CARE HOMES FOR OLDER PEOPLE
Langley House Langley House Sunderland Road Horden Peterlee Durham SR8 4NL Lead Inspector
Lesley Ann Moore Unannounced Inspection 11th January 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Langley House DS0000007485.V329799.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. Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Langley House Address Langley House Sunderland Road Horden Peterlee Durham SR8 4NL 0191 5861342 0191 5864483 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) Durham Aged Mineworkers Association Mrs Joy Sheila Atkinson Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability (3) of places Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10th November 2005 Brief Description of the Service: Langley House is owned and run by Durham Aged Mineworkers Association and provides personal care and accommodation for 29 older persons. The home may also accommodate 3 people with physical disabilities within this number. The home is located in the centre of the small town of Horden, close to the local shops and amenities and within easy travelling distance of surrounding towns and villages. It was first registered as a care home in 1989 and consists of a single storey building which was purpose built to meet the needs of older people with physical disabilities. The accommodation consists of 26 bedrooms all of which have en-suite toilets, three of the bedrooms were built for shared use but are currently used as single rooms. Adequate bathing and toilet facilities are provided. There are two spacious lounges (one of which is a smoking area) and additionally a further small quiet sitting room where service users’ can relax with their visitors if they prefer more privacy. The spacious dining room has a pleasant outlook over the garden and patio area to which access is readily available through the french windows. There is a committed team of care and support staff. The current weekly fees charged are between £364.50 - £416 with additional charges for hairdressing, newspapers, chiropody and dry cleaning. Langley House DS0000007485.V329799.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 on 11 January and lasted for approximately 6.5 hours. The Registered Manager supplied some information on the pre-inspection questionnaire. 5 service user surveys and 7 relatives/visitors comment cards were completed and returned. The inspection focussed on key standard outcomes for service users and to check whether the requirements and recommendations made at the previous inspection had been implemented; in particular, to confirm that the care plans contain sufficient detail on how an individual service user’s assessed needs are to be met; that the care plans identify risks to service users and how these are to be safely managed; that all entries in a service user’s care plan are clearly signed and dated; that the monthly review of the care plan clearly sets out any changes in health and personal care needs; that the admission process has improved by using a more structured and formal system upon which to record all information; that the recruitment procedure allows for a full employment history to be taken from prospective employees with an explanation of any gaps in employment before appointment is made; to meet with the service users’ and their relatives and to talk to them about their experiences of living in the home; to meet with the staff and to look at the home’s records. On entering the home there was a relaxed and homely atmosphere. Service users appeared happy, well cared for, were carrying out their normal daily activities and interacting well with the staff. It was noted that the requirements and recommendations made at the previous inspection visit had largely been implemented. What the service does well:
The home has a committed team of staff who promote service user choice and support service users to achieve their optimum independence within a safe environment. Service users and their relatives commented ‘My mother is very happy in the home and receives all the care and attention’, ‘The home is very clean, the food is very good and staff are kind’ and ‘We are very happy with the help and care my mother and myself receive’. A notice board prominently displayed in the entrance area provides information of staff on duty, activities organised and the menu for the day. There is a strong commitment to staff training and development that is supported by a comprehensive training programme. 100 of care staff hold the National Vocational Qualification (NVQ) level 2 in care with others going on to complete NVQ qualifications at levels 3 and 4. Catering and housekeeping staff are also supported to achieve NVQ’s in their relevant areas.
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 6 The general environment within the home is clean, well maintained, and individual rooms are pleasantly decorated and personalised with the service user’s own possessions. The flooring in the kitchen and larder area has recently been replaced improving the overall appearance of the kitchen. What has improved since the last inspection? What they could do better:
Individual service user contracts are stored in the home. However, the contracts do not clearly set out the terms and conditions for the provision of accommodation and personal care and who is responsible for meeting the fees. The service must ensure that each service user is issued with a contract that includes this information. The home has in place formal documents upon which a full assessment of the service user is recorded on admission. However, examination of the file of one service user who was recently admitted showed that a full assessment of health and social care needs had not been documented onto the record used for this purpose. The Manager should ensure that the care staff are carrying out a full assessment of needs on admission and that this is documented in the correct place in the service user’s file. On inspection of the premises a number of items were noted as requiring attention; in particular, damage to the surface enamel of a bath, the front of a radiator guard that has been removed by a service user, a damaged window lock, an absence of lids to 2 external waste receptacles, water temperatures recorded as being above acceptable limits, security of areas to which service users should not have access and the storage of equipment and unwanted furniture. Comments received from relatives and service users suggest that the home could review its staffing levels particularly at busy periods, i.e. ‘At times the home is so short staffed that it takes a while to attend to the needs of the residents’, ‘Once again staff shortages cause minor problems’, and ‘Staff are a bit slow in coming to me’. The Manager should satisfy herself that staffing levels are adequate to meet the needs of the service at all times.
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 7 The procedures relating to the holding of service user monies could be reviewed to ensure that safeguards are in place to protect both the service user and staff. It was noted that the revised Service User Guide refers to the Commission as the National Care Standards Commission. The Manager has agreed to amend this. 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. Langley House DS0000007485.V329799.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 Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives receive appropriate information about the home including a visit where possible prior to admission to the home. The home does not provide intermediate care and therefore assessment of Standard 6 is not required. EVIDENCE: The home provides adequate information within the Statement of Purpose and Service User Guide to prospective service users and they are able to visit the home in advance of placement where possible. A member of staff will also visit the service user in their own home or in hospital to assess their individual needs in addition to a care manager assessment if local authority funded. One relative commented ‘We visited the home first to have a look around and then
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 10 had Mam stay there for a period of respite before coming to our final decision’. During the inspection a family was being shown around with the prospective service user. The home’s newly revised Service User Guide was noted as referring to the Commission as the National Care Standards Commission. The Manager agreed to make the necessary amendments. The Manager was able to provide copies of the contracts given to service users setting out individual funding arrangements. However, it was noted that the contracts did not provide detail of the individual contributions to be made on the part of the service user and/or the Local Authority. Each service user should be provided with a contract that clearly sets out the terms and conditions for the provision of accommodation and personal care, and who has responsibility for meeting these fees. The home’s admission policies and procedures are in place and generally seen to be satisfactory. However examination of one service user’s file who had recently come to live at the home was unable to provide evidence that a full assessment of need had been carried out on admission. The Manager should review the admission procedures with the care staff and stress the importance of documenting the initial assessment upon which future care can be planned. Langley House DS0000007485.V329799.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. The service strongly believes that it is essential to involve service users in the planning of care that affects their quality of life. EVIDENCE: Each service user has a care plan, agreed with them where possible, which is easy to understand and considers the health, personal and social care needs of that individual. The care plan is reviewed regularly and the necessary action taken to respond to any changes in consultation with the service user. A monthly summary is included which gives a brief statement of the service user’s health and personal care needs including any changes, and any activities that they may have enjoyed during the period. Service users have choice over their personal care and are encouraged to be independent where this allows. 4 service users comment on the pre-inspection
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 12 questionnaire that they ‘usually receive the care and support they need’ whilst 1 comments that ‘he always receives the care and support that he needs.’ The home has a medication policy in place in which medicines are generally received, administered and disposed of safely. There are currently no service users who self-medicate. The aims and objectives of the home reinforce the importance of treating service users with respect and dignity in all aspects of their life. Langley House DS0000007485.V329799.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. Social, cultural and recreational activities meet service users’ expectations. Service users’ receive a balanced, wholesome diet according to their individual assessed needs and choice. EVIDENCE: Service users are helped in making choices about their daily activities and are given the opportunity to engage in social activity where possible. During the inspection the home’s Activities Co-ordinator was encouraging service users to engage in a game of indoor bowls. Other recreational activities available include playing bingo, movement to music and sing along sessions, learning how to use a computer, and outings to local clubs, pubs, library, churches and the theatre. A small room within the home has been equipped as a hairdressing salon and a local hairdresser visits on a weekly basis. Information relating to daily recreational activities is prominently displayed in the home. Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 14 Relatives are actively encouraged to visit the home and are kept up to date with service users’ progress. A small quiet lounge is available should relatives prefer a more private area to visit the service user. Meal times are considered a social occasion, however service users also have the option to have their meals in the privacy of their own room. Langley House DS0000007485.V329799.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. Service users have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. EVIDENCE: There is a clear and accessible complaints procedure within the home available to service users and their relatives to enable anyone associated with the service to make a complaint or make suggestions for improvement. Any complaint received by the home is fully investigated and an accurate record documented of the nature of the complaint and action taken. 4 out of the 5 service users completing CSCI questionnaires confirm that they always know how to make a complaint, with the remaining service user saying that they usually know how to make a complaint. All of the 7 relatives completing the CSCI comment cards recorded that they had never had reason to complain. Of the 5 complaints that the home has received over the past 12 months, the Inspector was able to look at the documented records and see that the home’s policies and procedures are being correctly followed. The policies and procedures regarding protection of service users are of a high standard and are reviewed and updated on a regular basis. Staff receive training on the protection of vulnerable adults. The service is clear when incidents require external input and which agency to refer the incident to.
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 16 The staff recruitment policy and procedure is adequate showing evidence of the appropriate checks being made prior to staff being employed. Langley House DS0000007485.V329799.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, 21, 22, 23 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and homely environment. EVIDENCE: The home appears to be a well-maintained environment with the provision of pleasant communal rooms including a large dining room and quiet areas for relaxation. A separate lounge is available for those service users who wish to smoke. Service users’ bedrooms are individualised giving the opportunity for personal possessions and a limited number of their own furnishings to be brought in. The kitchen and larder floor has recently been replaced. There is a selection of general aids such as hoists that are available for use by service users once their needs have been assessed. There is evidence to show that care staff are trained in the safe use of aids and equipment.
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 18 Inspection of one of the bathrooms showed the bath enamel to be chipped in 3 places. The home should consider the possibility of repairing the damaged area, or if this is not possible, replacing the bath. It was noted that a service user had chosen to remove the front of a radiator guard in his room and that the exposed radiator felt quite hot. The Manager should discuss with the service user the risks associated with this action and possibly consider other means of heating the room if the service user continues to feel that the room is too cool. In this same room it was also noted that a window lock was broken and still awaiting repair. During the inspection visit it was noted that some items of equipment and furniture were being stored in a bathroom to which service users had access. A mattress that was awaiting cleaning was also being stored in another bathroom. It was noted that a floor cleaner being stored in a sluice obstructed access to the sink area for staff. The Manager should arrange for the safe storage of such items to minimise risk to service users and staff. The home has installed locks on the doors to which access should be prohibited to all except designated individuals, e.g. cleaning cupboards, boiler room, treatment room, sluice. However, it was noted during the inspection of the premises that the key to the sluice was in the door. The Manager should remind the staff of the importance of keeping all areas secure and storing keys in agreed safe places. A recent environmental health inspection recommended that the lids to 2 external waste receptacles should be replaced. This has not yet been achieved and it is recommended that this be arranged as soon as possible. The Inspector was able to see evidence that all mandatory health and safety checks had been conducted and were up to date. Examination of the record of water temperatures showed some areas to which service users have access to be above acceptable limits. This was brought to the Manager’s attention who agreed that she would report it to the relevant authority. The home appeared to be clean in all areas. 3 service users report that the home is always fresh and clean whilst 2 report that it is usually fresh and clean. Langley House DS0000007485.V329799.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. The service ensures that all staff receive relevant training that is targeted and focused on improving outcomes for service users’ EVIDENCE: Discussion with the Manager, examination of the duty roster and observation during the inspection demonstrates that appropriate number of staff and skill mix are generally on duty to meet the needs of the service users. The Manager also reports that she is able to ‘bring in’ temporary staff at short notice to support the service needs. However, comments received from service users and relatives suggest that at times staffing levels may appear to be on the low side although this has not generated any complaints. The Manager should ensure that the staff are able to respond to service user needs during busy periods and keep staffing levels under constant review to accommodate the varying needs of the service. Staff are described as ‘lovely and very caring’ and ‘kind’. The service ensures that all staff receive relevant training that is targeted and focused on improving outcomes for service users. Documentation within the home gives evidence of the training that staff members are currently receiving,
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 20 e.g. equality and diversity, safe administration of medicines, food handling and hygiene, person centred dementia care, POVA and fire safety awareness. All care staff currently employed are reported to hold NVQ level 2 in care, with ancillary staff working towards an NVQ in housekeeping and food preparation. Improvements have been made to the recruitment procedure and there is evidence to show that a full employment history is being taken from prospective employees with a detailed explanation of any gaps in employment. Langley House DS0000007485.V329799.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. The Registered Manager has the required qualifications and experience to effectively manage the home. She provides sound leadership in supporting the staff to deliver a high quality of care for the service users. EVIDENCE: The Manager provides an environment in which staff are supported and developed to deliver a high standard of care for the service users. The leadership style is that of a democratic manager who listens to, respects and supports her staff whilst encouraging an open and friendly culture between staff, service users and their relatives and visiting support staff. Staff are
Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 22 given the opportunity to air concerns with the Manager at staff meetings. Only small amounts of personal monies are held on behalf of service users that require 2 signatories and receipts retained for any transaction conducted where appropriate. It was noted that the family of one service user hand sealed envelopes to staff containing an undisclosed sum of money for the service user’s use. Currently staff are documenting receipt of the sealed envelope and passing it to the service user unopened who then opens it in private. It is recommended that staff consider whether this practice be reviewed to safeguard all concerned by confirming the contents of the envelope prior to accepting its safe custody. Detailed health and safety policies safeguard the interests of service users, staff and visitors to the home, and were available for inspection to include evidence of regular servicing of fire equipment and gas and electrical appliances. There is evidence to confirm that accident records are duly completed and reviewed to detect any trend emerging in relation to an individual upon which remedial action is then taken. Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X 3 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP2 Regulation 5 Requirement The Manager must ensure that each service user is provided with a contract that clearly sets out the terms and conditions for the provision of accommodation and personal care and who is responsible for meeting individual service user fees. The Manager must ensure that staff are carrying out a full assessment of a service user’s needs on admission and that this is documented using the correct recording system in the care file. Timescale for action 30/06/07 2. OP3 14 28/02/07 Langley House DS0000007485.V329799.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 OP19 OP19 Good Practice Recommendations The Manager should consider the possibility of arranging repair of the chips to the damaged bath enamel, or if this is not possible, replacing the bath. The Manager should arrange for repair to the damaged window lock in the service user’s room that was brought to her attention during the inspection visit. The Manager should inform the relevant authority in the event that water temperatures are not within safe limits so that remedial action can be taken. The Manager should ensure that suitably qualified, competent and experienced staff are on duty at all times in appropriate numbers for the health and welfare of service users. The Manager should review the home’s policies and procedures for the safe keeping of service users’ monies. The Manager should conduct a risk assessment on the potential danger to the service user who has chosen to remove the front of the radiator guard in his room so as to heat the room. The Manager should arrange for the safe storage of all items of equipment and furniture so as to minimise risk to service users, staff and visitors to the home. The Manager should ensure that access to all secure areas is limited and that there is a safe system in place for storage of keys. The Manager should arrange for the replacement of the lids to the 2 external waste receptacles as soon as possible. 3. 4. OP25 OP27 5. 6. OP35 OP38 7. 8. 9. OP38 OP38 OP38 Langley House DS0000007485.V329799.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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
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