CARE HOMES FOR OLDER PEOPLE
Lodore Nursing Home Lodore Nursing Home 9 Mayfield Road Sutton Surrey SM2 5DY Lead Inspector
Alison Ford Key Unannounced Inspection 21st February 2007 10:45 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 Lodore Nursing Home DS0000019104.V330938.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. Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Lodore Nursing Home Address Lodore Nursing Home 9 Mayfield Road Sutton Surrey SM2 5DY 020 8642 3088 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) Mr Stephen Pittman Post Vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Physical disability (2), Terminally ill (0), Terminally ill over 65 years of age (0) Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. A maximum of ten service users in the DE(E) category. A maximum of eight service users in the TI and TI(E) categories aged 40 or over A maximum of two service users in the PD category aged 40 or over. Date of last inspection 25th October 2005 Brief Description of the Service: Lodore is a nursing home, registered with The Commission for Social Care Inspection, to provide nursing care for up to 36 older people. Up to eight of these beds may also be used for younger service users requiring palliative care. The home has forged strong links with the local hospice to develop a level of expertise in this field and is part of a community-based programme The Gold Standard Framework. The home is situated in a pleasant tree-lined road in Sutton within walking distance of the town centre. It is an Edwardian building, which has been tastefully extended to provide accommodation over three floors. Since being acquired by the present owners there has been an extensive programme of redecoration and refurbishment and this has been completed to a very high standard. There are eighteen single and nine double rooms. All but two of the rooms are accessible by means of a passenger lift and a stair lift is provided for those two. There are well appointed bathrooms on each floor and a variety of aids and adaptations have been provided. The home is staffed twenty-four hours a day by a mix of trained nurses and care staff supported by a range of ancillary staff. Fees at the time of this latest inspection range from £675 - £815 dependant on the choice of room and the level of dependency of the resident. Extra costs may be incurred for personal items and services such as hairdressing and these would be discussed prior to admission. Further information including copies of the homes Statement of Purpose and Service User Guide may be obtained from the home and a copy of their latest inspection report can also be downloaded from the Commission for Social Care Inspection website.
Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key inspection was an unannounced visit contributing to the inspection process of the home for the year 2006/2007. In compiling this report consideration has also been given to information received about the home throughout the year such as comment cards, complaints, visits made by The Registered Provider and the notification of any incidents. During the visit a tour of the premises was undertaken and several residents, relatives and members of staff were spoken with. A sample of care plans was assessed and various records and documentation required to be kept by the home was seen. Staff files of those who have been employed since the last inspection were also checked, to ensure that appropriate pre - employment checks had been completed. The home is currently without a registered manager although efforts have been made to find a suitable person to fill this role. The management role is being undertaken by the Registered Providers, supported by a team comprised from the homes head of care and senior staff from their other home. In this way they have been able to ensure that the majority of outcomes for residents have remained good during this time. What the service does well:
This home has a warm and friendly atmosphere and is decorated and maintained to a high standard. As usual all areas were clean and free from odour on the day of the inspection. All of the residents appeared well cared for and the majority were very happy. Those who were able to communicate expressed their satisfaction with the home and the staff who were described by several as being “lovely” and “so helpful “ The food served in the home and the choices offered were praised and menus seen were varied and nutritious. One resident commented that the food served was “excellent” and another that “it was always beautiful “ Special occasions are marked, the residents had enjoyed pancakes the previous day, Shrove Tuesday, and particular diets and preferences are catered for. Those maintenance records that were seen were in good order as were all of those records required to be in place to ensure the protection of residents. Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 6 Staffing levels are sufficient to ensure the safety and comfort of those living in the home. Many of the staff have been in post for some while and there is a positive commitment to training and development. Staff displayed an awareness of the issues and problems experienced by this client group and were observed treating them in a respectful manner. Resident’s views about the home and the services that they require are very important and the Residents Administrator visits all residents daily. As she is not a part of the nursing team and residents are assured of confidentiality, they are able to comment on all aspects of their care and comfort knowing that she will be able to liaise with the relevant staff members on their behalf. What has improved since the last inspection? What they could do better:
As previously stated, the home is currently without a Registered Manager a role, which is essential to ensure good leadership, supervision of staff and continuity of care and this must be addressed as soon as possible. It is also considered that the appointment of a suitably qualified and experienced manager would ensure that aspects of care planning are improved. Currently, potential residents are assessed prior to their admission, to ensure that the home will be able to meet their medical and nursing needs and care plans are drawn up to detail how these needs will be met. However little attention is currently given to their social interests, hobbies, or previous lifestyle. Greater detail to these issues will help to ensure that the daily life in the home and the activities that are provided will suit their preferences. Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 7 More “life history” work with residents, especially those who are confused, will also enable staff gain an insight into their previous lives and understand their current behaviour patterns. In addition, entries in the daily notes do not always provide details of all the care that is actually being delivered. This information could be essential if any concerns or complaints are raised about any aspect of a residents care. There must also be evidence that any potential risk to the health and safety of residents has been considered if equipment such as cot sides is thought to be necessary. There is a Statement of Purpose and Service User Guide for the home, which have been compiled, in great detail. However, these will need to be revised in line with current legislation. This will ensure that any potential resident or their relative will be able to access all of the information that they need in order to decide if the home will meet their needs and that they will be happy there. 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. Lodore Nursing Home DS0000019104.V330938.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 Lodore Nursing Home DS0000019104.V330938.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): Standards 1,3,6 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents are given all of the information that they require prior to admission to the home so that they can make an informed judgment as to its suitability and a comprehensive assessment ensures that their assessed needs can be met. However, changes need to be made to ensure that information is line with recent legislation and in a format that is easily accessible to residents. EVIDENCE: There is a Statement of Purpose and Service User Guide for the home, which have been compiled, in great detail. However, these will need to be revised in line with current legislation. The Service User Guide will need to be produced according to Regulation 5 and provide a “guide to the care home” for residents and their representatives and
Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 10 include a summary of The Statement of Purpose and details of all total fees that may be payable. This will help any potential resident to judge if the home, and the services that are offered, will suit them and help them to decide if they would be happy living there. Additionally all current residents and their representatives must able to have access to this document so that they are able to measure how well the home is meeting their stated aims. Pre admission assessment documentation provides a comprehensive assessment of potential residents nursing needs. This then forms the basis for care plans some of which were seen during the inspection. However, more detail must be obtained about resident’s social preferences and expectations as well. In this way both potential residents and staff can be sure that the daily life in the home will be suitable and that they will be happy living there. For those residents funded by the local authority a care managers assessment is also present. Lodore Nursing Home DS0000019104.V330938.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): Standards 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents in this home are treated with dignity and respect. Their healthcare needs are identified and reviewed regularly so that they continue to be met and they are able to access care from additional healthcare services. Medication policies and procedures are in place to ensure their protection. EVIDENCE: Four care plans were seen at this visit. The plans were generated from the initial assessment and showed evidence of regular review although they concentrate on the medical needs of residents. There is evidence of involvement from other members of the multi-disciplinary healthcare team including chiropodists and opticians. Regular assessments are undertaken of those factors, which could identify residents at risk from developing pressure sores, and appropriate equipment and interventions are in place. A new set of weighing scales has recently been purchased so that residents can be weighed even if they are in their wheel chairs.
Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 12 The daily notes that are written about residents would benefit from being more detailed. Although there is often very little change in residents overall health these records should provide evidence of the care that is actually being given on a daily basis. Care plans would also benefit from including details about residents social preferences, past lives, interests and achievements especially for those residents who may be confused. This would help staff to understand their current behaviour and to provide activities, which suit them. There must also be evidence available to show that residents or their representatives have been given the opportunity to contribute to these plans and influence the way that care and support is given. Documentary evidence was available to show that cot sides that were in use were being appropriately maintained however; there was no assessment to show that the possible risks involved had been considered. If residents participate in an activity, which could compromise their safety, or if it is thought that equipment should be used which could conceivably pose a risk to them, there must be evidence available to show that those risks have been considered and discussed either with them or with their representatives if that is appropriate. Medication storage and administration records were seen to be in order although there was no evidence to show that the supplying chemist audits these. It is recommended that this should be undertaken on a regular basis. Residents were observed being treated in a respectful manner and all personal care is delivered in private. Staff were seen to knock on doors and call out before entering. One resident who was in a shared room explained that they were experiencing some problems and the home will need to consider ways to resolve these. Lodore Nursing Home DS0000019104.V330938.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): Standards 12,13,14,15. Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Residents are able to exercise choice over their lives within the home and activities are provided which generally suit their needs. This provides interest and variation in their daily lives. Relatives and friends are always made to feel welcome. The food served within the home is well balanced, and nutritious and specialist diets are catered for as required. EVIDENCE: Residents explained that they were able to exercise choice over how they spent their days and whether they took part in organised activities. Some explained that they enjoyed “ doing things with the other people “ others preferred to remain in their rooms and watch television or read. One of the care staff has now taken over the responsibility for daily activities and the Resident Administrator will be coordinating these. She is currently talking with residents to try and discover what they would like to do and will then purchase appropriate equipment for them.
Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 14 Visitors confirmed that they always made to feel welcome and there are no restrictions to them coming in to the home. All the residents’ bedrooms that were seen contained personal possessions from home such as photographs, ornaments and small items of furniture. Those spoken with were all very complimentary about the food served in the home, menus were seen, they were varied and there was always a choice. There is a small dining room however; most service users choose to eat from tables in the lounge or in their rooms. On the day of this inspection there were sufficient staff to offer assistance to those who required it. Lodore Nursing Home DS0000019104.V330938.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): Standards 16,18 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Residents are made aware of the homes complaints policy and are confident that their concerns would be dealt with accordingly. They can be sure that training, policies, and procedures are in place to ensure that they will be protected from harm as far as possible. EVIDENCE: There is a complaints policy in the home and details are displayed in the hall. Residents and their relatives that were spoken with were generally confident that any complaints would be dealt with however, did not think that they would have any. The family of one resident in the home raised some issues of concern during the inspection, which are currently being addressed, and these will continue to be monitored. There had not been any complaints made about the home to the Commission For Social Care Inspection since the last inspection. Staff were able to demonstrate a clear understanding of issues concerning the recognition and reporting of adult abuse and staff files provided evidence that all pre-employment checks are carried out appropriately.
Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 16 Lodore Nursing Home DS0000019104.V330938.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): Standards 19,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home provides an extremely well maintained, clean, and comfortable environment, which meets resident’s needs. EVIDENCE: The home is an attractive property, which has been refurbished to a high standard and is well maintained. Adaptations have been provided throughout the home and in bathrooms and showers to aid those with reduced mobility. There is rear garden, which is accessible to all the residents and is much enjoyed in the summer months. A tour of the premises included a sample of resident’s bedrooms, which are comfortable and tastefully decorated. There are appropriate door locks and lockable facilities have been provided. Radiators have been guarded to reduce
Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 18 the risk of accidents. Automatic door closers, which operate in the event of a fire, have been fitted to bedroom doors to ensure the safety of residents in the event of a fire. On the day of the inspection the home was clean and free from odour and suitable measures are in place to reduce the possibility of cross infection and contamination. This includes the recent installation of anti-bacterial skin cleansers for the use of care staff. Lodore Nursing Home DS0000019104.V330938.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): Standards 27,28,29,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents in this home are cared for by well-trained and competent staff who are able to meet their assessed needs. The home’s robust recruitment policies and procedures ensure, as far as possible, that residents will be protected from harm. EVIDENCE: The home is staffed 24 hours a day by a mixture of trained nurses, care staff and ancillary and domestic staff. On the day of the inspection there were two trained nurses on duty, with six care staff. In addition there were domestic and kitchen staff on duty. This allowed staff to have the time to spend talking with residents as they cared for them and the atmosphere was calm and unhurried. All of the care staff have either undertaken an NVQ qualification at least to level 2 or are enrolled on the course. All of those spoken to were able to detail recent and relevant training that they had undertaken. A senior nurse, who has additional qualifications and experience, does much of this “in house”. Schedules were seen which highlight future staff training needs. Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 20 New members of staff have an induction programme and work alongside someone withy more experience until such time as they are considered to be competent. There is a robust recruitment process in place in the home. Staff files were seen of six members of staff appointed since the last inspection and all complied with the standard. There was evidence of Criminal Records Bureau clearance, appropriate references, photographs and contracts. Work permits are applied for as necessary. Lodore Nursing Home DS0000019104.V330938.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): Standards 31,33,35,38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents in this home can be confident that, despite the current lack of manager, measures have been put in place to ensure that outcomes for them will not be compromised. Policies and procedures are in place to safeguard residents’ money and the home’s health and safety policies and maintenance programmes minimize any risks to their safety. EVIDENCE: The home is currently without a Registered Manager however strenuous efforts are being made to appoint suitably qualified and experienced person to the role which is essential to ensure good leadership, supervision of staff and
Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 22 continuity of care. During this time great efforts have been made to ensure that outcomes for residents are not compromised and the providers and the management team of their other home have overseen the daily running of the home. The Residents Administrator has introduced a service quality audit to look at resident’s opinions of the care and services that they receive in the home and she aims to visit them all on a regular basis and gain their views. The Registered Provider visits the home on a regular basis and completes a report in accordance with Regulation 26. Small amounts of money are held in safekeeping for residents. This is mainly used to pay hairdressing bills or for small items of personal shopping. The records were seen and were accurate and well maintained. In order to maintain the wellbeing of staff and residents the home complies with current health and safety legislation. A selection of maintenance certificates was viewed and was in good order. Kitchen records were well kept, fire alarms, hot water temperatures and emergency lighting are checked weekly and staff were able to confirm a recent fire drill. The accident book was seen, all incidents had been minor and none had required admission to A/E. Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X 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 2 X 3 X 3 X X 3 Lodore Nursing Home DS0000019104.V330938.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 OP1 Regulation 4,5 Requirement The Responsible Person must ensure that The Statement of Purpose and Service User Guide are reviewed and updated in line with current legislation and produced in a format that is accessible to residents and their families. This will enable them to make an informed choice as to whether the home will meet their needs and measure how well the home meets it stated aims. The Responsible Person must ensure that pre admission assessments take into consideration potential residents social interests and preferences so that they can be sure that they will be happy living there and that any activities that are provided will suit them. The Responsible Person must ensure that there is evidence that residents or their representatives have been able to contribute to their care plans and influence the way that care is given.
DS0000019104.V330938.R01.S.doc Timescale for action 30/06/07 2 OP3 14 30/06/07 3 OP7 14(1)(c) 30/06/07 Lodore Nursing Home Version 5.2 Page 25 4 OP7 13(4)(c) 5 OP31 8(1)(a) The Responsible Person must 30/06/07 ensure that care plans contain risk assessments where any equipment in use could pose a possible threat to the health and safety of residents. The Responsible Person must 30/06/07 ensure that a suitably qualified and experienced person is put forward for consideration as Registered Manager of the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that “life history “ work should be undertaken with residents so that staff can gain an understanding into their past lives and current behaviour patterns It is recommended that daily notes should contain more detail regarding the care that is being delivered to residents. It is recommended that their should be evidence that the supplying chemist audits medication administration and storage on a regular basis. 2 3 OP7 OP9 Lodore Nursing Home DS0000019104.V330938.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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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