Inspection on 07/06/07 for Hazelwell Lodge

This inspection was carried out on 7th June 2007.

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

Hazelwell Lodge 24/07/06

Hazelwell Lodge 27/01/06

Hazelwell Lodge 01/09/05

Hazelwell Lodge 12/01/05

Hazelwell Lodge 21/06/04

Hazelwell Lodge 29/01/04

Hazelwell Lodge 14/05/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Hazelwell Lodge 67 Station Road Ilminster Somerset TA19 9BQ Lead Inspector Jane Poole Unannounced Inspection 7th June 2007 09:30 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 Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazelwell Lodge Address 67 Station Road Ilminster Somerset TA19 9BQ 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) 01460 52760 01460 52384 Hazelwell Lodge Ltd Mrs Nicola Ann Overd Care Home 35 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. REGISTERED FOR 35 OLDER PERSONS IN CATEGORIES OP AND DE (E). 24th July 2006 Date of last inspection Brief Description of the Service: Hazelwell Lodge is a late Victorian property with a purpose built extension to the rear and an enclosed garden to the side. The home is situated at the edge of the small town of Ilminster, close to local amenities. The home accommodates 35 people in two separate areas of the building. The Bay provides personal care for older people and specialises in care for older persons with dementia care needs. The Lilies provides personal care for older people with dementia care needs and is accredited by Somerset Mental Health and Social Care Partnership under the Specialist Residential Care (SRC) arrangements. The Lilies is supported by a development nurse from the mental health care services. Fees at the home range from £402.00 to £462.00 per week. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a 7.5 hour period. During this time the inspector was given unrestricted access to all areas of the home, was able to speak with service users and staff and observe care practices. All records requested were made available and service users and staff were open and co-operative. The manager of the home completed an Annual Quality Assurance Assessment prior to the inspection. 8 relatives, 7 staff members and 7 service users completed questionnaires prior to the inspection. Some of the comments from the above have been included in the report. What the service does well: What has improved since the last inspection? The night staffing levels in the home have been reviewed and there are now three members of staff on duty overnight. In addition to this 2 unit supervisors have been appointed and core staff for each unit have been identified. This provides consistency for service users and gives clear lines of responsibility and accountability within the home. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 6 A new induction programme has been introduced using the common induction standards. Pre admission assessments have been revised and now are more comprehensive. They focus on physical needs and staff completing them should ensure that they also include likes, dislikes and preferences. The home are now having monthly meeting with the Community Psychiatric Nurse, District Nurse and Link Nurse. This is an opportunity to seek advice and share concerns to ensure that service users receive appropriate care. The garden continues to be improved and provides an excellent outdoor space for service users. Some bedrooms have been redecorated. 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 Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 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 Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have their needs assessed by a senior member of staff to ensure the home is suitable for them. Intermediate care is not provided. EVIDENCE: The home keeps its statement of purpose under review to ensure that it accurately reflects the services and facilities offered by the home. In addition to the statement of purpose there is an A-Z directory of services which gives a clear picture of the services offered by the home and in the local area. Both documents are clearly written. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 10 All prospective service users are seen and assessed by a senior member of staff prior to being offered a place at the home. Since the last inspection the home have changed their pre admission assessment format. The new format is much more comprehensive than the previous one. However it appears to focus on physical needs and staff need to ensure that they also include likes, dislikes and preferred routines when carrying out the assessment. Copies of these assessments were seen in the care plans of service users and give evidence that the home only offers places to people when they are certain they can meet their needs. Care plans seen also contained copies of assessments carried out by professionals outside the home. The manager stated that people are also given the opportunity to visit the home prior to deciding to move in. This may be considered too disruptive for some prospective service users so visits by representatives are also encouraged. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home liaise and seek advice from outside professionals in order to give the appropriate care to service users. Medication policies and procedures promote good practice and therefore ensure the safety of service users. EVIDENCE: The inspector viewed 4 service user personal files. All had plans of care that were individual to the service user and showed evidence of regular review. The amount of personal detail about likes, dislikes and personal history was variable from good to very basic. The manager explained that many of the service users are unable to give these details and they therefore rely on relatives to supply personal information and the depth of this varies greatly. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 12 Staff spoken to appeared to have good knowledge of individual service users. Daily records written by staff gave limited information and it was difficult to see how care plans could be evaluated and reviewed using this information. The manager herself has highlighted this in the pre inspection information as an area for development. There was evidence on the day of inspection that staff monitor the needs of service users and call in outside professionals where appropriate. Since the last inspection the home has set up monthly meetings with the community psychiatric nurse, district nurse and link nurse to seek advice and discuss areas of concern. The management in the home felt that this was proving very useful. All service users are registered with local GPs and access other healthcare professionals according to their individual need. The inspector observed that staff interacted with service users in a friendly respectful manner. Staff were seen knocking on bedroom doors and waiting before entering. All personal care is provided in private and it was noted that staff assisted people in a sensitive manner. Bathrooms and toilets have locks on to promote privacy. All staff currently employed in the home are female meaning that service users are unable to make a choice about the gender of the person who assists them with personal care. The home uses a Monitored Dosage System (MDS) for medication. The inspector viewed the storage facilities and administration records. All medication entering the building is signed in giving a clear audit trail. The inspector noted some minor errors in the recording of drugs administered or refused and these were highlighted to the manager. Controlled drugs are appropriately stored and recorded. Records kept correlated with stocks held. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are no strict routines in the home and service users are able to choose how they spend their day. There is a wide range of activities and trips for service users to take part in if they wish to. EVIDENCE: Service users spoken to stated that there were no strict routines in the home and that they were free to choose how they spent their day. People said that they were able to decide when they got up and when they went to bed. It was noted that the new pre admission assessment forms gave details of people preferred times of getting up and retiring for the day. There is a full activity programme in the home that includes monthly trips out, musical entertainment, reflexology, visits from pat dogs, quizzes, games and Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 14 visits from the local clergy. People are free to join in with activities that interest them. At the time of this inspection the activity worker was away from the home but care staff were carrying on with some of the programme of activities. The inspector spent the morning in the lounge on the specialised residential care unit, The Lilies. There was music on in the room and service users were animated and chatty. Staff spent extended periods of time socialising with service users. Service users are able to have visitors at any time and many go out with friends and family. At lunchtime people were free to eat in the dining room, the lounge or their personal rooms. There is a four week menu that gives a choice of main meal (except on days when a roast dinner is served.) The inspector observed lunch being served on The Lilies. The main meal was roast chicken with vegetables. It was noted that service users were not given a choice of vegetables or condiments but served a full dinner each. There was a choice of hot and cold drinks but these were served at the same time. In The Bay hot drinks were served after the meal. Staff have begun to receive training on the Mental Capacity Act and staff meetings have emphasised to staff that they need to respect peoples wish to change their minds and vary their routines so choices need to be continually offered. The manager has given evidence outside this inspection on how choices of service users are upheld even when this may be in conflict with others views or wishes. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has taken reasonable steps to minimise the risks of abuse to service users. Service users are listened to and action taken to address concerns raised. EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. (Currently the whistle blowing procedure does not give contact details for the Commission for Social Care Inspection.) All staff have received training in the protection of vulnerable adults. One member of staff stated that the training was very informative and useful. One complaint has been received by the home since the last inspection. There was evidence that this was investigated and resolved to the satisfaction of all parties. There is a very warm and relaxed atmosphere in the home. The inspector observed that staff responded sensitively to a service user who appeared upset and spent time speaking to them. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 16 All 7 service users who completed questionnaires prior to the inspection answered YES to the question ‘ Do staff listen and act on what you say?’ All staff are checked against the Protection of Vulnerable Adults (POVA) register and undergo an enhanced Criminal Records Bureau (CRB) check. Recruitment records showed that staff are working under supervision before POVA 1st checks are received by the home. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hazelwell Lodge provides homely, comfortable accommodation for service users. Service users have unlimited access to a large secure garden. EVIDENCE: Hazelwell Lodge is a large, older style building that has been extended to provide 34 bedrooms. The home is divided into two units, The Bay and The Lilies. These are separated by an electronic keypad. All areas of the home are fitted with a fire detection and a call bell system. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 18 Currently all bedrooms are used for single occupancy although the home does have one room that could be shared if two people wished to do so. Since the last inspection the two rooms that had been made out of a larger room have been improved meaning that they are now two fully separate rooms. Some rooms have been redecorated since the last inspection. All bedrooms have either en suite facilities or a wash hand basin. There are adequate communal bathing facilities. The inspector viewed a sample of personal rooms and noted that service users were able to personalise their rooms to give them an individual feel. All communal areas are located on the ground floor. In The Bay there are two lounges and a large dining room, on The Lilies there is a lounge and a small dining room. All communal areas are homely in appearance and furnished in a domestic style. One relative wrote to the inspector stating that they felt the small lounge in The Bay could be improved and better used by service users and visitors. The inspector noted that only one service user was using this room on the day of inspection and it was not a particularly inviting space. A new carpet has been purchased and will be laid in the near future. Outside the home continues to develop the garden, which is shared by both units. The garden is secure and has many areas of interest. Service users are able to access the garden at all times and a range of seating has been provided. One service user took the inspector for a tour of the garden and others spoke of the importance of this space to them. Throughout the home aids and adaptations have been put in place such as hand-rails, raised toilets and some assisted bathing facilities. There is some signage to assist people who are disorientated to find their way around the home independently. The laundry is extremely small for the size and nature of the home. There is one washing machine and two driers. The only sink in the room is a tiny wash hand basin. The laundry assistant stated that if any laundry required soaking then buckets had to be filled from the bathroom opposite. There are plans to improve the laundry facilities. On the day of inspection all areas seen by the inspector appeared reasonably clean and fresh. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the skills to meet the needs of the service users. Staff are clear about their roles and responsibilities. EVIDENCE: The home employs 31 care staff and 18 ancillary workers. 10 members of the care staff team (31 ) have a National Vocational Qualification in care at level 2 or above. A further 9 members of staff are working towards this award. (These figures were taken from documentation provided by the home prior to the inspection.) 7 members of staff completed comment cards prior to the inspection. All answered Yes to the questions ‘Are you clear what service user needs are?’ and ‘Is there always a senior member of staff to confer with?’ 8 relatives/visitors completed questionnaires prior to the inspection and all made positive comments about the care staff team. Comments included “I am impressed by the patience of staff particularly when dealing with difficult Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 20 situations” and “Staff are always cheerful and keep me informed about events in the home.” There is an obvious commitment to staff training and staff spoken to were very pleased with the training opportunities. In addition to formal training sessions the inspector noted that staff meetings were also being used to raise awareness and train staff. For example at one meeting staff were made to dress up in clothes that were poorly fitting and un co-ordinated to see how it would be for service users if staff assisted them to dress in this manner. There is ongoing training in working with people who have a dementia and staff spoken to and observed appeared confident in their roles. The homes induction programme is based on the common induction standards and the inspector saw evidence that this in being used with new staff. 6 of the 7 staff who completed comment cards prior to the inspection sated that they felt they received adequate induction and supervision when they began work at the home. Since the last inspection the night staffing levels have been increased. There is now a minimum of 5 care staff on duty throughout the day and three overnight. Also since the last inspection 2 unit supervisors have been appointed and core staff for each unit have been identified. Staff felt that this provided consistency for service users and staff. The inspector viewed the recruitment records of the three most recently appointed staff. All contained application forms, 2 written references and proof of identification. All had been checked against the Protection Of Vulnerable Adults (POVA) register and had enhanced Criminal Records Bureau (CRB) checks. However documentation in recruitment files showed starting dates as prior to POVA checks having been received by the home. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is competently managed taking account of the views of service users and other interested parties. There are clear lines of accountability and responsibility in the home. EVIDENCE: The registered manager is Nicola Overd, who has many years of experience of working with older people and has managed Hazelwell Lodge for over 7 years. There is a deputy and 2 unit supervisors. All members of the management team have National Vocational Qualifications (NVQ) in care at level 3 or above. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 22 At the time of this inspection the manager and one of the unit supervisors were working at the home. Both demonstrated a good knowledge of service users and staff. Pre inspection information received by the inspector demonstrated that the home has an ongoing improvement plan for both the care and the environment. There is a commitment to ongoing improvement in the home and regular questionnaires are sent out to monitor views on standards of care. The pre inspection information also showed that the manager is aware of shortfalls and areas for further development. The inspector viewed the homes policies and procedure and noted that they covered a comprehensive range of issues. Some did not appear to have been reviewed since 2004. The home need to keep policies and procedures up to date to ensure that they remain relevant to the home and reflect up to date good practice guidelines. The home do not act as a power of attorney or financial appointee for any service user. Small amounts of personal allowance are held on behalf of some service users and records are kept of all transactions. There are systems in place to ensure the health and safety of service users and staff. A gardener and a maintenance person are employed to ensure that all areas are well maintained and kept free from avoidable hazards. A fire detection system is fitted throughout the home. The fire log shows that alarms are tested weekly, emergency lighting monthly and staff receive training in fire safety twice a year. All staff have received training in health and safety and moving and handling. There are up to date certificates of service for all hoists and the lift. All accidents are recorded and audited by the homes manager on a monthly basis. Appropriate insurance is in place. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 23 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 X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X 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 2 3 3 3 3 X 3 X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x 3 3 Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 (4) [c] Requirement All staff must be checked against the Protection Of Vulnerable Adults register before starting work in the home. Daily records must be detailed and accurately reflect care given to enable care plans to be evaluated and reviewed. Timescale for action 11/06/07 2 OP7 15(2) 31/08/07 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 OP26 Good Practice Recommendations It is strongly recommended that a sluice room including a bedpan washer be installed following consultation with Somerset and Dorset Health Protection Unit. This recommendation will remain ongoing. The manager should review how service users are offered choices at meal times. The whistle blowing policy should include contact details for the Commission for Social care Inspection. The homes policies and procedures should be regularly DS0000016068.V337321.R01.S.doc Version 5.2 Page 25 2 3 4 OP15 OP18 OP37 Hazelwell Lodge reviewed to ensure they are appropriate to the home and reflect current good practice. Hazelwell Lodge DS0000016068.V337321.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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