Inspection on 27/04/06 for Hadrian House

This inspection was carried out on 27th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hadrian House 15/07/08

Hadrian House 26/09/05

Hadrian House 28/01/05

Hadrian House 10/12/04

Hadrian House 02/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Hadrian House Garden Street Thurmaston Leicester Leicestershire LE4 8DS Lead Inspector Linda Clarke Unannounced Inspection 27th April 2006 08:45 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 Hadrian House DS0000032914.V288319.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. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hadrian House Address Garden Street Thurmaston Leicester Leicestershire LE4 8DS 0116 2694397 0116 2694397 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) www.leicestershire.gov.uk Leicestershire County Council Social Services Mrs Angela Pauline Horobin Care Home 40 Category(ies) of Dementia - over 65 years of age (20), Learning registration, with number disability over 65 years of age (4), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (6), Old age, not falling within any other category (40), Physical disability over 65 years of age (12), Sensory Impairment over 65 years of age (4) Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User Categories DE(E) No person falling within category DE(E) may be admitted to the home when 20 persons who fall within category DE(E) are already accommodated within the home Service User Categories MD(E) No person falling within category MD(E) may be admitted to the home when 6 persons who fall within category MD(E) are already accommodated within the home Service User Categories LD(E) No person falling within category LD(E) may be admitted to the home when 4 persons who fall within category LD(E) are already accommodated in the home Service User Categories PD(E) No person falling within category PD(E) may be admitted to the home when 12 persons who fall within category PD(E) are already accommodated within the home Service User Categories SI(E) No person falling within category SI(E) may be admitted to the home when 4 persons who fall within category SI(E) are already accommodated within the home Service User Categories Service users between the age of 55-65 years who fall within the above categories and were resident in the care home at the date of registration may continue to reside there To be able to admit the named person of Category A under 65 years of age as identified in correspondence in application number V13681 dated 4:11:04 To be able to admit the named person of category DE who is under 65 years of age as identified in Application Number V17607 dated 23/02/05 To be able to admit the named person under the age of PD(E) named in the variation application number V25720 for a period of six weeks, commencing from the date of her admission to Hadrian House. 2. 3. 4. 5. 6. 7. 8. 9. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 5 Date of last inspection 26th September 2005 Brief Description of the Service: Hadrian House is a care home providing personal care and accommodation for forty older persons, who may have associated conditions, which may include dementia, mental disorder, learning disability and sensory impairment. The home also provides two beds offering respite facilities and a rehabilitation unit. The forty single bedrooms are without ensuite facilities. The home has a central and surrounding garden. Accommodation is provided over two floors with access between floors being via stairs or a passenger lift. Hadrian House is situated close to Thurmaston town centre where service users have access to shops, pubs and other amenities. Information is located on site detailing the range of services offered, which includes the Statement of Purpose, in addition to this Hadrian House has copies of the Commission of Social Care Inspections, Inspection Reports, which are located in the foyer and are available upon request. The maximum weekly fee is £451.50, which was provided on the day of the Inspection. There are additional costs for individual expenditure such as Chiropody, Optician and hairdressing services, and the fee will depend on the services received. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection Report reflects a visit to the service, which included discussions with service users, relatives, and staff and the reading of documents relevant to service user care and welfare, along with staffing records. In addition documents supplied direct to the Commission for Social Care Inspection by the care home, which includes reports of incidents involving individual service users. Records of visits undertaken by a representative of the Responsible Individual were viewed on the premises and have been incorporated. What the service does well: What has improved since the last inspection? Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 7 Environmental improvements have taken place since the last inspection, which includes the decoration and replacement of carpets in the foyer, ground floor corridor and stairwell. Further decoration has taken place on the first floor corridor. Bathroom and toilet facilities have also been refurbished to include an assisted bath. The rehabilitation unit has also benefited from improvements, which includes a walk-in shower, and the refurbishment of the lounge, to include a fire surround and new chairs. 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. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The content and the distribution of information could be improved to support prospective service users in making a decision as to where to live. EVIDENCE: Information regarding the service and facilities, which Hadrian House provides is kept on site, this details the initial assessment and referral process and includes environmental information along with the aims and objectives. Incorporated is information as to how complaints, comments and compliments can be raised. The information provided by Hadrian House does not include views or comments of service users who already reside within the home. Service users with sight impairments may experience difficulty in reading the documentation; other formats could be considered, with consideration being given to the range of service users needs for which Hadrian House is registered too provide. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 10 Information in relation to fees was incorporated within the handout packs, including information on savings and assets. Copies of this information for existing service users is kept in service user bedrooms. The records of three service users were viewed; all were found to contain an initial assessment of need undertaken by an appropriate person, one assessment in particular was very detailed providing care staff with detailed information to help in the delivery of care. A discussion was also held with the relatives of one individual who was currently residing at Hadrian House, they said that they were satisfied with the information provided. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a site visit to this service. Service users are looked after well in relation to health and care needs. EVIDENCE: The care plans and records of three service users were viewed. Care plans contained information as to how the care needs of the service users were to be met with reference to the service users views and expectations of care. The care plan of one service user detailed additional external agencies, which were involved to ensure that aspects relating to physical disability were addressed. Care plans are regularly reviewed, and reflect risk assessments where appropriate, which identify potential risks and the process for minimising them. The records of one service user accessing rehabilitation services were briefly viewed, and contained a comprehensive assessment and identified goals of achievement to maximise independence. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 12 Two service users, whose records were viewed, spoke positively of the care they received and praised the staff and the care they provided. One service user said that he had felt much better since moving into Hadrian House. Discussions were held with two service users whose records were not viewed, but had indicated they wished to speak with the Inspector, both service users said they were happy with the level of care they received, and found staff to be caring and supportive. The Inspector spoke with relatives who were visiting at the time of the Inspection, both praised the care provided and the attitude of staff, both confirmed that they had no concerns. Records viewed indicated regular access to health care professionals, including General Practitioners, District Nurses, Chiropodists and specialist medical staff including hospital appointments. The intensity of health care input is individual to each service user. Members of staff interviewed including the Deputy and Assistant Manager confirmed that the development and reviewing of care plans is conducted with service user and relative involvement. The medication and medication records of some service users were viewed; all were found to be in good order. The supplying Pharmacist has recently visited to view medication processes and had found no areas of concern. Throughout the inspection process staff were observed speaking with service users in a sensitive manner, with consideration being given to the promotion of their privacy and dignity. Care plans viewed outlined the wishes of the service user and the role of relatives where ill health is of concern, which includes the arrangements following death. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users experience a homely life style and visitors are encouraged to visit. Various activities are available to service users, the frequency of external activities does not meet the needs of all service users. EVIDENCE: Hadrian House employs an Activity Organiser who supports service users both in groups and individually to participate in activities, a formal programme of activities is not in place. The Activity Organisers hours are flexible in order that service users benefit from day and evening activities, which includes facilitating service user meetings with the Deputy Manager. The Inspector spoke with the Activities Organiser who detailed the range of activities on offer, which include bingo, skittles, board games, art and craft, which includes pottery. Service users had recently participated in an Easter Bonnet competition; service users spoke of the prizes they had won. External entertainers also provide activities these include a musician a musician/singer, dancer and formation dancers. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 14 The Activity Organiser also organises trips to garden centres, public houses, shopping, visits to local and regional parks and boat trips, which leave from Thurmaston and terminate at Mountsorrel. A fete is planned for early May to celebrate Hadrian Houses anniversary. On the day of the Inspectors visit a group of service users were going out for lunch. The records of one service user and a conversation with the lady confirmed that she regularly attends to the local Baptist Church. The Inspector sat with a group of service users, and sampled the mid-day meal. The quality of the food was good, the first course being home made using fresh ingredients. Vegetables are placed into serving dishes on individual dining tables enabling service users to serve themselves. Choices for both the main course and dessert were available. All service users spoken with confirmed that all meals were of a good quality and were enjoyed. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has robust arrangements in place to ensure concerns are responded to in an efficient and effective manner to protect people who use the service. EVIDENCE: Service users when asked were confident that should they have any concerns, they were clear as to whom they should speak with, in addition there is a written complaints procedure, and information as to how to contact advocacy services. Visiting relatives confirmed that they were aware of the complaints procedure. Staff who were interviewed were aware of policies and procedures which detail staffs role in protecting service users from abuse, including the policies, which support staff in raising issues of concern. The Complaints Record was viewed, which evidenced that the home has received one complaint since the last inspection; the outcome of the complaint was recorded along with any action necessary. The Commission for Social Care Inspection has not received any expressions of concern with regards to Hadrian House. Service user meetings are held; the next planned meeting was for the evening of the Inspectors visit. Minutes of previous meetings evidenced that service users views are recorded. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comfortable and clean standard of accommodation is provided for service users. Improvements could be made to the accessibility and enjoyment for service users within the garden. EVIDENCE: Hadrian House provides a large lounge to the ground floor, and additional smaller seating areas on the first floor, one seating areas is for those service users who wish to smoke. On the day of the Inspection the home was found to be clean and tidy, and protocols were in place for the management of infections including MRSA. Environmental improvements have taken place since the last inspection. The ground floor foyer, corridor and stairwell have been decorated which includes the fitting of new carpets. A ground floor bathroom has been re-furbished and now provides an assisted bath, with toilets on the ground floor also having Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 17 been re-furbished. The first floor corridor has been decorated, and toilets refurbished. The rehabilitation unit has also undergone improvements, which includes the refurbishment of the bathroom to provide walk-in shower facilities. The lounge within the rehabilitation unit has been decorated, which includes the provision of new carpets and furniture and the fitting of a fire surround. The kitchen has also been decorated, and provides additional equipment such as an ironing board and iron. The bedroom of one service user was viewed and found to be personalised to their taste, the service user did say he wished he could have a larger room, but understood why this was not possible. Hadrian House has a central courtyard style garden, which provides a patio, grass area and plant borders. Access to the garden is limited to one exit, which is also a fire exit, therefore if the doors are not open service users need to use the push bar to open the doors. Once outside there is a patio area for service users to sit, which includes chairs and benches, borders surround the garden. The grass and border are areas only accessible to those service users who are ambulant, as there are no additional walkways, therefore access is restrictive to a majority of service users. The Deputy Manager said they were planning to provide additional paving in order that service users can gain access to all areas of the garden, and to provide raised beds that will be accessible to service users who wish to take part in gardening activities. The timescale for such work is however dependent upon monies being raised through fund raising activities. The needs of service users with a sensory impairment need to be considered, for example through the provision of fragranced flowers and shrubs and noise stimuli such as chimes. The Inspector spoke with one service user who said she very much enjoyed gardening, and used the greenhouse to propagate seeds, however she couldn’t take place in the planting of these into the garden, as a wheelchair user she could gain neither access to the plant borders or reach them as they were at ground level. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Trained and qualified staff are employed following robust recruitment checks and are employed in sufficient numbers to meet the care needs of service users. EVIDENCE: The Inspector viewed the staff duty rota, for the week of the Inspectors visit, and found that service users are supported during the week by six members of care staff in the morning, with an additional member of staff supporting individuals within the rehabilitation unit, in the afternoon/evening service users are supported by four members of care staff, with an additional member of staff working within the rehabilitation unit. The rota did however indicate that at weekends there is one less member of staff on duty. There is a member of the management team on duty at all times. Staff spoken with felt that staffing numbers were generally sufficient, however that in addition to their being less care staff on duty at the weekend, there were also less ancillary staff on duty, however the same tasks still need to be performed. Care staff interviewed felt that the level of care service users received was good. This was supported by positive comments received by service users on both the delivery of care and the friendliness of care staff. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 19 The Inspector viewed a selection of staff recruitment records, all necessary employment checks, which included written references and a Criminal Record Bureau check. Staff receive regular supervision from a member of the management team. Hadrian House employs twenty-nine members of permanent care staff, of which ten have completed a National Vocational Qualification in Care at level 2, which represents 34 of the staff team. In addition two members of the management team have a National Vocational Qualification in Care at level 2, whilst one member of the team is a qualified Assessor. Training records were viewed which highlighted a variety of topics, pertaining to the health and safety of service users and staff. Staff have also received training which directly affects the quality of care service users receive, which includes training in Dementia Care and Alzheimer’s Disease. There is a proportion of service users residing at the home who have a Sensory Impairment, staff have not received training in this area, training could improve the care service users receive. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Registered Manager offers a clear sense of leadership, however service users are limited as to how they can influence the running of the home. EVIDENCE: The Registered Manager has attained the Registered Managers Award and the level 4 National Vocational Qualification. A representative of the management team of the Local Authority, who is external to Hadrian House, visits the home on a monthly basis, representing the Responsible Individual. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 21 A report is generated following each visit, the purpose of the visit being to review documents, speak with service users, staff and the management team, to view the environment and deal with any specific issues, the Inspector viewed the reports whilst at Hadrian House. Copies of the visits are currently not being forwarded to the Inspector. Reports evidenced funding for future training, decoration to parts of the home, review of budgeting and development of care plans. Quality assurance needs further development, to formalise the process of gaining service user, relative and friend views. Through this the home will be able to review its practices, to ensure its ability to continue to improve both the care and quality of life for its service users. Service user meetings take place on a regular basis; the Inspector viewed minutes of the meetings. Issues brought up by service users have been acted upon, evidencing service users views are central to the running of the home. Although service user meetings take place this is a public gathering and not all service users attend, it is therefore necessary for quality assurance processes to be reviewed. Quality assurance processes will be followed up at the next inspection, when it is expected that significant improvements will have been made to enable service users and their representatives to comment as the services offered by Hadrian House. Health and safety records were viewed, evidence of regular checks was seen, any concerns are brought to the attention of the appropriate department, and a date when the works are completed is entered into the record. Fire records were completed, which evidenced regular fire drills and tests. A fire risk assessment was also in place, which is reviewed. The accident and incident book was viewed; service user records supported the entries within the accident book. Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 2 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP1 Good Practice Recommendations It is recommended that the information about services offered is revised and improved, with consideration being given to content, format and distribution, in order that there are effective and accurate processes for the dissemination of information to prospective service users their families and friends. The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home. It is reasonably expected this includes service users and their representatives. 2 OP33 Hadrian House DS0000032914.V288319.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Hadrian House DS0000032914.V288319.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!