Inspection on 18/07/07 for Mellish House Residential Home

This inspection was carried out on 18th July 2007.

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

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

Other inspections for this house

Mellish House Residential Home 19/06/06

Mellish House Residential Home 22/11/05

Mellish House Residential Home 28/01/05

Mellish House Residential Home 11/05/04

Mellish House Residential Home 20/01/04

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

CARE HOMES FOR OLDER PEOPLE Mellish House Residential Home Kings Hill Great Cornard Sudbury Suffolk CO10 0EH Lead Inspector John Goodship Key Unannounced Inspection 18th July 2007 09:50 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 Mellish House Residential Home DS0000024446.V346648.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. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mellish House Residential Home Address Kings Hill Great Cornard Sudbury Suffolk CO10 0EH 01787 372792 01787 377953 mellishhouse@caringhomes.org 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) Stour Sudbury Limited Suzanne Elizabeth McKeon Care Home 34 Category(ies) of Dementia - over 65 years of age (34) registration, with number of places Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th June 2006 Brief Description of the Service: Mellish House provides care for 34 older people who have dementia. The home is located in a residential area of Great Cornard on the outskirts of the market town of Sudbury. There is a Public House close by, and the town of Sudbury provides a range of shops and eating-places. The home shares grounds with another registered care home, which is also owned by Stour Sudbury Ltd. Mellish House is a purpose built home arranged on two floors. There is a passenger lift and stairs to the first floor, and ramped access to an enclosed garden. All thirty-four single rooms, which are located on both floors, have a wash hand basin and ensuite lavatory. Each floor has a dining room, lounge and two communal bathrooms and lavatories. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and covered the key standards which are listed under each outcome group overleaf. This report includes evidence gathered during the visit together with information already held by the Commission. The inspection took place on a weekday and lasted six hours. The manager was present throughout, together with staff on the morning shift and, later, those on the late shift. The inspector toured the home, and spoke to some of the residents and relatives, and the staff. The inspector also examined care plans, staff records, maintenance records and training records. A questionnaire survey was sent out by the Commission to residents and to relatives. Only two relatives responded. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. The manager also completed a pre-inspection questionnaire and information from that has been included where appropriate. What the service does well: Comments from the relatives who responded to the questionnaire included: “The unique thing about Mellish is that it manages to create the relaxed atmosphere of a true home for its residents and all the visitors notice this.” “All the residents appear to be treated as individuals with patience and respect. The good humour of the staff also goes a long way, not just with the residents but helping relatives and friends cope with a difficult situation.” “They are more caring than I expected them to be.” Residents can choose to move around the home to where they want to be freely within a very relaxed atmosphere. Information from relatives and other professionals as to how residents would like to be cared for is set out in detail. This includes resident’s likes and dislikes. The home employs a part time activity co-ordinator, who has created a varied programme of activities and games, with full recording of participation in each resident’s file. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 6 There is an in-company training unit which organises and delivers the majority of the training. What has improved since the last inspection? 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. Mellish House Residential Home DS0000024446.V346648.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 Mellish House Residential Home DS0000024446.V346648.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): 1,2,3,5. Standard 6 is not applicable to this home. Quality in this outcome area is good. Prospective residents can be assured that they will have sufficient information to decide if this home is where they wish to live. The home will also collect information to assure the person that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and the Service Users Guide had recently been revised as part of the home’s application to register fourteen additional rooms. This had been accepted as complete by the Commission. One relative confirmed that they had seen these documents when their relative had been admitted. The file for the most recent admission was examined. It contained the preadmission assessment covering the appropriate aspects of the person’s health Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 9 and social care needs, such as communications, mobility, nutrition, behaviour, and recreational and spiritual activities. Residents, or their advocates, were given a contract which set out the terms of residency. A copy of the contract was signed by both parties. Mellish House Residential Home DS0000024446.V346648.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): 7,8,9,10,11. Quality in this outcome area is good. Personal healthcare needs including specialist health, nursing and nutrition requirements are clearly recorded, with guidance for staff, to ensure that residents’ needs are met. Residents are protected by the home’s medication policy and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were examined. All but the most recent admission had a photograph attached. Each plan had a Summary at the front highlighting key aspects of the person’s needs and how they should be supported. Each aspect of the plan was reviewed monthly. One person had been reassessed in May 2007 because of changes in their continence needs. Another had been reviewed the same month for falls risk, following a number of incidents. Instructions had been given to staff on anticipating and preventing Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 11 falls. These were all recorded. Incidents and accidents were reported monthly to the provider for analysis. All residents were weighed monthly. The home had a weighing chair for the convenience and safety of residents. One resident had been weighed weekly during a chest infection. This person’s weight had now been stable since November 2006. The weight record of another resident showed a weight loss of 5 kilos over five months, but the weight had now stabilised. The home used the Malnutrition Universal Screening Tool to highlight changes in body mass index and to set down nutritional guidelines for each resident. A resident had been closely monitored over the previous twelve months because of concern over their weight loss and poor appetite. Weight recording, medication reviews, risk assessments and guidance to staff on encouraging them to eat seemed to have succeeded in halting the decline in weight. The record showed a stable weight, with the monthly diet sheet recording a good food intake. One resident’s plan recorded that staff should report any change in the person’s behaviour. This person was observed during the inspection. Staff were concerned at their behaviour and they were walking about in a distraught manner. It was decided to call the GP, who arrived after lunch and prescribed for an infection. The daily record had not always been completed at least twice a day earlier in the year, but recently recording had improved. It was now completed at the end of each shift. Sometimes standard phrases were used which seemed to correlate with the record being completed by a member of staff whose first language was not English. But the recording of factual information had improved since the last inspection. Both care plans examined contained information on the wishes of the resident or their close relative at the end of life. The home had received a letter of thanks from Addenbrookes Hospital praising swift action taken by home to observe the wishes of a deceased resident. The lunchtime medication round was observed in the first floor dining room. All administration was done with two people both of whom had been trained. The session was conducted in an unhurried way giving residents plenty of time to take their medication. A sample of Medication Administration Records were examined. All were completed fully with two signatures. Since the last inspection, the drug store room had been moved to enable a more constant temperature below 25°C to be maintained. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15. Quality in this outcome area is good. Residents are being offered a choice of activities. They are supported to maintain family and other contacts. They are offered a choice of nutritional meals with a choice of where they take them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information in the care plans gave a biographical account of each resident, including their interests. This was transferred to a plan for their social and recreational activities. The activities co-ordinator was on duty during the inspection. They described how they tried to find activities personal to each resident. She had found that working in a group was not very successful, so she always tried to support residents on a one-to-one basis. This was observed throughout the day, with her playing games with individuals, talking to them, and dancing with one person. There were examples on the walls of artwork done by some residents with support. One relative wrote: “The activities coordinator deserves a special mention for her untiring efforts to find interesting and fun things to do for Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 13 residents and social events for family and friends.” The provider had set up an opportunity for their activities co-ordinators to meet and share experiences of what worked, and to share best practice. The effect of this was apparent from previous inspections and from the records made by the Co-ordinator. She had also done the dementia awareness training. The home arranges some outside trips using a disabled access minibus from Community Start. The activities coordinator said that there had been a trip last week to a café in a nearby village. Seven residents went on the trip. The activities coordinator completed full records of the activities undertaken by each resident and these were inspected. At lunchtime a carer asked a resident if they wanted to go to the dining room. The person said they felt too tired so they were askd if they would like to have lunch in the lounge, which they did. Two others also ate in the lounge. The lunch menu was shepherds pie or macaroni cheese. All the residents in the first floor dining room had shepherds pie. All residents bar one were able to eat without support. Two residents had plate guards to assist them to eat. Three staff were on duty in the dining room and supervising those eating in the lounge. Visitors were welcomed in the home, and the monthly reports by the provider recorded their comments. All appreciated the care given. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 14 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): 16,18. Quality in this outcome area is good. Residents can be assured that their views will be listened to, taken seriously and acted upon. There is a proper policy, procedure and training programme in place to give residents confidence that they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints log was inspected. There were four concerns reported in 2007 which had been investigated and sorted out by the manager to the satisfaction of the resident or relative. They covered missing items of clothing or personal belongings, and,in one case, food left on the floor. A member of staff had been disciplined over the latter matter. There was a notice on the board regarding the providers whistle-blowing policy. It displayed prominently the phone number of the responsible senior officer in the organisation who staff should ring in confidence. In addition there had been one complaint to the Commission about the smell in a resident’s room, and lack of cleaning to remove it. This was investigated during a random inspection. The resident was prone to erratic urination. There was no reference to the particular instances in the daily record, nor any guidance to staff on preventing or treating this problem. The home was required to regularly review care plans to reflect the changes in residents’ care Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 15 needs and to set programmes for meeting those needs. This had been actioned. Two staff files which were examined contained a record of the training sessions on adult protection which staff had received. These were repeated annually. Also kept in the files were the test questionnaires completed by staff at the end of each training session. A member of staff was asked how they would react to seeing or suspecting any form of abuse. They were able to give the appropriate response. Mellish House Residential Home DS0000024446.V346648.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): 19,20,25,26. Quality in this outcome area is good. Residents and relatives can be assured that the home provides a comfortable and well-maintained environment and that the home is clean and odour free. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An extension was being built on the end of the home to provide 14 additional resident rooms and associated facilities. This extension may be visited by the Commission when it is complete to assess its suitability for registration. On the day of the inspection, some breaking through was in progress. There was a degree of noise, although this was decreased when the corridor doors were closed. Two rooms closest to the extension work had been vacated and the residents moved to vacant rooms. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 17 When completed, existing residents would be moved into these new rooms while the rest of the home was refurbished. This would include a new laundry room, a new boiler and re-carpeting. In addition the home had obtained a government grant to improve bathroom facilities, new flooring in the dining areas, and a sensory garden. New closers linked to the fire alarm had been fitted to all doors following a visit from the Fire Service in November 2006. All room doors had the names of each occupant in large print against a background which reflected an interest of theirs. The walls of rooms were decorated in deeper colours than other surfaces to allow residents to differentiate. The front door had a keypad entry system which required all visitors and residents to be let in and out by staff. However the other external doors around the buiding were linked to the call system, so alerting staff if a resident went into the garden. This happened several times during the inspection and it was noted that staff reacted very quickly. The inspector was able to discuss with a member of the domestic staff the methods used to maintain the cleanliness and atmosphere of the home. He was aware of those residents who needed surveillance of rooms for staining and odours. Control measures were in place and in only one room was a faint unpleasant odour detected. One room had been refloored with laminate to improve hygiene but it retained a homely feel. Mellish House Residential Home DS0000024446.V346648.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): 27,28,29,30. Quality in this outcome area is adequate. Residents and relatives can be assured that residents’ needs will be met by the numbers and skill mix of staff and that the home will provide training to ensure that the staff are competent to do their jobs. They cannot yet be assured that all staff are able to communicate appropriately with residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a ratio of 1:5 staff on duty during the daytime. On the day of the inspection there were five care assistants and two seniors on duty. Three staff covered nights with one of them always being a senior. The files for two recently appointed staff were examined. Both contained all the recruitment and identification documents required. For one person, one reference came from Poland, the other from the UK. Polish language documents had been translated by a registered agency. Most care assistants in the home did not have English as their first language. Most originated from Poland and the Philippines. In the interview notes for one of the new starters was written: “English is quite good.” However when the inspector spoke to this person, they had great difficulty understanding what was being asked. Another member of staff was slow to comprehend the Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 19 inspector’s questions although they were able to give good information about residents. In particular this person was able to understand and explain the procedure for the protection of vulnerable adults. When it was lunchtime, a carer came into the first floor lounge and clapped her hands to get residents to start getting up to go to the dining room. Her lack of fluent English meant that she used short words and phrases which on first hearing seemed sharp. However, the staff member’s manner was kindly but their actions were somewhat institutional. This person was not wearing a name badge. The manager explained that it had not yet arrived. A relative said that it was confusing for residents when the staff spoke to each other in Polish. The senior carers and the deputy manager were able to help the non-English speakers with their communications but it was of concern that a specialist dementia unit relies so heavily on some staff who are not fluent in speaking or understanding English. Some staff were attending language lessons, but this would take time to improve the situation. Training records were up-to-date for all staff. The provider had their own training organisation so induction training and mandatory course were held inhouse with a trainer. Other courses covered pressure area care, dementia awareness (one day), and infection control. There were notices in the home with lists of staff attending tissue viability and fire training in July 2007. Certificates were issued for training. Some staff were working through the Dementia training pack produced by the Alzheimer’s Society with video and training manual covering topics at NVQ Level 2. Only 28 of care staff were qualified to NVQ Level 2 or above. Mellish House Residential Home DS0000024446.V346648.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): 31,32,33,35,36,38. Quality in this outcome area is good. There is appropriate leadership providing staff with guidance and direction to ensure that residents receive consistent good care. The system of auditing, and the regular maintenance checks ensure that the home is safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager was registered by the Commission in 2003 and had been working in the home for some years prior to that. She had gained the NVQ Level 4 in care and management. The management style of the home was open and informal. Residents were able to enter the manager’s office if they wished, and one did so several times during the inspection. After all, this was part of their home. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 21 Since the last key inspection, the home had been visited by the Fire Officer, and the Health and Safety Officer. New door closers had been fitted, and a sticker placed on a patio door to prevent a person accidentally walking into it. The fire risk assessment had been revised to take account of the building work. The fire log showed that the fire alarms were tested weekly. During the inspection, the fire alarms were inadvertently set off several times by the builders, in spite of precautions. Staff reacted correctly and calmly, and attended to those residents who were worried by the noise. Hot water temperatures had been regularly checked until the maintenance man left at the end of May. When this was pointed out, the deputy manager immediately did a check which showed no temperature was outside the safe range. The manager agreed to arrange for regular checks to be made by care staff until the replacement maintenance person started. Although there was a programme of supervision sessions for staff, this was behind schedule. The provider had a comprehensive quality assurance process. A monthly visit report by the Regional Manager acted as the report required by Regulation 26 of the Care Homes Regulations. It was also a useful management document identifying the need for action and whose responsibility it was to take action. There was a system of monthly audits by the manager and regional staff, with a full audit of the home annually. There were numerous audits including cash, care records, training, and medication. Questionnaires were sent annually to residents and to relatives, and to staff. The latest one was issued in May but the manager said no analysis had yet been made of the comments. The home did not hold any money on behalf of residents. All residents, or their representatives, were invoiced for fees and extras such as hairdressing. Mellish House Residential Home DS0000024446.V346648.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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 2 X 3 Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP27 OP28 OP36 Good Practice Recommendations All staff should be able to communicate appropriately with residents and should be able to be understood by them. At least 50 of care staff should be qualified to NVQ Level 2 or above. All staff should receive regular supervision sessions. Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Mellish House Residential Home DS0000024446.V346648.R01.S.doc Version 5.2 Page 25 - 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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