Inspection on 01/08/06 for Hillersdon Court

This inspection was carried out on 1st August 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hillersdon Court 12/06/07

Hillersdon Court 01/11/05

Hillersdon Court 11/07/05

Hillersdon Court 16/11/04

Hillersdon Court 17/06/04

Hillersdon Court 23/09/03

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hillersdon Court 18 College Road Seaford East Sussex BN25 1JD Lead Inspector Nigel Thompson Unannounced Inspection 1st August 2006 10:00 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 Hillersdon Court DS0000021137.V296238.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. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hillersdon Court Address 18 College Road Seaford East Sussex BN25 1JD 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) 01323 897706 Mr James Lord Mrs Sylvia Lord Mrs Kathleen Waller Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That service users must be aged sixty-five (65) years or over on admission. That a maximum of twenty (20) service users are accommodated. Date of last inspection 1st November 2005 Brief Description of the Service: Hillersdon Court is registered to provide residential care and support for up to twenty older people. The premises comprise of a large detached house, which has been extended over the years. The home is situated close to the shops and railway station in Seaford town centre and within walking distance of the seafront. Service user accommodation comprises of seventeen single rooms and one double room, eleven of which have en suite facilities. All rooms are fitted with a call bell system. The proprietors of Hillersdon Court also own Bybuckle Court, another care home for older people situated in the Seaford area. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The range of weekly fees, as of 1 August 2006, is £322 - £400. Additional charges, not included in the fees, include hairdressing, chiropody, newspapers and holidays. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five and a half hours in August 2006. It found that the majority of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were seventeen service users living at the home. The inspection involved a tour of the premises, examination of the home’s records and discussion with the Deputy Manager. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. Five service users, three members of care staff and two visitors were also spoken with. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: The relaxed, homely and welcoming environment has evolved over several years and reflects the stability and commitment within the staff team and the open and inclusive management style. Communication within the home and consultation with service users’ family members is effective and ongoing. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 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 Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Documentation, including a ‘Statement of Purpose’ and ‘Service Users’ Guide’ ensures that prospective service users and their relatives have sufficient information about the home and the services provided. The home’s admission criteria and procedures ensure that service users are admitted only on the basis of a thorough needs assessment, undertaken by people competent to do so. EVIDENCE: Although there is a ’Statement of Purpose’ and ‘Service User Guide‘(Statement of Intent) in place and made available to prospective service users, it is evident that neither document has been reviewed or updated, since December 2004, containing as they do references to the NCSC (National Care Standards Commission). As discussed with the deputy manager, it is required that they be reviewed and amended, in accordance with Schedule 1. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 9 It was noted in files that were examined that the ‘Contract of Residence’, relating to new service users, was fully completed and had been signed by both the individual service user (or their representative) and the manager, on behalf of Hillersdon Court. Since the previous inspection, the pre-admission assessment format has been reviewed and improved, as recommended. In service users’ files that were examined, relating to people recently admitted to the home, there was documentary evidence of their individual care and support needs having been adequately assessed, prior to them moving in. The deputy manager confirmed that intermediate care is not currently provided at Hillersdon Lodge and emergency or unplanned admissions are avoided. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Service users’ care plans enable staff to meet their assessed needs in a structured and consistent manner. However individual plans, including risk assessments do not always reflect changing support needs. Service users are protected by adequate staff training and procedures for the control and safe administration of medication. EVIDENCE: Individual care plans that were examined show areas of significant improvement since the last inspection, particularly in the level of detail regarding action to be taken by staff. Consequently identified care and support needs are now being met in a more structured and consistent manner. However, it was noted that care plans and individual risk assessments are not being routinely updated, to reflect changing needs and there is still little evidence of service users or their relatives being involved – or having the Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 11 opportunity to be involved, as required, in developing or reviewing individual care plans. A relative, spoken with during the inspection, confirmed this situation: ‘I couldn’t be happier about how the staff treat her and the care she receives but I haven’t seen any care plan and it’s not been discussed with me’. All service users are registered with local GPs and have access to other health care professionals, including district nurses, via the surgeries. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Nutritional screening is carried out as part of the initial assessment procedure. The deputy manager confirmed that there is currently no incidence of pressure sores in the home. Regular ‘gentle exercise’ classes, provided as part of the home’s activities programme, continue to be popular among service users. As part of their induction programme, the deputy manager confirmed that all staff receive instruction on the principles of dignity and respect. This was evident, through discussion during the inspection, and from direct observation of staff interacting sensitively and professionally with service users. Documentation relating to the handling and control of medication was found to be accurate and generally well maintained. During the inspection, staff were observed administering medicines appropriately. However the recording of a controlled drug, used in the home, was found to be unsatisfactory as there was no appropriate register in place. One service user continues to maintain responsibility for the storage and handling of her medication and has signed a ‘self medication disclosure’ Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Service users maintain contact with family and friends as they wish and benefit from regular activities and from good quality menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: Visiting is unrestricted at Hillersdon Court, although service users’ friends and relatives are politely requested to avoid mealtimes. Service uses are able to choose whom they see and when and are able to entertain their visitors in their own room or in the lounge. Relatives, spoken with during the inspection, were able to confirm this: A relative, spoken to during the inspection, was able to support this: ‘Whatever time I come here, I’m always made very welcome. Everyone is so kind and helpful ’. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 13 The Deputy Manager confirmed that a garden party is to be held later in the month and invitations have been sent out to service users’ relatives. Activities are provided in the home for service users on a regular basis, including quizzes, skittles, handicrafts and the popular ‘gentle exercise’ session that is held in the main lounge each morning. In the wider community, service users attend local churches and make use of nearby shops and restaurants. Afternoon drives out in a mini bus are also organised. Service users, spoken with during the inspection, commented favourably and enthusiastically about the daily exercise class: ‘It feels much better when we’ve finished!’ Varied, balanced and nutritious meals are provided, reflecting service users’ choice and preferences. The newly appointed cook confirmed that service users are consulted and directly involved in compiling the four-week rolling menu. The standard of meals provided at the home remains high and service users spoken to during the inspection expressed overall satisfaction with the food they receive: ‘The food here is always good and there is always plenty of it’. ‘We all eat well here – the food is excellent’. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The open and inclusive atmosphere within the home enables service users, staff and visitors to feel able to express any concerns, confident that they will be listened to and acted upon. However, service users are at potential risk from abuse, through inadequate staff training and unsatisfactory and outdated policies and procedures. EVIDENCE: Hillersdon Court retains a very comfortable, homely and inclusive atmosphere, where open conversation is encouraged. A clear, simple, up to date and accessible complaints procedure is displayed in the entrance hall. A copy of the procedure is also contained in the service user guide. Service users, members of staff and relatives spoken with during the inspection confirmed that they would have no hesitation speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to: ‘If we had any concerns – which we don’t have – I would certainly speak to the manager and I know that she would listen and something would be done’. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 15 It was noted that there have been no complaints received by the home since the previous inspection. The home has policies and procedures on adult protection based on the East Sussex, Brighton & Hove multi agency guidelines for the Protection of Vulnerable Adults. However there was evidence that these documents had not been reviewed or recently updated and both contained references to the NCSC (National Care Standards Commission). The home also has a detailed ‘Whistle Blowing’ procedure that, the deputy manger confirmed, staff are made aware of through induction training. However this was not supported by staff, spoken with during the inspection, who were not able to demonstrate sufficient awareness or understanding of abuse policies or of their role and responsibilities in respect of adult protection procedures. There was also no documentary evidence made available during the inspection that staff receive appropriate training or guidance, relating to abuse and adult protection. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23, 24 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from accommodation that is safe, comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: There has been little change in the physical environment at Hillersdon Court since the previous inspection and overall standards remain satisfactory throughout. The well maintained décor and generally good quality furniture and furnishings provide a comfortable and pleasant environment for service users. Many of the rooms have been personalised, with pictures, family photographs and other small items of furniture and personal belongings, to reflect individual taste, choice and preference. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 17 Service users, spoken with during the inspection, expressed satisfaction with the home and their individual rooms: ‘I’m very happy with my room, it’s so comfortable here’. ‘I couldn’t fault it here. It’s clean and comfortable and has everything that I need’. There are sufficient baths and toilets throughout the home, with an assisted bathroom situated on each floor. Two new bath hoist shave been provided since the last inspection. Eleven of the service user’s rooms are fitted with ensuite toilet and washbasin facilities. The light and spacious lounge continues to provide a comfortable focus for many of the daily recreational and leisure activities in the home and clearly meets the individual and collective needs of the service users. Since the last inspection, several new comfortable chairs have been provided. A pleasant dining area provides a relaxed, homely and sociable setting for meal times. Levels of cleanliness remain high throughout. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. Unsatisfactory recruitment policies, procedures and documentation and inadequate staff training compromise the safety and protection of service users. EVIDENCE: During the inspection, concerns were raised in relation to the recruitment procedures within the home and the provision and recording of appropriate staff training. Since the previous inspection, three new members of staff have been appointed. However it was evident, through examination of the respective individual files, that thorough and robust procedures had not been adhered to. There were no details regarding employment history and, despite appropriate references having been identified in individual application forms, there was no documentary evidence that these references had been requested or obtained. It was also noted that there was no evidence that either Criminal Record Bureau (CRB) or Protection of Vulnerable Adults (POVA) disclosures had been applied for or received. However the manager subsequently provided evidence that satisfactory POVA checks had been completed. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 19 Assurances were also given by the manager that, in these cases, the individual members of staff would only work under supervision until satisfactory CRB disclosures were received. Unsatisfactory procedures were also noted relating to the provision of staff training within the home. A training matrix, developed and implemented following a previous inspection, highlighted major shortfalls. The many gaps on the matrix indicated that the majority of staff had not undertaken any mandatory training, including fire safety, first aid, abuse or appropriate refresher training this year. This was supported by members of staff, spoken with during the inspection: ‘We haven’t done any training recently – or if we have I don’t remember’. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Service users benefit from stable and effective management and are protected by improved quality assurance systems, however, they are at potential risk from some unsatisfactory health and safety practices. EVIDENCE: The registered manager is competent and experienced and has been in her current post since 1993. She has completed the City and Guild Advanced Management for Care and undertakes periodic relevant training, including refresher training to update her knowledge and skills. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 21 The deputy manger confirmed that all care staff continue to receive formal supervision on a six weekly basis. As previously documented, the manager also operates an ‘open door’ policy, with staff able to discuss any issues at anytime. Staff spoken with confirmed the support they receive and acknowledged the personal benefit of effective supervision. ‘Both the manager and deputy manager are so helpful and supportive’. Quality assurance systems within the home have improved. Since the previous inspection, as required, the registered provider now carries out monthly monitoring visits to the home, in accordance with Regulation 26 of the Care home Regulations 2001. As well as inspecting the premises and consulting with staff and service users, the provider compiles a report, a copy of which is forwarded to the CSCI. In addition, service user and relatives’ satisfaction questionnaires are distributed on a regular basis. Positive responses to the most recent survey indicate a high degree of satisfaction with the home and the services provided: ‘The management and staff cope admirably well under every circumstance. My health has improved with the calm, happy environment’. ‘This is a lovely home. The staff are friendly and caring’. Effective systems for communication and consultation include regular staff and service user meetings. Unfortunately there were no minutes available for the most recent service user meeting, held on 7 July. The deputy manager confirmed that the majority of service users maintain responsibility for their own finances. However money for five service users is lodged with the manager. It was evident that the monies are held securely and all financial transactions are recorded. Documentary evidence was made available of fire safety systems, including emergency lighting, having been checked regularly and of a recent fire drill having been carried out. The current procedures for the storage and safe handling of cleaning materials is to be reviewed, after bottles of bleach were found in an unlocked room, easily accessible to service users. General infection control policies and procedures were also found to be inadequate and, following discussion with the deputy manager, they are to be reviewed and updated in accordance with COSHH guidelines. Temperature regulators are fitted to all hot water outlets, accessible to service users. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 22 All accidents, incidents and injuries are recorded and reported, as required. Hillersdon Court DS0000021137.V296238.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 2 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 X X X 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (2) Requirement It is required that that the service users’ care plans, including risk assessments, be kept under review and updated to reflect changing needs. It is required that robust and up to date policies and procedures for the safe keeping, recording, and safe administration of medicines be implemented and adhered to. It is required that service users be protected by updated and robust policies and procedures and appropriate staff training, relating to abuse and adult protection. It is required that a minimum ratio of 50 of care staff obtain NVQ level 2 in Care. It is required that the home’s current recruitment procedures be reviewed, including the obtaining of references, ensuring the protection of service users. Timescale for action 30/09/06 2. OP9 13 (2) 30/09/06 3. OP18 13 (6) 30/09/06 4. 5. OP28 OP29 19 (5) (b) 7, 9 & 19 Schedule 2 31/12/06 30/09/06 Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP1 OP27 Good Practice Recommendations It is recommended that both the Statement of Purpose and the Service User Guide be reviewed and updated. It is recommended that staffing levels be kept under review to reflect the changing care and support needs of service users. Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Hillersdon Court DS0000021137.V296238.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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