Inspection on 11/10/05 for Palatine Lodge

This inspection was carried out on 11th October 2005.

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

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

Other inspections for this house

Palatine Lodge 20/05/09

Palatine Lodge 26/11/08

Palatine Lodge 02/01/08

Palatine Lodge 11/07/07

Palatine Lodge 19/09/06

Palatine Lodge 23/02/06

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

CARE HOMES FOR OLDER PEOPLE Manderley Residential Care Home 17/19 Palatine Square Burnley Lancashire BB11 4JF Lead Inspector Mrs Pat White Announced Inspection 11th October 2005 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 Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Manderley Residential Care Home Address 17/19 Palatine Square Burnley Lancashire BB11 4JF 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) 01282 431450 Dr Morgiana Muni Nazerali-Sunderji Mrs Sandra England Care Home 15 Category(ies) of Dementia (10), Learning disability (5), Mental registration, with number disorder, excluding learning disability or of places dementia (10) Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must employ a suitable qualified and experienced manager who is registered with the Commission The home is registered for a maximum of 15 service users to include: Up to 10 service users in the category of MD Up to 10 service users in the category DE Up to 5 service users in the category LD No new service users under the age of 55 years will be admitted to the home. 17/02/05 3. Date of last inspection Brief Description of the Service: Manderley is registered with the Commission for Social Care Inspection to provide personal care and accommodation for a total of 15 people, in the following categories: Dementia ( up to 10), Learning disability (up to 5) and Mental Disorder, excluding learning disability or dementia (up to 10). As a home registered before the implementation of the National Minimum Standards in April 2002, Manderley is not subject to most of the new environmental standards. Manderley is a large 2 storey Victorian style property, situated close to the town centre and a number of amenities. There is a bus stop near to the home, en - route to the town centre. The home was well maintained and furnished. The garden areas were ramped to allow easy access for residents. Accomodation consisted of 11 single and two double rooms. The upper floor was accessed via a stair lift. There was equipment and adaptations to assist the residents with mobility problems. All rooms were linked to the call system. Appropriate activities for residents were arranged throughout the week. There were a wide range of policies and procedures, as recommended by the National Mininmum Standards for care homes for older people, to underpin good practice. The home had its Investors in People Award renewed in June 2004. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Announced Inspection 12th October 2005 This inspection was an announced inspection, the purpose of which was to assess important areas of life in the home that should be inspected over a 12 month period, to check the legal requirements and recommendations from the previous inspection and to check other matters which came to the inspector’s notice. The inspection took 7 hours 30minutes, and comprised of spending time with the residents, looking around the home, looking at residents’ care records and other documents, and discussion with the registered manager, Mrs Sandra England. Two members of staff were also spoken with. Two residents were asked about their views on the home and other residents spoke to the inspector. Two visitors were spoken with at the time of the inspection. Written information about the home (the “pre – inspection questionnaire”) was provided before the inspection and some of that information is included in the report. Eleven residents completed comment cards with the assistance of staff and six relatives completed comment cards. N. B. The summary is particularly aimed at residents and staff are asked to help some of the residents to understand it. The home should also ensure that the full report is widely available to all those who are interested. What the service does well: The manager, Mrs England, made sure that the home could look after people properly by meeting them before they came to live at Manderley, and inviting them to spend time in the home. This made sure that the staff working in the home knew what they needed to do to look after people. Because of this residents were well cared for in the home and kept as healthy as possible. Staff tried hard to make the residents comfortable and happy. Residents who wrote down some things about the home, with the help of staff, stated that they felt well looked after and liked living in the home. Some residents who could talk to the inspector said that they were well cared for and that staff were good and kind to them. One resident stated that “they were a happy little band”. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 6 Relatives who wrote down some answers to questions, and those who were spoken with, stated that they thought the residents were well looked after. One person stated that her relative “couldn’t be in better hands”. There was good and useful written information about how the residents should be looked after and what they liked to do each day. Residents were encouraged to do as many things for themselves as possible and to choose what they wanted to do and where they wanted to go. One resident said she enjoyed doing things on her own, or with the help of staff The way the staff looked after the residents’ medication and the way the residents took their medication was done safely, and helped to make sure they were kept as healthy as possible. The staff in the home organised a lot of things for the residents to do, such as going to luncheon clubs and going out for the day and to places of entertainment. Some of the residents had been to Blackpool for a holiday and told the inspector how much they had enjoyed it. Sandra England and Linda Zephir had made sure that the home was nicely decorated, clean and well kept. All the staff were properly taught how to look after people like the ones who lived at Manderley, and they were able to do it properly. Sandra also made sure that only the right kind of staff were allowed to work in the home. The manager of Manderley, Mrs Sandra England, had worked in the home for over 15 years. She had the right training and experience, and made sure the residents were well looked after. She also made sure that the staff were happy at work and helped each other. What has improved since the last inspection? What they could do better: Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 7 The inspection did not show any things in the home that could be done much 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. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 & 5. Standard 6 is not applicable The home’s admission procedures, including information supplied to prospective residents, pre admission assessments and prior visits by prospective residents and relatives to the home, helped to determine whether or not the home could meet people’s needs. Residents’ needs were being met in the home. EVIDENCE: Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 10 Manderley had a statement of purpose available for people making enquiries about the home and which was in compliance with Regulation 4 and standard 1. The residents guide was produced in different formats, for example picture format, that would assist residents who had with difficulty reading. The new owner of the home was reviewing both documents. The records of the most recently admitted resident showed that the social work assessment had been received, and that the manager had undertaken an in house assessment prior to admission. This demonstrated that the home could meet her needs. The residents living at Manderley had a wide range of different needs, associated with dementia, learning disability and mental disorder. The inspection demonstrated that the home was meeting these individual needs through assessments, staff training and expertise and care practices. There was evidence that staff had under taken training in dementia, mental health and challenging behaviour. Some staff could use Makaton. The home operated a key worker system, which facilitated continuity of care for the residents. Residents spoken with indicated that they were well looked after. One resident stated that the home was “smashing”. Another relatively independent resident stated that she was supported in maintaining her independence and that “they were a happy band”. Records showed that the most recently admitted resident had visited the home several times prior to a decision being made about whether or not she should live there. The home does not provide intermediate care. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 11 Residents’ care needs were comprehensively recorded in a variety of ways, and which enabled these needs to be understood by staff. The residents’ physical and psychological health was well monitored and matters addressed through the appropriate health professionals. Residents who are terminally are looked after with sensitivity and respect EVIDENCE: The viewing of records showed that the residents had a comprehensive care plan which included a detailed “preferred daily routine”. The care plans contained useful detail regarding the residents, their capabilities, limitations, psychological / emotional issues and their needs in terms of support and assistance and daily activities. Risk assessments were also completed, for example in moving and handling and vulnerability to pressure sores. One resident, whose records were viewed, would benefit from a risk assessment re risk of falling, including falling out of bed. The residents’ physical and psychological health was monitored and health needs were addressed. The district nurses attended the home for any clinical nursing procedure required for the residents. Risk assessments regarding pressure sores had been undertaken and preventative and remedial measures Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 12 were recorded appropriately on the care plan. Residents had access to specialist continence advice and care. Some residents had mental health assessments and intervention by the mental health services. A community psychiatric nurse, visiting the home at the time of the inspection, stated that the community psychiatric nursing team felt that Manderley provided good care to people with mental health problems. Nutrition assessments were undertaken, and matters of concern regarding eating issues, diet and weight were also monitored and recorded. The management of medication in the home was not fully inspected. However at the previous inspection, the pharmacy inspector reported that residents’ medication was handled and managed to a high standard. At this inspection it was established that the legal requirement and good practice recommendation from the previous inspection had been met. Two residents had died since the previous inspection. There was evidence that these residents, at the end of their lives, had been cared for with sensitivity and with respect for their privacy and dignity. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15 The residents benefited from taking part in varied and fulfilling activities to suit preferences and abilities. They also benefited from a variety of links with the local community, including their relatives and friends. The food served appeared healthy and varied and based on residents’ likes and preferences. EVIDENCE: The routines of daily living and activities were flexible and varied to suit individual preferences and abilities. On the day of the inspection two residents went to a luncheon club, and the home’s hot (cooked) meal was served at tea - time so that these, residents could have this meal fresh rather than warmed up. On the day of the inspection staff played board games with the residents. Residents’ hobbies and interests were recorded on the care plan. The relatives who were spoken with confirmed that staff took residents out, and that there were social events in the home to which they were invited. Some of the residents had recently enjoyed a holiday in Blackpool. Five relatives who completed comment cards and the relative who was spoken with stated that they felt they were made welcome in the home at any time. One who completed a comment card stated that they were not and that the “welcome can be erratic”. All said they could visit their friend / relative in private if they wished and that they were kept informed of important matters. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 14 Relatives confirmed that they had received the service user guide which states the home’s policy on visiting and keeping in touch. The food served was according to residents’ tastes, preferences and needs. It appeared wholesome and nutritious. Three full meals were served each day and there was a choice of two main cooked meals. On the day of the inspection residents who didn’t like either option were give a meal that they wanted. A variety of options were always available for the snack meal. Menus changed frequently according to residents’ preferences and seasonal variations, and which were discussed at residents’ meetings. Appropriate assistance was given to those who needed it. It was strongly recommended that the records of food served at supper - time is recorded, and that when food is blended individual parts of a meal are blended and presented separately. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 There was a complaints procedure, but most residents were dependent on staff understanding their likes and dislikes, interpreting their behaviour and on informal methods of discussion, to establish whether or not they were happy. Relatives knew how to make a complaint. Policies and procedures assisted in the protection of residents from abuse and neglect and were in accordance with Government guidance. EVIDENCE: Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 16 There was a complaints procedure that complied with legal requirements and this standard. The service user guide included a copy of the complaints procedure. All the relatives who completed comment cards stated that they were aware of this procedure. Most of the residents would be unable to follow a formal complaints procedure and were dependent on staff interpreting behaviour and reactions. Some would be able to voice their displeasure. Relatives expressed satisfaction about the service. Two verbal complaints had been made since the previous inspection and these had been investigated and recorded appropriately. However the manager was advised that the records made should clearly state the issue of concern. There were policies and procedures for residents’ protection based on the publication “No Secrets In Lancashire” and which included a whistle blowing policy. There was written guidance for staff regarding how to deal with aggression by residents, and there had been “in house” training on challenging behaviour. There was a safe in the office in which residents’ valuables could be stored. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24, 25 & 26 Manderley provided well - maintained and clean accommodation that suited the residents’ needs and preferences. Residents benefited from specialist equipment and adaptations and comfortable bedrooms that had some of their own possessions EVIDENCE: The premises were well maintained and decorated, and certain areas had been redecorated since the previous inspection. The requirement and recommendations made at the previous inspection had been met. It is commendable that following the previous inspection the previous owners and the home’s manager had undertaken an audit of disability equipment in the home. As a result some cushions had been purchased to help protect people who were at risk from falling out of bed. The bedrooms were furnished, decorated and equipped for the comfort of the residents, and residents had brought small items of furniture with them. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 18 Bedrooms were redecorated as they became vacant and residents were able to choose wallpaper and furnishings. One resident was proud of her bedroom, and her part in its redecorating. Those residents who were able to express a view were complimentary about the accommodation. Since the previous inspection water temperatures were being checked, and recorded, once per week, to ensure a speedy adjustment and comfortable water temperatures. The home was clean and fresh at the time of the inspection with appropriate laundry systems in place for the control of infection. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 29 The number and type of staff on duty enabled the needs of the residents to be met. Staff training was in accordance with the needs of residents and staff, and in accordance with the recommendations of Government guidance. Staff recruitment procedures were thorough, in accordance with legal requirements, and assisted in the protection of the residents from unsuitable staff. EVIDENCE: At the time of the inspection the number and type of staff on duty were meeting the needs of the residents and ensured that standards in relation to meals and cleanliness were maintained. According to information supplied by the home in the “pre – inspection questionnaire”, 75 of care staff were qualified to at least NVQ level 2. Therefore the target of 50 by the end of 2005, set by the national Minimum Standard, was exceeded. The staff records viewed showed that the home was adopting thorough staff recruitment procedures in accordance with the Care Homes Regulations and which contributed to the protection of residents from unsuitable staff. Staff training and development records were kept and showed that staff had attended a variety of relevant training courses in accordance with their own needs and those of the residents. These included the TOPSS based “Induction”, moving and handling training, first aid, infection control, food Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 20 hygiene and palliative care. Mr and Mrs Zephir, the previous owners, who are both qualified nurses in mental health, had delivered various in house courses Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 A competent, qualified and experienced person had run the home for over 15 years. She demonstrated a clear sense of direction and leadership and ensured that staff were well supervised and confident in their work. There was a system of quality monitoring, involving residents and relatives, which contributed to the service development. Residents’ monies were managed safely and the health and safety of the residents and staff were promoted in a safe environment. EVIDENCE: Mrs Sandra England had managed Manderley for over 15 years. She therefore had considerable relevant experience and skill. She also had the qualifications recommended by the National Minimum Standards. However at the time of the inspection, Mrs England was leaving her post as manager of Manderley and the new owner will inform the CSCI of the new management arrangements. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 22 There was an annual development plan based on aims and outcomes for residents, and which was based on the results of the home’s quality monitoring systems. These included the annual use of a pictorial questionnaire for residents and annual consultation with relatives and residents at the various meetings held. The CSCI was provided with the evaluation of the most recent survey, which showed positive views on all areas covered by the questions Residents’ monies were managed safely and appropriately. Accurate records were kept of the spending money received and spent by residents. However the records kept of the residents’ benefits and fees paid were not kept in the home at the time of the inspection. Residents’ spending money was kept in the home’s safe. Staff records viewed, and the member of staff spoken with, confirmed that staff were appropriately supervised. Members of staff met with the manager on a one to one basis every few months to talk about their work and receive guidance. Staff meetings were also held regularly. The manger and former owners of Manderley ensured that the health and safety of the residents and staff were safeguarded. Staff had training in moving and handling, first aid, food hygiene, fire safety and infection control. The records showed that the fire safety precautions were satisfactory. The gas and electrical installations and electrical appliances had been appropriately tested. Risk assessments had been undertaken on safe working practices. However the registered person must ensure that the home’s water system does not pose a threat of Legionella. Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 x 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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 OP38 Regulation 13(3) & (4)(a)&(c) Requirement The registered person must ensure that the home’s water system does not pose a threat of Legionella. Timescale for action 31/12/05 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 OP15 Good Practice Recommendations It was strongly recommended that the records of food served at supper - time is recorded, and that when food is blended individual parts of a meal are blended and presented separately. The registered person should notify the CSCI how the matter of two shared rooms under 16sq.m. will be addressed. 2 OP23 Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Manderley Residential Care Home DS0000064567.V251810.R01.S.doc Version 5.0 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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