the inspection 33 of the service users had a diagnosis of dementia. An application for a variation, to Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 9 increase the number of persons registered who require care primarily because of dementia by one, was handed to the inspector. Details had not been provided of the number of service users who fall outside of the current registration, and any legal status that applies. This had been required at the previous inspection when it was found that some of the elderly service users had longstanding enduring mental illnesses, which may or may not involve dementia, and had been referred by the consultant psychiatrist. This included one service user who was subject to a 117 order under the Mental Heath Act, who had a longstanding bi-polar disorder, and frontal lobe damage, and no diagnosis of dementia. The Registered Manager advised that this had been discussed with the NHS partners, and there was concern that there was no where else for the service users. The Registered Manager was reassured, that CSCI were not requiring that these individuals be moved, however the home must operate within its category of registration. The Registered Manager confirmed that Intermediate care is not provided. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 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 the following standard(s): 7,9,10 Service users on the nursing unit cannot expect their care plan will reviewed on a monthly basis. EVIDENCE: Standards 8,9 and 10 were found to be met at the previous inspection. On the nursing unit, service user’s reviews are arranged by the nurses, who are also the Care Programme Approach (CPA) co-ordinators, and include the carers Team Leader. CPA reviews and the home’s review are one and the same. A nurse spoken with had about one service user had a very good knowledge of the service users’ needs, physical, and psychological and interests, and goals that they were working on with the service user, including hoping to encourage a previous hobby of gardening once the summer came. They described positive changes in the service user since they had been at the home, having been very withdrawn whilst in hospital. This service user had in the past had a serious problem with aggression. The nurse advised that they got a bit short tempered. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 11 The nurse introduced the service user to the inspector, and whilst they were doing so were distracted by another service user with immediate needs. The first service user got quite upset about this, and with some difficulty explained that it made them angry when they started to talk and were then cut off. This service user’s latest review that took place in January 2006 was on file, and was consistent with the information provided by the nurse. There was an up to date care plan and single assessment. Two other care plans were inspected, and the last review on one was 9 months prior to the inspection, on the other file was over 12 months prior to the inspection. There was no evidence that care plans for service users on the nursing unit were reviewed at monthly intervals. One service user spoken on a frail elderly unit did not like receiving personal care from a man. This preference was discussed with the Registered Manager who advised that the service user had not previously stated this. When spoken with the service user had said that they knew the pressures homes were under to get staff, that she’d seen it on the television, so really didn’t like to complain. They described waiting in to find out if the male was on duty by listening to the steps in the corridor, and not liking going through this. Of three care plans inspected, all had care plans and risk assessments; the person centred care plan on one was not dated. Medication was fully inspected at the previous inspection and no requirements were made. An audit of medication had been undertaken by Boots the pharmacist in December 2006, and by the deputy manager in February 2006. These audits were inspected. The boots audit had found a few odd tablets left in files that were either marked as given or not signed for. The deputy manager’s monthly audit undertaken in February had not identified any problems. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: All of these four standards were inspected at the last inspection and found to be met. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Service users can expect any concerns or complaints to be taken seriously and handled appropriately, and to be protected by the home’s procedures. EVIDENCE: Standards 16, 17 and 18 were found to be met at the previous inspection, although a recommendation was made in respect of standard 16. Clarification of this was sought by the Registered Manager as the complaints log still required an entry for outcomes. A relative spoken with said that if they did have any concerns, they would speak to the team leader in the first instance, but that they felt they could raise concerns with any of the staff their attitude was so nice. They added that they had been coming every week for three months and that they hadn’t got a single complaint. A pilot advocacy scheme had recently been undertaken in the home. One service user who had some involvement with this was spoken with. All staff had received training in the protection of vulnerable adults during the last 12 months. An incident involving an agency nurse had been reported in December, when door sensors had been turned off on Elm unit. The agency nurse is no longer used by the home, and the Registered Manager advised that the agency nurse had put in a complaint of bullying and harassment against the home for deciding not to use them. The Registered Manager advised that Social Care services did not consider this to be a PoVA. An up to date County Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 14 Protocol was available in the home. Two situations had been appropriately referred to Customer First since the last inspection; it had been subsequently determined that one was not a PoVA, a strategy meeting was held in respect the other, which related to a missing sum of money and the outcome was that the situation be monitored. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,22, 25, 26 Service users can expect to live in a comfortable, clean and attractive home. EVIDENCE: Standards 20, 23,24, 25, and 26 were found to be met at the previous inspection. The entrance to the home is a very attractive comfortable area, where the Statement of Purpose and latest inspection report is available. The home’s certificate of Registration was displayed, as was a current public liability insurance certificate. CSCI fact sheets on aspects of care were also available on display. A relative spoken with said that “ It’s like coming to an hotel, everything is so nice.” Bathrooms seen were clean and tidy and had appropriate paper towels and liquid soap. A carer was spoken with about protective clothing. They advised that they wore an apron and gloves for all personal care, and that they washed their hands and then used gel after every time they took their gloves Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 16 off. A recommendation had been made at the previous inspection that a hoist which staff can reliably use without it stalling should be provided in the bathroom on Cedar unit. Service users had reported that they did not like using the hoist seat, which sometimes got stuck as they were being moved by a carer, and unnerved them. A service user spoken with said that they had not noticed any difference. The deputy manager advised that someone had been in to look at the hoist, but that it remained temperamental, and sometimes they were unable to make the adjustment for it to turn smoothly first time. Windows opening onto balconies on the first floor were appropriately locked. The doors to the small sensory garden on the dementia unit were not locked, and service users were able to access this area freely. The manager advised that action had been taken to minimise the risk of tripping presented by a small lip on the doorway to the sensory garden. An addition forming a slight slope to the outside had been fitted. The inspector walked into the garden with a service user who had mobility problems and this doorway was negotiated without difficulty. The key pads on the doors of the dementia unit do not have the number for the pad written on them. Also at the last inspection, it was recommended that a standard lamp be provided for a service user who enjoyed doing jigsaws, but who had found that the low level of light made this difficult. The manager advised that the service user had decided that they wished to get their own as a present, and a table light had been provided in the interim, which the service user thought was too bright. The service user was spoken with, the present had not materialised, and they no longer had the small light; they still wished therefore to have a decent light to enable them to enjoy their hobby. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 Service users can expect to be cared for by a well-trained staff group. EVIDENCE: Standards 27, 28, and 30 were found to be met at the previous inspection, although recommendations were made in respect of standard 27 and 30. At the time of the inspection, two team leaders were absent with illnesses that were likely to involve significant periods of sickness leave. Two carers were acting up. The Registered Manager advised both had NVQ2, one also had NVQ3. There was also some staff sickness amongst the nursing staff; the home had some regular agency nurses in. On the nursing unit, the nurses were working 10-hour shifts. They work two days on this basis, and then have a day off. The Registered Manager advised that they did not think this was ideal, and care staff are not allowed to do this, but that this was a nursing decision she had no responsibility over, and advised that the nurses thought that it was this new arrangement that had allowed them to catch up and get ahead of reviews. The new dementia unit, Beech was full, including one service user on a short stay. On both Cedar and Maple frail elderly units there were seven service users in residence and 1 short-term vacancy. One of the service user required up to 3 carers for moving and handling. The nursing unit was full, with 24 service users in residence. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 18 On the day of the inspection the home was short of one carer upstairs and one carer downstairs on the usual numbers during the morning. The afternoon shift was at proper levels. The level of nursing staff was maintained constantly, with the use of agency staff if necessary. A service user spoken with said that “the girls have been a bit pushed, they are good girls, they do my shopping and anything I want.” The service user was asked how the pressures had affected their care. They replied, “ we should get out.” The service user was looking forward to the summer when they could get out into the home’s garden. This was particularly important to them, as their medical problems got them down at times, and the service user said that they had “ a job keeping (their) spirits up.” A carer spoken to was asked how they managed to care for the service user who required three carers. The carer explained that whilst the unit usually had one carer plus a float, they would get the other float in just for moving the service user. Enhanced Criminal Record Bureau checks were found to be on file of five recently recruited members of staff, proof of identity was also on file. Photographs were on file for all, and proper recruitment processes had been followed. The home had produced a spreadsheet showing training received for the care staff, but the manager did not have full information on the update training nurses may have received. In particular, care staff undertake Unisafe Training, whereas the nursing staff do a different course for safe handing. The Registered Manager therefore had no evidence that nursing staff working within the home had received this, although they had records that all nursing staff employed had received in house fire training, medication training and vulnerable adults training. The up to date spreadsheet showed that all carers had received moving and handling training in 2005, and all but one had received fire training. A float spoken with confirmed that they had manual handling training the previous November. The spreadsheet supplied showed that out of a team of 53 carers and 6 team leaders, 23 had NVQ2 or above, and 6 had commenced NVQ2. Domestic staff had all received food hygiene training, Control of Substances Hazardous to health training and Uni-safe training. The relative spoken to said, “ I can only speak highly of staff, I usually stay about an hour and a half, everyone is no nice, everyone smiles, and I think that means a lot.” Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34,35,38 Service users in the frail elderly unit and new dementia unit can expect to live in a well managed home that is run in their interests, and they can expect to receive good information about the home and any events and changes planned. Further management activity is required on the nursing unit to establish that all training is in place and that reviews of the care received at the home are held at appropriate intervals. EVIDENCE: The Registered Manager confirmed advice given by the locality manager, advised that as from the end of March 2006, she will take unpaid leave, although her substantive post as Registered Manager will remain at Glastonbury, and a seconded Manager from another home will cover the post for six months. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 20 The Registered Manager’s qualifications have previously been seen, they advised that they are currently undertaking a one year diploma course on Dementia Mapping run by the University of Salford, Guildford. The Registered manager also has a licence for alcohol to be sold on the premises, and the licence certificate, dated May 2005 was seen. They advised they advised that the home’s cook also has this qualification, so the home will be able to continue running the bar at the monthly socials and special occasions, when the licensee has to be present. The Registered Manager and Deputy undertook a Dementia Care mini map on Beech unit in January 2006. The latest dementia mapping report was seen, and had a well being score of 2.3. The deputy advised that dementia mapping had occurred on the nursing unit on three occasions and was conducted by the manager of another home. The atmosphere in the home was good at the time of the inspection. The manager advised that some tensions arising from the management structure continued. The home is managed by Suffolk County Council. A newsletter published in February 2006 gave details of the residential review that is being undertaken by the County Council. Records of service users petty cash were provided for three service users; they were signed as checked against balance at regular intervals, and copies of receipts were available. A service user spoken with confirmed that they heard the fire bell tested regularly, and said that “sometimes they tell you, sometimes they don’t.” A carer spoken with was able to describe the drill and the action that they had to take. They advised that fire drills took place on a weekly basis. The fire logbook did not reflect this, whilst a drill was entered for the 9/02/06, the previous one entered here was in 2004. Regular emergency light testing was recorded in the fire logbook. The fire logbook showed a large number of staff without fire training updates, this did not accord with the training schedule provide. Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X 2 2 X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 2 3 Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP4 Regulation C S Regs 2001 Requirement The home is operating outside of the category and must provide details to the CSCI of the number of service users who fall outside of the current registration, and any legal status that applies. This is repeat requirement. Care plans must be reviewed frequently. Service users preferences about personal care must be elicited and recorded as part of their care plan. Keypads which secure the doors from the special needs unit to the ground floor must have the code written on them. The Registered Persons must ensure that there is a staff training and development programme for nursing staff working in the home which meets the changing needs of service users. Timescale for action 30/06/06 2. 3. OP7 OP10 15 14(a) 31/05/05 31/05/06 4. OP22 13(7) 30/04/06 5. OP28 18(1) 30/06/06 Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 23 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. Refer to Standard OP16 OP21 OP25 Good Practice Recommendations The complaints log should include the outcome. A hoist which staff can reliably use without it stalling must be provided in the bathroom on Cedar unit. A standard lamp to provide adequate lighting for service users to do fine work or read should be provided in the service users lounge on Cedar unit. This is a repeat requirement. Staffing levels must be maintained and dependency levels of service users monitored to ensure levels remain adequate. Dementia mapping on the ground floor should include the service user on a 117 order. Records should be dated. The fire logbook should be kept up to date. 4. 5. 6. 7. OP27 OP33 OP37 OP37 Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Glastonbury Court DS0000037079.V285300.R01.S.doc Version 5.1 Page 25 - 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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