CARE HOME ADULTS 18-65
Healey House 1 Oakenshaw Avenue Healey Whitworth Lancashire OL12 8ST Lead Inspector
Mrs Christine Mulcahy Unannounced Inspection 16th January 2006 10:00 Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Healey House Address 1 Oakenshaw Avenue Healey Whitworth Lancashire OL12 8ST 01706 759692 01706 759692 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Anna Geraldine Ellis Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission 4th July 2005 Date of last inspection Brief Description of the Service: Healey House is registered with the Commission for Social Care Inspection to provide care and accommodation to eight younger adults who have a learning disability. Healey House is situated close to the boundary that divides Rossendale and Rochdale. The home is sited on a main bus route and service users can use public transport with staff support. Transport provided by Healey House is also available for service users to access facilities in both areas. The home is an end terraced Victorian building that provides homely spacious accommodation on two levels. Access to the first floor is via a passenger lift. The first and second floor can be accessed via a staircase. There are large single bedrooms, bathing and toilet facilities on the ground and first floor. The ground floor consists of two lounges a dining area and a kitchen. Confidential information and medication are both stored securely in separate rooms. The home is decorated, equipped and furnished to a good standard. Furnishings are domestic in character. There are enclosed garden areas surrounding the property. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The summary below is an overview of the findings of an unannounced inspection conducted at Healey House on 16th January 2006. The service was inspected against the National Minimum Standards for Adults (18 – 65) At the time of the inspection 8 service users were accommodated at the home. The inspection involved discussion with service users, the registered manager and care staff. Observations were made throughout the visit and records were examined. There are various references to ‘case tracking’ throughout this report. All records relating to these people are inspected, along with the rooms they occupy in the home. Observations are of the care provided, and the service users are invited by the inspector to discuss their experiences of services in the home and what this means for them. The inspection was carried out with the co-operation of the registered manager and service manager. What the service does well:
It was apparent from the friendly welcome received by the inspector that service users were always happy to receive visitors to their home. The atmosphere was warm and friendly and a number of service users were eager to introduce themselves. From the comments and conversation held between the staff and service users it was clear that the registered manager and staff had developed a relaxed and familiar relationship with service users. Service users were in safe hands at all times and staff had the necessary skills to meet their needs. Staff were well trained experienced and were visibly content carrying out their duties. They were also employed in sufficient numbers to ensure the needs of service users were met and extra staff support was available for one service user with complex needs. Throughout the inspection it was clear that service users were given the same opportunities regardless of age, and ability and were actively encouraged to use their daily living skills to contribute to the running of the home, like helping in the kitchen or keeping communal or personal spaces tidy. Daily routines in the home promoted independence, individual choice and freedom of movement for the majority of service users. It was evident that service users had the opportunity to maintain and develop social, emotional and communication skills through regular contact with outside agencies, groups and clubs. This information was well documented in care plans that addressed service users personal emotional and social care
Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 6 needs. Service users were seen relaxed in their home and using staff to support them in their chosen activities. What has improved since the last inspection? What they could do better:
To ensure safe working practices and protect service a number of policies and procedures still require update and review. The service manager has scheduled this work to be completed by July 2006. Examination of the homes medication administration records sheets highlighted staff had not signed to confirm the administration of medication to service users. This had occurred on one occasion only. The registered manager was required to ensure that staff complied with the home’s policy and procedure for the recording, handling and administration of medicines ensuring that up to date and accurate records were kept at all times. Staff rotas were examined and confirmed there were sufficient numbers of staff with appropriate skills to support service users to meet the assessed needs. The rota indicated staffing levels at another scheme house as well as at Healey House details were unclear. The staff rota should always identify the shifts worked by those employed at Healey House only. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 7 A copy of the buildings maintenance plan forwarded to the Commission identified the first floor bathroom for refurbishment. However facilities in the first floor bathroom are not accessible to service users and therefore cannot be used in it’s current state. The registered manager was reminded that the bathing and toilet facilities on the first floor of the building must meet service users assessed needs and offer sufficient privacy as stated in the Statement of Purpose. The Commission required a suitable completion date the refurbishment of the first floor bathroom. 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. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 2, 3, 4, 5 Written information about the home and facilities was comprehensive and set out the aims and conditions of the home. Service user had a plan of care for daily living and longer-term outcomes based on the care management assessment. Service users were always assessed prior to admissions to the home. EVIDENCE: Case tracking of a service user recently admitted to Healey House took place. The service user case file was examined and confirmed that the service users and their representative had been provided with a service user guide and statement of purpose. The service user representative had also signed a contract of conditions. Both documents held information needed for a service user to understand how the home was run and would meet their needs and aspirations. The registered manager said that service users always visited the home to test drive the facilities before moving in. This was confirmed briefly by the service user who said that he had been to Healey House to look around before moving in. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 6, 7, 8, 9 All service users had an individual care plan. Staff provided service users with the support needed to make decisions about themselves and the day-to-day running of the home within a risk managed environment. EVIDENCE: Case tracking of one service user confirmed that the service user had been appropriately assessed and attention to their needs as individuals was paramount. Service users each had an individual care plan. The plans were used to identify service user needs and how carers and service users would meet the needs. The care plan seen described the services and facilities to be provided by the home and how the services would meet current and changing needs and aspirations and achieve goals. The plan was drawn up with the involvement of the service user and was generated from a care management assessment and the homes own assessment. It covered all aspects of personal, social and healthcare support. The plan clearly described the strategies staff would use to support the service user to meet the agreed goals. The care plan made clear how the service user wanted things to be done in a section called, “Looking after myself.” There were also clear instructions for the
Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 11 service user to be supported by 2 members of staff at all times due to a serious health condition. Included in the care plan were individualized procedures to be followed by staff as his health condition was likely to cause him harm. This included a specific risk assessment and details about the administration of medication for the health condition. Alongside this was a detailed record that clearly identified and tracked the service user seizures, recovery time, and the emergency treatment required. The inspector observed staff demonstrating a sensitive understanding, and professional approach to service users and it was apparent they were keen to ensure that service users maximised control over their own lives. Staff were seen allowing service users to make choices about the menu and activities like what to watch on TV. This information was recorded in care plans along with decisions made by staff, others and why this was the case. Care plans had been reviewed regularly and care plan review sheets had been completed and signed by staff and service users. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 12, 13, 14, 15, 16, 17 Staff helped service users to take part in fulfilling and valued activities through community links and social inclusion. Daily routines promoted independence and freedom of movement for most service users. The meal served was nutritious and balanced. EVIDENCE: Many service users were supported to take part in activities that suited their abilities like social outings and helping with shopping or day centre attendance. There were a number of outings and trips planned to local places of interest and staff were heard helping service users make decisions about where they would like to go for a short drive that day. Service users were encouraged to make use of services, facilities and activities in the local community like shops, library, cinema, pubs and leisure centres. Transport was always available and was provided by the homes own people carrier vehicle. Some service users were encouraged to use public transport to promote independence as identified in their care plan For one service user where this was the case, the care plan described restrictions to movement imposed by a specialist programme and was agreed by the service user and professionals.
Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 13 Service users were supported by staff to maintain family links where appropriate. Friendships inside and out of the home were encouraged with the service users agreement. Service users had unrestricted access to most parts of the home and grounds and were responsible for some household tasks that maintained the general common areas. Meals were available throughout the day in the form of full meals and snacks and service users were actively encouraged to help plan, prepare and serve meals where possible. On the day of the inspection service users when asked said they had enjoyed their lunch and had eaten at the dining room table with other service users and staff. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 19, 20 The health care needs of service users were met and identified through care plans. The control of medication was managed to promote good service user health. EVIDENCE: Case tracking confirmed that service user healthcare needs were assessed and recognised and procedures were in place to address these needs. Care plans and daily records were examined and confirmed that service users were supported to choose their own GP and where possible make decisions about their own health care needs. The care plans examined detailed the monitoring of one service user who had specific health needs. The care plan highlighted potential complications and problems and at what stage staff, specialists or professionals dealt these with. Service users received regular health checks paying attention to vision, hearing, medication or disability. The registered manager confirmed that none of the service users at Healy House self medicated and that staff administered all medication. Records were kept of all medicines received, administered and leaving the home or disposed of to ensure there was no mishandling. Medicines were stored in a secure room in the home and a record was kept of current medicines for each service user.
Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 15 The inspector examined a number of medication administration records sheets (MAR) and noted that on one occasion staff had not signed the MAR sheet to confirm that medication had been given to a service user on that day. The inspector recommended that the registered manager ensured compliance with the home’s policy and procedure for the recording, handling and administration of medicines. A majority number of staff had received appropriate training on administering rectal diazepam including basic knowledge of how medicines are used and how to recognise and deal with the problems in use. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 22, 23 The homes clear and effective complaints procedure included the stages and timescales for the process. Service users knew who to complain to. EVIDENCE: A copy of the homes complaints procedure had been given to all service users at Healey house. When asked service users said that they knew whom to complain to. One service user said, “If I had a complaint I ‘d go to see the manager and talk to her. The staff are very good here, you can talk to them about anything.” When asked the registered manager and staff confirmed they always listened to and acted on the views and concerns of service users and others. The registered manager said, “We always listen to service users and try to sort things out before they develop into problems and something bigger.” The inspector examined the homes record of complaints and noted that no complaints had been made since the last inspection There was a robust procedure for responding to suspicions or evidence of abuse or neglect (including whistle-blowing) that ensured the safety and protection of service users. When asked one staff said that he had received abuse training and said that challenging behaviour displayed by service users was understood by all staff and dealt with appropriately. There were strict guidelines that information relating to challenging behaviour must be recorded after any incident of prevention. Risk assessments were available and were examined along with care plans to ensure that service users were protected from harm at all times including during the use of control and restraint.
Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 17 The homes policies and procedures regarding service users money and financial affairs ensured safe storage of money and valuables within the home. Service users were encouraged to have separate savings accounts or relatives took responsibility for this. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 24, 25, 27, 30 The homes premises are suitable for it’s stated purpose and meets service users individual and collective needs. Current bathing facilities did not meet with service user requirements. EVIDENCE: Healey House is a large Victorian end terraced house with gardens to the front and side. There are car-parking facilities to the rear and side of the building. The home is situated close to local amenities and near a main bus route. Furniture and fittings to the home are domestic in character and of a good standard. The registered provider has recently ensured improvements to the home meet with the details in the statement of purpose. The home is in keeping with the local community and has a style and ambience that reflects the homes purpose. Risk assessments for the outside steps have now been carried out to prevent service users and staff from the risk of slips and trips. The registered person has provided the Commission with a copy of the homes planned maintenance programme which includes dates for work to be carried out on areas of the home that require repair. The inspector was informed of the plans to change the purpose of the attic space from a recreational room to service manager’s office space. The registered manager advised that a meeting was held to consult with service
Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 19 users. Notes of the meeting were available at the home. The registered manager was reminded to ensure that the information in the service user guide and statement of purpose must reflect these changes. The refurbishment of the ground floor bathroom is now complete and is used by 8 service users. However facilities in the first floor bathroom are not accessible to service users and therefore cannot be used in it’s current state. A copy of the buildings maintenance plan identified this area of the home for refurbishment. The registered manager was reminded that the bathing and toilet facilities on the first floor of the building must meet service users assessed needs and offer sufficient privacy as stated in the Statement of Purpose. A requirement was made for the registered manager to ensure a suitable completion date the refurbishment of the first floor bathroom. The premises were clean and free from offensive odours Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 33, 34, 35 Robust recruitment policies and procedures were in place to protect service users. Ongoing training ensured up to date information for staff. Staff were trained well enough to ensure the needs of service users were met. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 21 EVIDENCE: Case tracking of a new employee confirmed that she had been recruited using the homes thorough recruitment procedure. All necessary employment checks to protect service users had been carried out. The inspector discreetly observed staff working with service users and using skills and techniques that were appropriate. Staff demonstrated their understanding of the cultural and social needs of each service user and communicated appropriately and sensitively with them confirming they had the competencies and qualities required to meet service user needs. Further discussion with staff confirmed that training and development opportunities were frequently available to ensure service user needs were understood and met. When asked staff confirmed they had received training in Health and safety, first aid, NVQ 2, medication training, and fire training. The staff rota was examined and it was clear that the ratios of staff to service users was determined by service user needs. There was a core team of existing staff who worked at Healy house and another house that was part of the scheme. The inspector noted that the staff rota did not clearly indicate the capacity of the staff on duty. The rota was also used to indicate the hours worked at the other scheme house. The registered manager was required to ensure that the staff rota indicated the work times and roles for staff who worked at Healey House only and not other establishments within the scheme. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): YA 37, 39, 42 The management and staff provide a safe and well-run environment for service users to live in. Policies and procedures at the home safeguarded service users rights and best interests. EVIDENCE: The registered manager has 10 years experience of working with adults with a learning disability and has numerous work related qualifications. She has a BA in “Professional Studies Learning Disabilities”, and should complete the Registered Managers Award (RMA) in July 2006. She was actively involved in the Investors In People quality award, used to review and internally audit the service on an annual basis. The health safety and wellbeing of staff and service users were promoted through the homes policies and procedures. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 23 A review of the homes policies and procedures had begun and would take place in their priority order. The newly revised policies and procedures on adult protection and abuse met all elements of the national minimum standard. All employees had signed to confirm their understanding of both documents. Staff meetings and supervision were said to be in place Records of staff employed at Holt Mill House were kept in a secure office within the adjacent day centre. Staffing levels were always increased at busier times of the day for example mornings, evenings, and weekends. There had been some progress towards updating systems to ensure the health, safety, and welfare of service users was being protected. Staff had received training in moving and handling, fire safety, first aid, food hygiene, and the safe handling of medicines. Systems were in place to ensure challenging situations involving service users were risk assessed to ensure staff and service users were safe from harm. A planned maintenance programme included details of maintenance work required around the home. The inspector was satisfied the registered manager ensured compliance with other relevant health and safety legislation through robust policies, procedures and practices. Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
YESCHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 X 2 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 2 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Healey House Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000009602.V273101.R02.S.doc Version 5.0 Page 25 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA40 Regulation Requirement Timescale for action 16/06/06 Regulation The registered manager shall 17 ensure that all records including the homes policies and procedures are reviewed and up dated regularly to ensure safe working practices at the home. Regulation The registered manager was 12(2) required to ensure that staff complied with the home’s policy and procedure for the recording, handling and administration of medicines. Regulation The registered manager was 23(2)j required to ensure that sufficient numbers of lavatories, washbasins, toilets and showers fitted with a hot and cold water supply are provided at appropriate places in the premises. Schedule The registered manager must 4(7) ensure that a separate copy of the duty rota is kept for Healey House this should include people working in the home and confirm whether the rota is actually worked. 2 YA20 16/01/06 3 YA27 16/05/06 4 YA33 16/01/06 Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Healey House DS0000009602.V273101.R02.S.doc Version 5.0 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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