Inspection on 04/01/07 for Lilybank Hamlet

This inspection was carried out on 4th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lilybank Hamlet 11/06/08

Lilybank Hamlet 07/12/07

Lilybank Hamlet 17/10/05

Lilybank Hamlet 19/07/05

Lilybank Hamlet 07/02/05

Lilybank Hamlet 21/06/04

Lilybank Hamlet 04/11/02

Similar services:

Hillside

Applegarth

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

Parkmanor Residential Home

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

CARE HOMES FOR OLDER PEOPLE Lilybank Hydro Chesterfield Road Matlock Derbyshire DE4 3DQ Lead Inspector Rose Veale Kay Unannounced Inspection 09:30 4th January 2007 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 Lilybank Hydro DS0000002062.V323554.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. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lilybank Hydro Address Chesterfield Road Matlock Derbyshire DE4 3DQ 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) 01629 580919 01629 760019 Progressive Care Limited Post Vacant Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To be able to admit the named person of category DE named in variation application No. V35749 dated 10 October 2006. 17th October 2005 Date of last inspection Brief Description of the Service: Lilybank Hydro is situated in the town of Matlock. There is a range of facilities in the town, including shops, pubs, restaurants and public transport. The home provides personal care for up to 34 older people, plus 4 day care places. The home is an older, converted building with accommodation on the ground floor and two upper floors with good views over the surrounding countryside. There are attractive and well maintained gardens to the rear of the home. The home and garden are fully accessible to residents. The fees range from £345 to £360 per week. This information was provided by the acting manager on 04/01/07. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and took place over 7½ hours. The inspection visit focused on assessing compliance to requirements made at the previous inspection and on assessing all the key standards. There were 22 residents accommodated in the home on the day of the inspection visit. Residents, visitors and staff were spoken with during the visit. The acting manager was available and helpful during the inspection visit. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. A questionnaire and surveys had been completed prior to the inspection and information from these has been included in the body of this report. What the service does well: What has improved since the last inspection? A new manager was appointed in November 2006. The manager was suitably qualified and experienced and had applied for registration with CSCI. An activities coordinator was appointed in November 2006 working for 30 hours per week. The range of activities had improved and the activities coordinator had plans to further develop activities for residents. A permanent cook had recently been appointed, following a series of temporary and agency cooks. This had resulted in improvements to the meals and choices offered to residents. Three of the four requirements made at the last inspection had been met, resulting in improvements to records. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lilybank Hydro DS0000002062.V323554.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 Lilybank Hydro DS0000002062.V323554.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was a good assessment system in place, but there were gaps in care plans and staff training so that residents’ needs were not always fully met. EVIDENCE: The care records of 4 residents were examined. Each of the records included assessment information from the Social Services care manager, and an assessment made by the home prior to admission. The home’s assessment was comprehensive. 2 of the care records included a care plan devised from the assessment information. 2 of the care records did not have a care plan devised by the home. 1 care record included confirmation to the resident that the home was able to meet their needs. Residents spoken with and those responding to the surveys said that their needs were met at the home. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 9 The staff training records were seen and showed that staff mostly had training to meet the needs of residents, although few staff had received specific training about caring for people with dementia. 2 of the care records were of residents with dementia. Staff spoken with were generally knowledgeable about the care needs and preferences of residents. From discussion with staff and observation it was clear that residents and staff would benefit from the staff having training about dementia. Standard 6 does not apply to this service. Lilybank Hydro DS0000002062.V323554.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans were missing, lacking detail, not always regularly reviewed and did not involve residents and / or their representatives, so it was not clear that residents’ needs were fully met. EVIDENCE: The care records of 4 residents were examined and 2 of these included care plans. The acting manager said that the care plan documentation was in the process of being changed to a new format. 1 care plan seen was completed using the new documentation. The care plan was not dated and was not signed by the resident / their representative or by a member of staff. The care plan had been reviewed monthly up to September 2006. The care plan did not include sufficient detail in some of the sections. For example, the section about mobility did not refer to the resident’s history of falls and the action that should be taken by staff to reduce the risk of further falls. There was a risk assessment in place about falls that was part of a general risk assessment dated August 2006. There was no evidence that the Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 11 risk assessment had been reviewed and updated. There were two manual handling assessments in place, one dated in 2005 and the other undated so it was not clear whether the assessment had been reviewed and updated. There was a nutritional risk assessment in place that had been completed in September 2006 with no evidence of further updates, despite the resident being assessed as at high risk. The other care plan seen was in the older style documentation. There were sections of the care plan covering the activities of daily living, such as communication, eating and drinking, and personal hygiene. The sections completed had sufficient detail of the resident’s needs and the action required by staff to meet them. The care plan did not include all the assessed needs of the resident. For example, there was no reference to the action required by staff to reduce the risk of the resident developing pressure sores, despite a risk assessment that the resident was at high risk. There was no reference in the care plans to the social, psychological or spiritual needs of the resident. The care plan had been reviewed monthly up to date. There was no evidence of the involvement of the resident and / or their representative in care planning and review. Both of the care plans included a photograph and short profile of the resident at the front of the file. Both included satisfactory daily records. Both included reference to maintaining the privacy and dignity of the residents. 2 of the care records seen did not have any care plans devised by the home, although the Social Services care plans devised prior to the admission of the resident were included. There were no daily records in place for one of the residents. The absence of care plans meant that it was not possible to check whether the residents’ needs were properly met. From discussion with staff, and from observation, it appeared that the needs of two of the residents were not fully met. The care records seen included records of the input of other health care professionals, such as GP, District Nurse, chiropodist and dentist. Residents spoken with confirmed that they were able to see their GP as required and had access to other health care services, including referral to hospital outpatients where necessary. From speaking to residents, visitors and staff, and from observation, there was clear evidence that privacy and dignity were promoted and maintained at the home. Residents said that staff were “pleasant”, “kind” and “very helpful at all times”. Medication in the home was securely stored and was administered by staff who had received appropriate training. The Medication Administration Records, (MARs), were seen and were correctly completed. Records were seen of the Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 12 daily maximum and minimum temperatures of the medication fridge to comply with a requirement made at the last inspection. Lilybank Hydro DS0000002062.V323554.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 adequate. This judgement has been made using available evidence including a visit to this service. There was a good range of activities offered, meals had improved, and routines in the home were sufficiently flexible, so that residents’ lifestyle preferences were generally met. EVIDENCE: The home employed an activities coordinator working 30 hours per week, usually Monday to Friday. There was a programme of activities available to residents, including chair-based exercises, bingo, dominoes, quizzes, outside entertainers and trips out. Records were kept for each resident of activities offered and whether they had taken part. There was evidence that residents were consulted about the activities they would like through residents meetings and informal discussion. The activities coordinator was experienced in the care of older people and was enthusiastic about the role. Residents spoken with were pleased with the activities offered, particularly the exercises and the bingo sessions. One resident said they had enjoyed a party arranged to celebrate the New Year. One resident said they had enjoyed going out for a Christmas meal. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 14 Residents spoken with said they were able to get up and go to bed when they wanted to. Staff spoken with said that residents who were unable to express a choice were assisted to get up once they were awake. Two residents said that sometimes staff were too busy to immediately respond to requests for help and this sometimes meant waiting to go to the toilet, or waiting for assistance with getting dressed. It was observed that there were times during the day when staff were not immediately available to residents. Residents were encouraged to bring their own possessions into the home and the bedrooms seen were well personalised. Visitors spoken with said they were able to visit at any reasonable time and were always made welcome. Residents spoken with said they were able to see their visitors in private if they wished. Residents family details were noted in their records. The home had recently employed a permanent cook, having relied on temporary or agency cooks for several months. The menus had been revised and appeared varied and well balanced. The tea time meal included choices of hot and cold food. The lunchtime meal on the day of the inspection visit appeared appetising. The dining room was pleasant, although in need of some refurbishment. Staff were observed to assist residents in an unobtrusive way. Residents spoken with were pleased with the meals at the home and said the meals had improved since the arrival of the new cook. One resident was pleased that fresh fruit was always available and that the meals included fresh vegetables and salads. One resident commented that they could not read the menu displayed on a ‘white board’ and that it was not always written every day. The cook said there were plans to have menus on each table, and also to ensure more choice of main courses. Lilybank Hydro DS0000002062.V323554.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. There were satisfactory policies in place and good staff awareness so that residents were protected and their concerns effectively dealt with. EVIDENCE: The complaints policy for the home was included in the service user guide. Records of complaints were seen. The records showed the action taken and the outcome of the complaint. Complaints had been dealt with within 28 days. Residents spoken with were aware they could complain. One resident said that when any problems were raised with staff, they were usually dealt with promptly. No complaints had been received about the home by CSCI since the last inspection. The home had a policy in place for safeguarding vulnerable adults. Staff training records showed that most of the staff had received training in safeguarding vulnerable adults. Staff spoken with were aware of safeguarding adults issues and of correct reporting procedures. Lilybank Hydro DS0000002062.V323554.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was suitably equipped and generally well maintained so that residents lived in a safe, clean, comfortable and pleasant environment. EVIDENCE: A tour of the building was carried out, including some of the bedrooms, the lounges, dining room, bathrooms, laundry and kitchen. The home was clean throughout, free from offensive odours, and appeared generally well maintained. The home had suitable equipment to meet the needs of residents, such as hoists and wheelchairs. There was a large lounge that retained original features of the building and had impressive views over the surrounding countryside. Since the last inspection, an office had been converted back to use as a smaller lounge. The lounges were comfortably furnished. The dining room was spacious and bright. The Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 17 acting manager said that it was planned to refurbish the dining room, including the carpet which was showing signs of wear in places. The bedrooms seen were pleasant, comfortable and personalised with residents’ own possessions. Residents spoken with were satisfied with their bedrooms The laundry had 2 washing machines but it appeared that 1 was out of order. The washing machine in working order had a sluice programme to deal with soiled bedding or clothes. The home employed a laundry assistant. Residents spoken with said that their clothes were usually laundered properly, though not always returned very promptly. One resident commented that the bedding was changed regularly and was always clean and fresh. The kitchen appeared clean, tidy and well organised. It was found that a fridge had not been repaired or replaced as recommended by the environmental health officer on a visit in March 2006. There was another fridge in full working order, but this did not provide sufficient storage space for all the food requiring refrigeration. The acting manager said that the providers had plans for generally refurbishing and upgrading the home. Lilybank Hydro DS0000002062.V323554.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels and staff training were not always sufficient to ensure residents’ needs were properly met. EVIDENCE: The rotas for the home were seen and showed that the usual staffing levels for 22 residents was to have 3 care assistants on duty throughout the day and night, plus the acting manager during the day. The care staff were supported by domestic, kitchen and laundry staff. Residents spoken with commented that staff were “always busy” and that they sometimes had to wait for assistance in the mornings and to go to the toilet. Staff spoken with said that staffing levels were not always sufficient to meet the needs of the residents, particularly when day-care was provided and there were 23 people to provide care to. The home was in a large building with residents on 3 floors which caused further difficulties in staff being available to assist residents when needed. Staff spoken with said that if the kitchen or laundry assistant was off work, no additional cover was provided and staff were expected to carry out the extra work, causing further problems. The acting manager said that a new kitchen assistant had been employed and would be starting soon, and that a new Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 19 system for annual leave would ensure the home was not left without ancillary cover. The use of the Residential Forum guidance for care home staffing was discussed with the acting manager to determine whether the current staffing was appropriate for the dependency of the residents. The records of 3 members of staff were examined. The records included the required information, such as 2 written references and a satisfactory Criminal Records Bureau disclosure. The records were well organised and were kept securely. There were no records of induction training for new staff. Staff spoken with confirmed that they had received orientation to the home when they first started, but no formal, structured induction programme. There were records of training received by staff. The records showed that most staff had received training in manual handling, first aid, fire safety, basic food hygiene, and safeguarding vulnerable adults. A few staff had received training about dementia. There were residents at the home who had specific needs due to dementia so it was important that all staff had relevant training. Of 13 care assistants, 6 had achieved NVQs in care. The home was therefore making good progress towards the National Minimum Standard of 50 of care staff with NVQ in care at level 2 or above. Lilybank Hydro DS0000002062.V323554.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was satisfactory management of the home, and the acting manager was well aware of the areas requiring improvement to ensure that the home was run in the best interests of residents. EVIDENCE: The acting manager had been in post since November 2006. She had already achieved the Registered Manager’s Award and had previous experience of managing a care home. She had applied to CSCI for registration as the manager. Staff spoken with were pleased there was a permanent manager in place after a period of temporary management and said the acting manager was “friendly” and “approachable”. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 21 There were some quality assurance measures in place: an annual survey of residents and / or their representatives; monitoring visits by the provider under Regulation 26; and residents’ meetings. There was no formal report produced of the results of the surveys. Residents’ personal money was kept securely. Records were kept of all transactions and all entries had two signatures. The records were audited annually by the provider. Health and safety records were sampled, including the fire log book, accident book, lift maintenance, and gas safety checks. All the records seen were well kept and up to date. It was noted that several bedroom doors were wedged open, which would put residents at risk in the event of a fire. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 22 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Each resident must have a care plan that includes all their assessed needs, is reviewed and updated regularly, and is prepared and reviewed in consultation with the resident and / or their representative. The fridge in the kitchen must be replaced as required by the Environmental Health Officer. An assessment must be carried out of staffing levels appropriate to the needs of residents, taking into account day care, and the design of the building. A copy of this assessment is to be sent to CSCI. Staff at the home must have training appropriate to the needs of residents, specifically, training in the care and support of people with dementia. Fire doors must not be wedged open. Timescale for action 31/01/07 2. 3. OP19 16(2)(g) (j) 18(1)(a) 28/02/07 31/01/07 OP27 4. OP30 18(1)(c) 31/03/07 5. OP38 13(4)(c) 23(4)(a) 12/01/07 Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 24 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. 5. Refer to Standard OP7 OP19 OP27 OP30 OP33 Good Practice Recommendations Care plans should be updated at least every month, or more frequently if there are changes in the resident’s condition. The second washing machine should be repaired or replaced to ensure adequate facilities for laundry. The Residential Forum care staffing tool should be used to provide guidelines for the staffing levels required to meet the assessed needs of residents. There should be an induction programme for new staff to meet Skills for Care standards. There should be a structured quality assurance system with a report made available to residents / their representatives. Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. Extracts may not be used or reproduced without the express permission of CSCI Lilybank Hydro DS0000002062.V323554.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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