Inspection on 13/12/05 for Heathfield

This inspection was carried out on 13th December 2005.

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

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

Other inspections for this house

Heathfield 27/04/09

Heathfield 03/05/07

Heathfield 10/05/06

Heathfield 21/06/05

Heathfield 02/02/05

Heathfield 07/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Heathfield Cannell Green Norwich Norfolk NR3 1TT Lead Inspector Kim Patience Unannounced Inspection 09:30 13 December 2005 th 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 Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heathfield Address Cannell Green Norwich Norfolk NR3 1TT 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) 01603 612768 01603 614765 Norfolk County Council Mrs Karen Sell Care Home 37 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (32) of places Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. People who need wheelchairs to assist with their independent mobility can only be accommodated in the home in rooms 12, 19, 34 & 41 added in response to letter of 24.10.03. 21st June 2005 Date of last inspection Brief Description of the Service: Heathfield is situated near to the centre of Norwich, in a quiet residential location close to Mousehold Heath. The service is operated by Norfolk County Council, providing residential accommodation for a maximum of 37 older people. Registration conditions stipulate that nursing care is not available and that of the 37 places, 5 may be offered to older persons suffering from dementia. Accommodation is on 2 floors in single rooms. The upper floor is served by a shaft lift and staircase. Service users have access to a pleasant, enclosed garden area.A day centre, providing specialist care for people suffering from dementia is attached to the care home. This centre has its own manager and staff, working there each week-day but the premises is overseen by the care homes manager. The Heathfield service users and staff can make use of the centres facilities when the day centre is not operational. Those service users with dementia who are resident at Heathfield have a daily place at the centre where they take part in recreational and therapeutic activities designed to meet their particular needs. Local bus services pass in the vicinity of Heathfield and the railway station lies within walking distance. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took approximately 4.5 hrs to complete. During the inspection records held in respect of staff, service users and health and safety were inspected. Staff and service users were spoken with and the manager was helpful in facilitating the inspection process. Fourteen service user comment cards were returned to the Commission, the result of which were analysed and incorporated in the report. What the service does well: What has improved since the last inspection? A number of improvements have been made since the last inspection. Care plans are being reviewed more frequently. Some improvements have been made to the environment. For instance, a ventilation unit has been fitted to the bathroom as identified at last inspection. A plan of staff supervision has been implemented. The homes medicine management practice has significantly improved. The home has a full time registered manager. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards not assessed on this occasion. EVIDENCE: NA Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 The home has a system in place to ensure that service users needs are assessed and reviewed at regular intervals. However, some improvement is still needed. Whilst the home has shown significant improvement in its medicine management practice, some areas of medication record-keeping, administration and storage practice still pose risks to the health and welfare of service users. EVIDENCE: A random selection of service user care plans were inspected. Each care plan contained detailed information regarding the individual’s health and personal care needs. Most care plans were being reviewed on a monthly basis, however, some had not been reviewed as frequently and the home must ensure that all care plans are reviewed to provide up to date information about peoples needs. See recommendations. The care plans in respect of social care needs contained limited information and should be further developed to provide more detail about people’s interests and preferred activities. The home should use these care plans to form a programme of activities that will interest people living in the home. See Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 10 recommendations. Standard 12 provides more detail in respect of the activities provided at the home. The inspection of the medication standard (Standard 9) was conducted simultaneously by Pharmacist Inspector Mr M Andrews to follow up on widespread concerns identified during the previous inspection of 21/06/05. Overall, the inspector was pleased to find significant improvements in the homes medicine management practice specifically in relation to systems in place and procedures followed for the administration of medicines, for the safe handling of medicines and record-keeping practice. He did, however, find that there were still some inadequate records, which did not clearly set out the prescribed doses of medicines, against which medicines could be safely selected for administration. In addition, there was evidence that some medicines may consequently not be administered in line with most recent prescribed instructions. Whilst the overall storage of most medicines is adequate, concerns were raised in relation to the non-secure storage of prescribed external medicines in areas of the home accessible by service users with dementia. The inspector made good practice recommendations in relation to improving risk assessment records for service users self-administering medicines, the handling of containers of external medicines and additional controlled drug register recording for controlled drug temazepam. The registered manager confirmed that all members of care staff authorised to handle and administer medicines are provided with regular training on medication. A copy of the full pharmacy inspection report has been sent to the registered provider alongside this report and is available subject to request. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 11 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, 15 The home needs to consult with individuals to ensure that they know what peoples social needs and preferences are. Without completing this process, they cannot demonstrate that people’s needs are being met in this respect. The home supports people to maintain a good diet and provides pleasant dining areas in which people can eat their meals if they wish. EVIDENCE: As described in standard 7, the care plans in respect of social care needs do not demonstrate that people are adequately consulted about their preferences in respect of social activities and interests. However, the manager states that people are consulted on a daily basis about what activities they would like to do. Some activities are held on an individual basis and a record of the activities provided is maintained. The home had a care assistant with an interest in activities, but unfortunately, this carer has left. However, there are plans to allocate the responsibility to another care worker in the near future. Unfortunately, the home does not have a main communal lounge in which group activities and events can be held and this restricts people’s choices in Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 12 this respect. All activities are currently provided in the small lounges in each unit or in the reminiscence room created within the home. The day centre attached to the home occupies what once was the main lounge and some entertainment events are held in this area, to which residents are invited. However, residents are not consulted about what entertainment is provided and therefore choice is not being promoted. On the day of inspection, entertainment was taking place in the daycentre and the majority of residents were in attendance. The home does not have a programme of activities and following consultation with the residents one must be developed. See requirements. The service user surveys indicated that 57 of resident felt that suitable activities were provided, however, the remaining 43 felt that sometimessuitable activities were provided. Service users spoken with did not express any concern about the provision of activities. The menus at the home were inspected and service users were consulted about the range and quality of the food provided. The menus show that a good range of choice is offered over the course of a week. There are various options at breakfast time and a choice of two main meal options served with a variety of vegetables. The catering is provided by Norfolk Catering Services (NCS) and the menus are prepared in consultation with service users. Both the chef and the manager regularly talk to residents about the food provided to ensure that people are satisfied in this respect. Service users spoken with said that the food had improved since the return of a chef who had worked at the home previously and overall those spoken with were satisfied with the food provided. Service user surveys showed that 71 of residents liked the food served while 29 stated only sometimes. It is recommended that the home conducts their own survey to establish why a number of residents are not entirely happy with the food. See recommendations. Meals are served in the small dining areas in each residential wing within the home. The areas were nicely decorated and create a pleasant homely environment. Some residents prefer to eat in their rooms and the staff promote choice in this respect. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a mechanism in place for the effective handing of complaints and service users are assured that complaints will be taken seriously. There are systems in place to ensure that people living in the home are protected from abuse. EVIDENCE: The local authority has a clear, well publicised complaints procedure. The home has received one complaint in the last 12 months and records inspected, show that the complaint was dealt with in accordance with the procedures. Service users spoken with and those surveyed all indicated that they knew who to speak to if they were unhappy with any aspect of the service. The home has a policy and procedure for the protection of vulnerable people. All staff are trained in adult protection and have a copy of the whistle-blowing procedure. There has been one adult protection matter that has now concluded, resulting in the dismissal of the member of staff concerned. Following a discussion with the manager it was not clear whether a referral had been made to the protection of vulnerable adults team in order to prevent the person from Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 14 working in other care establishments. However, following the inspection the Commission was notified that the personnel department would be making a referral. It is a concern that the referral has not been made in accordance with the statutory requirements that state, if a person is suspended due to allegations of abuse a referral to the protection of vulnerable adults team must be made for entry on the register. If at a later stage the allegations are not substantiated, the name can be removed from the register. However, in the meantime it will prevent people working with other vulnerable individuals. A delay such as this places other people in need of care at risk of abuse. The manager must confirm who is responsible for making such referrals to prevent this occurring in the future. The manager must also ensure that a referral has been completed. See requirements. Service user surveys indicate that people living in the home feel safe. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The environment is generally safe and well maintained. However, it cannot be said that it is safe for people with dementia care needs. The home has systems in place to ensure it is kept clean and tidy. EVIDENCE: The home is fairly well maintained, however some areas are in need of repair and redecoration. Norfolk property services (NPS) are responsible for the maintenance of the building and carryout annual inspections. The regulation 26 reports provided also highlight issues around maintenance and renewal. There has been an ongoing concern about the safety of those with dementia care needs and a site meeting was held recently with NPS, the Commission and the care standards officer, in order to address the concerns. Following the meeting, it was agreed that doors would be fitted to the top and bottom of the main stairway, which was the greatest risk. However, during the inspection it was evident that people are also exposed to other risks as they are able to Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 16 wander throughout the building into other rooms and communal areas. It is required that all the areas of the home are risk assessed with the needs of those people in mind, and that areas of risk are identified and action taken to minimise or eliminate the risks posed. See requirements. The home was found to be clean and tidy with no obvious concerns in this respect. Cleaners are employed to ensure that good standards of cleanliness are maintained. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The home cannot demonstrate that the staffing levels are adequate to meet peoples needs at all times of the day. The home can demonstrate that staff are appointed through a rigorous procedure that aims to protect people and staff are well trained to meet the needs of people accommodated. EVIDENCE: The Commission is still concerned about the adequacy of staff in the home and the local authority have not taken steps to reassess peoples needs and determine the staffing levels according to those needs. The following paragraphs are once again taken from the previous report and still provide an accurate assessment of this standard. Heathfield is registered to accommodate 37 service users, 5 of who may fall into the category of persons with dementia. It is however possible that, since their admission, other residents living in the home have slipped into this category due to a deterioration in their mental health. The home currently has four service users with dementia care needs who attend the day centre attached to the home during 9.15am and 4pm. The home operates with four care assistants in the morning and four carers Monday, Tuesday, Wednesday evenings, reducing to three carers on Thursday, Friday, Saturday and Sunday. In addition, a carer is employed in the dementia unit 4-7pm Monday to Friday specifically to assist those people with dementia back from the daycentre and to supervise mealtime. During the night there are two waking night care staff on duty. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 18 Given the size of the home, the number of residents accommodated and the additional needs of people with dementia, the adequacy of staffing is questionable, particularly in the evening and at night-time. During the inspection a number of care assistants were spoken with and they all expressed great concern over the lack of staff employed at the home. They talked of being under immense pressure and the workload being too great to manage at times, resulting in delays in responding to peoples needs. They also expressed concern over the care of people with dementia and stated that at times they were at risk due to the lack of staff to supervise them. Staff talked about the times the dementia unit is left unattended and people are found wandering around the building and into other residents rooms. This can be very distressing for all concerned and puts people with dementia at risk of harm. The care assistants work very hard to ensure that peoples needs are met and it is because of this dedication that service users state that they feel well cared for. At the time of inspection there were 33 service users accommodated, 12 of who were assessed as high dependency, 12 as medium dependency and 9 as low dependency. The total number of care hours allocated are 486 plus 111 care co-ordinator hours. The manager, in conjunction with the local authority, must provide the Commission with information that demonstrates that staffing levels at the home are adequate to meet people’s needs. The information must include dependency assessments on each individual along with an account of how the number of care hours are determined according to need, taking into consideration the layout of the home and the risk factors. See requirements. The home has a staff training and development plan that includes induction, foundation and NVQ 2. 46 of staff are already trained to NVQ level 2 or above. The recruitment of new staff is robust and the HR department at County Hall supports the process. Application packs are sent to prospective employees, face-to-face interviews are conducted and records are maintained in this respect. No employee commences work without a criminal records check and two written references. Staff files are kept in accordance with the requirements. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 The home has a mechanism to ensure that it is run in the best interests of it service users. There are systems in place to ensure that people who need support with their finances are protected. There are systems in place to ensure that the health, safety and welfare of service users and staff is promoted and protected. However, it cannot be said that the systems have been fully implemented for people with dementia. EVIDENCE: The home has a policy and procedure for quality assurance. Service users, relatives and staff are surveyed annually and the results are produced in a report, a copy of which was provided during the inspection. The report had been shared with staff at a team meeting, however had not been shared with the other stakeholders. It is recommended that a copy is made Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 20 available to all those involved in the survey so that people know the comments they have made are valued and are used to promote the improvement of the service. See recommendations. Resident and staff meetings are held on a regular basis and minutes were available for inspection. Regulation 26 visits are conducted by the local authority and monthly reports are provided in accordance with the regulations. The safekeeping and handling of service users money was inspected. The money of each individual service user is kept in a wallet and stored in a safe inside the manager’s office. Only authorised persons have access to the safe. All financial transactions are recorded and signed by the service user where possible and two authorised persons. The monies held were cross-checked with the records and found to be accurate for all those inspected. The administrator carries out quarterly checks and the manager conducts her own random checks to ensure that all is in order. In addition, the local authority finance department carries out annual audits. The home has policies and procedures that promote the health and safety of staff and service users. All staff have received training in health and safety that includes manual handling and fire safety and is updated annually. Fire safety records were inspected and showed that regular checks were carried out on fire safety equipment, in accordance with the regulations. The manager and staff have developed a fire contingency plan that provides clear information on the procedures to be followed in the event of a fire, including evacuation. The manager completes risk assessments on the premises and NPS complete annual risk assessments on the building and on fire safety. The hot water temperatures at baths and hand-basins are regulated at source and maintained at 41 degrees. The home has a new procedure for testing the water supply for legionella. The procedure requires manager to complete monthly water tests to ensure that the risk of legionella is minimised. External contractors check all electrical equipment and records of the checks are maintained. Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP12 Regulation 16(2n) Requirement The registered person must ensure that there is a programme of activities that is generated from the residents social care plans. The registered person must ensure that they are aware of the procedures and timescales for referring people to POVA. The registered person must ensure that the member of staff who was dismissed is referred for inclusion on the POVA list without delay. The registered person must ensure that unnecessary risks to the health, safety and welfare of service users are identified and eliminated. This relates to people with dementia care needs The registered person must demonstrate to the commission that staffing levels are adequate to safeguard the health and welfare of service users. This is carried forward for the third time. The registered person must take steps to ensure that medicines DS0000035281.V261546.R01.S.doc Timescale for action 31/03/06 2 OP18 13(6) 31/01/06 3 OP18 13(6) 31/12/05 4. OP25 13(4) 14/01/06 6. OP27 18(1a) 31/01/06 7 OP9 13.2 13.4 13/01/06 Heathfield Version 5.0 Page 23 8 OP9 13.2 13.4 17.2 prescribed for external application are stored safely The registered person must take steps to ensure that full records of each prescribed medicine and its dose directions are maintained, against which respective medicines can be safely administered. Medicines must be administered I line with the most recent prescribing instructions at all times. This requirement remains partly unresolved since the last inspection. 30/12/05 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 OP7 Good Practice Recommendations It is recommended that care plans in respect of social care needs are further developed to provide more information about what activities and interests people would like to fulfil. It is recommended that the system for reviewing care plans is improved. It is recommended that the home consults with service users about the range and quality of food offered to ascertain why some service users are not entirely satisfied. It is recommended that the results of the quality monitoring are made available to all stakeholders involved in the surveys. 2 3 OP7 OP15 4 OP33 Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Heathfield DS0000035281.V261546.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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