Inspection on 17/09/07 for Knightsbridge Lodge

This inspection was carried out on 17th September 2007.

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

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

Other inspections for this house

Knightsbridge Lodge 18/08/09

Knightsbridge Lodge 08/11/06

Knightsbridge Lodge 21/02/06

Knightsbridge Lodge 17/02/05

Knightsbridge Lodge 18/08/04

Knightsbridge Lodge 27/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Knightsbridge Lodge Knightsbridge Green Cheltenham Glos GL51 9TA Lead Inspector Mrs Eleanor Fox Key Unannounced Inspection 17th September 2007 09:20 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 Knightsbridge Lodge DS0000016488.V343756.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. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knightsbridge Lodge Address Knightsbridge Green Cheltenham Glos GL51 9TA 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) 01242 680168 Mrs Ann Dorothy Easdown Mr David Easdown Mrs Carol Ann Coates Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2006 Brief Description of the Service: Knightsbridge Lodge is situated adjacent to the main Tewkesbury Road near the hamlet of Knightsbridge. The home is conveniently positioned about six miles between Gloucester and Cheltenham. The house was originally a Victorian Toll House and has been sympathetically extended to provide accommodation for 22 older people. Bedrooms are positioned on the ground and first floor; a shaft lift provides access to the first floor. All bedrooms have wash hand basins and three rooms have en-suite facilities. All the rooms are single occupancy. Well-equipped bathrooms are provided on each floor with a shower room on the ground floor. Toilets are provided within close proximity of all bedrooms and communal areas. On the ground floor there are two lounges and one dining room; the dining room has just been extended and redecorated. The attractive gardens are well maintained and fully accessible to all residents. The provider supplies information about the home, including the most recent CSCI report to anyone who has expressed an interest. The details are maintained in a file, which is displayed in the front hall of the home. Current fees range from £375.90 to £465. Hairdressing, chiropody and any personal purchases are charged extra; the individual prices are available on request. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the home and takes into account the views and experiences of people using the service. One inspector undertook this unannounced inspection of Knightsbridge Lodge over the course of one day in September 2007. The inspector checked the home’s compliance with any outstanding requirements made by the Commission for Social Care Inspection. On this occasion, she chose the care of three of the residents for particular scrutiny. The inspector spoke to each of these people, visited their bedrooms, read all their relevant care records, and, where possible, observed their interaction with members of staff. The inspector also looked at the medication administration processes, particularly with reference to those people who had been selected for case tracking. She observed the medication storage arrangements and the protocols in place for self-medication. She examined the processes for training staff in the administration of drugs. The inspector walked around the property, and observed the service of the mid day meal during the course of the visit. She also observed the residents’ participation in a variety of activities, meeting the activities coordinator and discussing her role at the home. She checked that residents were able to exercise choice and to maintain social contacts. The inspector also looked at the processes in place to protect the residents from any risks. Arrangements for and records relating to the maintenance of equipment were examined. The inspector read selected personnel and recruitment records and looked at the opportunities provided for training. Finally, she spoke to the manager, and to the administrator, particularly in relation to general management issues and other responsibilities of their roles. The inspector extends her thanks to all the staff that provided assistance during the inspection processes. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 6 Prior to the inspection, CSCI surveys were distributed to residents and relatives of those living at Knightsbridge Lodge. Nine were returned from residents; seven responses were sent in from relatives and advocates and two from health professionals who had experience of the home. Many of their opinions are reflected in the content of this report. What the service does well: What has improved since the last inspection? The dining room has been extended and redecorated in recent months. Replacement carpets have also been provided in many areas of the home. The registered provider now inspects the quality of the service provided by Knightsbridge Lodge on a regular basis and supplies a report to the Commission for Social Care Inspection. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 7 Urgent maintenance was undertaken of the hot water systems to ensure that hot water temperatures do not exceed safe levels. Records show that the issue has now been fully resolved. 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. The summary of this inspection report can be made available in other formats on request. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents may be assured that their needs will be met as there is an effective assessment process in place at this home. EVIDENCE: Records seen in the residents’ care files showed that thorough assessments are undertaken of each person’s particular care requirements to ensure that the home is able to meet his or her needs. These processes are undertaken prior to the resident’s admission, usually in hospital but sometimes in the person’s own home. In some cases, further details had been provided by other health and social care professionals previously involved in the care of these elderly people. Intermediate care is not provided at this home. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 10 Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at this home may be assured that all their care needs will be met appropriately and in a manner that respects their privacy and dignity. EVIDENCE: Clearly written care plans are developed for each resident; those relating to the three people chosen as part of a case tracking exercise were read in detail on this visit. In each case a full assessment, known as the resident profile, had been undertaken followed by the preparation of specific care plans. These provided the information required to guide the members of staff who were providing personal care. Each had been reviewed appropriately and appeared to reflect the resident’s current condition. Some had been signed by the resident to indicate their awareness and agreement with the information. However, it was identified that some of the guidance, although very pertinent, was crammed into a small space. It is strongly recommended that care plans Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 12 relating to specific care needs should be written on separate pages to aid clarity and to provide adequate space for undertaking reviews appropriately. In addition, detailed risk assessments are documented as appropriate; these are reviewed as necessary. There were records to indicate that care from other healthcare professionals is sourced when required. There was evidence to show that people living in the home had received chiropody, dental care, physiotherapy and attention from the district nursing team and the continence care nurse, as required. The medication administration systems relating to the three selected residents were checked on this occasion. Medication storage was also assessed. On this occasion all handwritten records on the medication administration sheets had been signed by the person making the record and then countersigned by another person. All were written clearly and fully legible. Medication policies are readily available and a recent copy of a medication reference book is provided for staff information. Care plans are prepared to guide staff when medication prescribed as, ‘as required’ is to be administered. One of the selected residents chose to take responsibility for her own medication. Robust risk assessment procedures are in place to support her in these processes. A lockable cabinet is provided in her bedroom to use as storage and staff monitor the ‘as required’ medication usage. However, these are not yet documented on the home’s medication administration sheets although these processes are now being introduced. There were records to show that staff receive appropriate training in medication administration prior to undertaking these processes. Residents’ privacy and dignity appeared to be fully respected by staff during the inspection. Carers spoke in a friendly but courteous manner and ensured that doors were firmly closed when attending to residents. Residents confirmed in the surveys that they are treated well by staff with one person writing, “All the staff are most kind and considerate”. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are given the opportunity to take part in a good variety of social activities, if they wish, and to eat a nutritional and balanced diet. EVIDENCE: During conversation with the residents it was very evident that the majority of people living in this home have a real sense ‘of belonging’ and a pride in their surroundings. They were anxious that the inspector did not miss any of the recent improvements and spoke enthusiastically about a variety of special events, which had taken place throughout the year. An innovative plan of activities has been developed, including trips out and the provision of entertainers. Some of the residents were clearly enjoying a quiet chat; one person was knitting. Four ladies commented on how much they enjoyed the quizzes, which are arranged. A member of staff was observed undertaking a one to one activity with one of the residents; however, consideration should be given to developing further specialist activities for those people with short-term memory loss. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 14 The residents who did not wish to be involved in group activities pursued their own particular interests in their bedrooms or in one of the alternative communal rooms. Families and friends are welcomed into the home and efforts are made to ensure that visitors are fully aware of any planned events or specific news. One relative wrote, “They make visitors feel very welcome”, and another, “They always let me know what is happening at Knightsbridge.” Residents go out with friends and family when possible. Residents, who spoke to the inspector, confirmed that they were able to get up and retire when they wished and that they were free to eat their meals and spend their days where they preferred. The service of the main mid day meal was observed during the visit. The majority of the residents ate their meals in the recently enlarged dining room; a few chose to remain in their bedrooms. A good variety of food was offered and most people appeared to enjoy what they were eating. A few required some degree of assistance or gentle encouragement. Staff were observed being attentive and supportive, giving residents time to consume their meal at their own pace. They also gave good support to those with poor eyesight, ensuring that they knew where and what they were eating. Although one person commented on “the chewy vegetables”, in the main, all those who responded to the surveys or spoke to the inspector were extremely positive in their comments. One person said, “The meals are excellent” and another said, “The cook is marvellous”, and another,” You can’t better this food.” The kitchen was clean, tidy and well organised. The meal of the day was advertised on the notice board; however, it is recommended that notices advertising menus should be written in large print for the benefit of residents with poor eyesight. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home may be assured that any concerns or complaints they identify will be investigated and addressed appropriately. There are also systems in place to ensure that their rights are protected. EVIDENCE: A clearly explained Complaints Procedure has been prepared for Knightsbridge Lodge. A copy of the document is provided to each prospective resident and/or relatives with other information about the home. The details are also displayed within the home. There have been no formal complaints about Knightsbridge Lodge since the last inspection. During conversation, one resident said, “If anyone is worried about anything, we tell the staff; it’s soon sorted out.” Another person said, “I know whom to approach but I have never had anything to complain about.” The home has developed policies and procedures to address all forms of abuse. The guidance is readily available for staff to read. Abuse issues are covered in the Induction Programme, which each newly appointed member of staff undertakes. There has also been additional formal training on the subject. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 16 POVA (Protection of Vulnerable Adults) legislation is correctly followed at Knightsbridge Lodge. All new applicants are screened prior to working at the home. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a most comfortable and well-maintained environment, which has benefited from recent maintenance and decorative work. EVIDENCE: During a walk around the building it was observed that the whole home was decorated and maintained to a very good standard. New carpeting has been provided throughout all the ground floor corridors, in one of the lounges and on the front staircase. The colourful gardens were looking particularly attractive on this occasion. Residents mentioned that they enjoyed sitting out in the shaded areas during the good weather; some had been involved in doing some gardening chores earlier in the year. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 18 The dining room has recently been extended and redecorated; a new carpet has also been laid in this room. Sturdy comfortable furniture has been provided throughout the property to suit the needs of the residents living at the home. The lounges are bright, welcoming and equipped with books, games and televisions for the residents’ entertainment. The whole property appeared very clean and fresh; there was only slight evidence of a mildly offensive odour in one area. Although not specifically identified to any of the staff, a further visit to this part of the home later the same day showed that the issue had been appropriately addressed. It was a warm day but windows had been opened to ensure that the home was maintained at a comfortable temperature. The laundry is well equipped; it was tidy and organised with washing segregated appropriately. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in this home receive care from a competent well-recruited workforce. EVIDENCE: On the day of the inspection there were twenty-one residents living in the home. The manager and two carers were on duty to look after the residents. The administrator, the maintenance man, a cleaner, the cook, and the gardener were also working that day. Two carers were due to be on duty in the evening with two carers, one awake and one sleeping in the building, scheduled overnight. Discussions with residents and staff suggested that these numbers were quite adequate to care for the needs of the residents at the current time. Records show that 50 of the care staff are trained to National Vocational Qualification, Level 2 or Level 3 in Care. The registered Manager is trained to Level 4. Four new members of staff have been recruited to the home since the last inspection. Personnel files relating to these people were read on this occasion. In each case, the prospective employee had completed an application form Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 20 providing an employment history. Limited records had been maintained of the interview processes and POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening had been completed. Two written references were provided for each applicant. It is recommended that more comprehensive records should be maintained of the interview discussions in case of queries at a later stage. Records are provided to show that new employees undertake full induction when they commence duties. Training needs are well managed at this home. Clear records are maintained, showing dates of attendance and identifying any staff who may require ‘update tuition’ in food handling, first aid, manual handling and fire training. Other specialist subjects are covered, as required. Certification of attendance was seen in the personnel files. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents may be reassured that there are robust management systems in place at this home, which ensure that these vulnerable people are fully protected. EVIDENCE: The Manager is well experienced in the care of older people. She attends regular courses to keep herself updated in care issues and has also undertaken management training to assist her in her role. Survey results show that she is well respected by the residents, their families and staff working in the home. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 22 There are a number of quality improvement measures undertaken at Knightsbridge Lodge. A residents satisfaction survey was circulated earlier in the year; the results of this survey have now been collated and any identified issues have been addressed. Residents meetings are arranged twice a year; the minutes of the most recent one were displayed on the notice board. This had been well attended with a number of issues, such as food, activities and staffing covered. Those present were also given the opportunity to raise any other matters they wished to discuss. Medication processes, care planning, housekeeping, and any accidents, are all closely monitored. The home has been awarded three stars by the Environmental Health Department following an assessment of food hygiene and safety procedures, an assessment of the structure of the establishment and confidence in management, and an assessment of the control systems in place. The home takes responsibility for the personal monies for a few of the residents; the records relating to the residents selected for case tracking were checked on this occasion. It was observed that meticulous records are maintained and that individual secure storage is provided. These processes are maintained correctly. Residents’ status in relation to ‘Power of Attorney’ is also maintained on file. Since the last inspection, the services of an external company have been engaged to provide advice and support on Health and Safety matters. The Fire Risk Assessment is now being reviewed, as is fire training to ensure that the home complies with current legislation. Records were provided to show that maintenance and inspection of equipment is undertaken, as directed by the manufacturer. Water temperatures are checked at outlets on a monthly basis; in recent months these have remained within safe levels. Certification was provided to show that water storage areas were free of Legionella. An Environmental Health inspection took place recently; there were no issues highlighted for attention. Any accidents or incidents are recorded appropriately. Security issues are managed well in this home. Knightsbridge Lodge DS0000016488.V343756.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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 4 x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Knightsbridge Lodge DS0000016488.V343756.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 OP9 Regulation 13(2) Requirement A record must be maintained when residents who are selfmedicating take ‘as required’ medication. Timescale for action 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 4 Refer to Standard OP7 OP12 OP15 OP29 Good Practice Recommendations Care plans relating to specific care needs should be written on separate pages to aid clarity and to provide adequate space for undertaking reviews appropriately. Consideration should be given to developing further specialist activities for those people with short-term memory loss. It is recommended that notices advertising the meal of the day should be written in large print for the benefit of residents with poor eyesight. It is recommended that comprehensive records should be maintained of the interview discussions in case of queries at a later stage. Knightsbridge Lodge DS0000016488.V343756.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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