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Inspection on 26/04/07 for Melrose Residential Home

Also see our care home review for Melrose Residential Home for more information

This inspection was carried out on 26th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Melrose has a good staff team who work well together as a team, residents spoke well of the care they receive saying that both the manager and staff are very approachable. There comments included, "the staff are very good and look after everything well". "I am very happy, the staff are very kind". There is a relaxed friendly atmosphere in the home and residents are happy with the care they receive. Residents said they are happy with the meals they receive and were able to have some say in food provided.

What has improved since the last inspection?

More staff have completed NVQ2 six are registered to complete NVQ3. Garden areas have been tidied up and some areas of the home have been redecorated.

What the care home could do better:

Care plans need to detail more clearly the actions to be taken to meet residents assessed needs. Assessments and care planning should be more person centred and contain information regarding social interests and background. Medication policies and procedures should be followed by staff dispensing medication. When dispensing medication staff should ensure it is taken. All medication received into the home must be properly recorded. There needs to be an effective programme of renewal and maintenance in place to ensure areas which need repairing are attended to when needed. All persons working in the home must receive appropriate clearances and vetting before taking up post. Better internal quality assurance and development plans need to be put in place, which canvas the views of residents. A programme of staff supervision needs to be undertaken and records of this kept. As following the previous inspection there are concerns regarding communication between the registered providers and the manager, previous recommendation for management meetings have not been acted upon. Information does not appear to be shared by the providers with the homes manager. It is felt that the manager should be given the information and tools to more effectively manage the home.

CARE HOMES FOR OLDER PEOPLE Melrose Residential Home 50 Moss Lane Leyland Preston Lancashire PR25 4SH Lead Inspector Mr Patrick Rooney Unannounced Inspection 26th April 2007 10:00 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 Melrose Residential Home DS0000039455.V335140.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. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Melrose Residential Home Address 50 Moss Lane Leyland Preston Lancashire PR25 4SH 01772 434638 F/P 01772 434638 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) Mrs Amina Makda Miss Shazmeen Makda Mrs Janet Lesley Turner Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (1) of places Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered in the category Old Age, not falling into any other category (OP) for 25 persons, and one named person in the category of Physical Disability (PD). The total numbers in the home are not to exceed 26 Date of last inspection 11th May 2006 Brief Description of the Service: Melrose is a care home providing personal care and accommodation for up to 26 older people. Nursing care is not provided by the home and the district nursing team undertakes any nursing intervention needed. Melrose is privately owned and is situated close to the town centre of Leyland with all the local amenities. The home provides accommodation on three floors in both shared and single rooms. The majority of the shared rooms have a single occupant. One single room has an en-suite facility. The communal areas are situated on the ground floors and the home has a passenger lift and stair lift. The grounds to the house are small but adequate for the service users to enjoy. Fees for a place in the home range from £313 to £382.50 Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a seven-hour period. This inspection was the key inspection for the current year. At the time of the inspection there were sixteen persons living at the home. During the inspection the inspector spoke to the registered manager, looked at care plans for four residents and discussed their care with them. Other residents and two visitors were also spoken to about the care provided by the home. Three residents completed and returned questionnaires. Two staff were interviewed separately and other staff were spoken to. In addition, policies, procedures and records were examined. A tour of the whole building was carried out. A pre inspection questionnaire was completed and returned by the manager. What the service does well: Melrose has a good staff team who work well together as a team, residents spoke well of the care they receive saying that both the manager and staff are very approachable. There comments included, “the staff are very good and look after everything well”. “I am very happy, the staff are very kind”. There is a relaxed friendly atmosphere in the home and residents are happy with the care they receive. Residents said they are happy with the meals they receive and were able to have some say in food provided. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Care plans need to detail more clearly the actions to be taken to meet residents assessed needs. Assessments and care planning should be more person centred and contain information regarding social interests and background. Medication policies and procedures should be followed by staff dispensing medication. When dispensing medication staff should ensure it is taken. All medication received into the home must be properly recorded. There needs to be an effective programme of renewal and maintenance in place to ensure areas which need repairing are attended to when needed. All persons working in the home must receive appropriate clearances and vetting before taking up post. Better internal quality assurance and development plans need to be put in place, which canvas the views of residents. A programme of staff supervision needs to be undertaken and records of this kept. As following the previous inspection there are concerns regarding communication between the registered providers and the manager, previous recommendation for management meetings have not been acted upon. Information does not appear to be shared by the providers with the homes manager. It is felt that the manager should be given the information and tools to more effectively manage the home. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 7 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. Melrose Residential Home DS0000039455.V335140.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 Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information provided by the home has been reviewed and updated the Statement of purpose and service users guide provides good information about facilities and services provided by the home. Pre admission needs assessments are thorough and care needs clearly identified. However social interests, hobbies and cultural needs information was lacking. EVIDENCE: A service users guide has been produced, this was seen and is relevant to services provided by Melrose and is laid out in a clear and understandable format for residents. During a tour of all residents rooms it was observed that Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 10 the service user guide has been provided to all residents. Residents spoken to also confirmed that they have received the service users guide. Files of four residents were looked at and these persons were spoken to by the inspector. An initial needs assessment had taken place and there was good information about the care needs of residents. There is a section in the assessment process for a personal profile, however in formation contained in these was very brief and did not include previous histories, social interests, hobbies, religious or cultural needs. This is an area which requires some work and a reccommendation is made regarding this. It is noted that this was discussed at the last inspection. While there are good systems in place for assessment these are not being fully utilised. Risk assessments and nutritional assessmtents have been improved and clearly indicate care required for each resident. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. There is a good care planning systems in place, however not all assessed needs are contained in the care plans. Policies and procedures are in place to ensure the safe recording and handling of medication however these are not always followed. Residents right to privacy is upheld by the home. EVIDENCE: Care plans were looked at for four residents and their care was discussed with them. Residents looked well care for and said that they are happy with the Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 12 care they receive. Comments received were “the staff are very good and look after everything well”. “I am very happy, the staff are very kind”. While residents looked well cared for and staff were aware of care needs, these are not always documented in the care plans. One resident, who it was stated as being at risk of pressures sores and requiring turning every two hours, did not have nay detail of this recorded in the care plans or daily records. It was also recommended that monthly weighing and nutritional monitoring should take place, these were not consistently recorded. With regard to the same resident bed rails were being used without a full assessment including other professional/medical advice being obtained. Other areas documented in assessments were not fully generated into the care plans viewed. There was also little information regarding social interests, hobbies, religious and cultural needs. The manager and staff are aware of individual needs and accepted that these are not always recorded however it accepted that these must be more fully documented to ensure that there is good continuity of care and that any new staff are fully aware of care plans. There are policies and procedures in place for administration of medication and designated staff who have received training are responsible for giving out medication. However it was observed that these procedures are not always being followed. In one case it was noticed that the resident had not taken a tablet and in another two pots containing different tablets were seen in the residents room. When dispensing medication staff must always check the record, give the medication and ensure that it is taken. When looking at the medication records and medication trolley it was noted that in one case the quantity of medication received was not recorded and dated. Eye drops, which should be discarded one month after opening, did not have the date of opening recorded. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Daily routines are flexible and respect individual needs and wishes. There is a need to ensure a more varied programme of activities to ensure residents interests and hobbies are included. Meals are good and residents are able to have input into formulation of menus. EVIDENCE: The records record of activities was discussed since the last inspection there has been a decline in activities offered. There needs to be an appraisal of what activities can be offered based on a knowledge of the background and interests of reside4nts currently at the home. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 14 Residents said that daily routines are flexible and that they are able to make decisions about when they get up or go to bed, meal times can be flexible and residents have the choice of eating in the dining room or in the privacy of their own rooms. There was a relaxed atmosphere within the home and good interaction between resident and staff was observed. The home has a clear policy regarding visitors and residents told the inspector that all their visitors are made welcome and are provided with refreshments and privacy. A signing in book is provided at the entrance and is signed by visitors. Menus seen showed that a balanced nutritious diet is offered to residents. Resident’s preferences are clearly recorded and residents told the inspector the food is very good and they are offered choices. A meal was observed during the inspection, this was of good standard and well presented, the mealtime was relaxed and assistance given as and when necessary. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a suitable complaints procedure, which is available to residents. The policies, procedures and training in protection provided by the home have improved. EVIDENCE: The complaints procedure has been reviewed and includes information about the registered providers, the Commission for Social Care Inspection and the Ombudsman. This is available on the homes notice board and is contained in the service users guide, which is in all residents’ rooms. Residents told the inspector and said they are aware of the complaints procedure. All residents spoken to say that they find the manager very approachable and are confident any concerns they raise will be dealt with appropriately. The record of complaints was seen and one complaint was recorded, which had been dealt with in accordance with the homes policy. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 16 There are and procedures in place regarding adult protection and whistle blowing. Since the last inspection almost all staff have received training in the protection of vulnerable adults, records of this were seen. Staff spoken to were aware of the adult protection and whistle blowing procedures and felt confident to approach the manager if they had any concerns. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There has been improvement in decoration, however there is still no adequate repair and maintenance system in place. The home is clean and tidy, however procedures for disposal of incontinence pads need to be followed. EVIDENCE: A tour of the building took place and records were consulted. Nine bedrooms, the hallway and conservatory have been repainted. Old curtains and duvet covers referred to in the last report have still not been replaced. A record was Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 18 made in the repair log in November 2006 regarding leaking and wall damage in the downstairs toilet. Repairs to this have still not been completed and the wall behind the toilet has most of the tiles off. This needs completing urgently, to ensure cleanliness of surfaces can be properly maintained. An open rubbish bin containing used incontinence pads was seen in this toilet. Incontinence pads must always be placed in a closed container and appropriately bagged prior to disposal. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers of staff with training and experience provide a good mix of skills to meet resident’s. Recruitment procedures were not sufficiently robust to protect residents. EVIDENCE: Rotas showed that there is always a good mix of experienced staff on duty to see to the needs of residents in the home. Two night staff visiting to register for NVQ3 training were interviewed at the time of the inspection and staff on duty were spoken to all said they were happy working at the home and felt they are supported in this by the manager. A suitable induction programme had been carried out for new members of staff. Out of 18 members of staff 14 currently are qualified to NVQ2 and 6 have registered to complete NVQ3. This has been a big improvement as there are now 75 of staff with this qualification. Recruitment procedures are in place to ensure suitability of potential staff members and a checklist is in place to monitor applications. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 20 On examination of staff records it was noted that one member of staff had begun working at the home before suitable clearances had been obtained. In this case there had been a mistake in the persons name and CRB forms had to be returned before a clearance could be completed, however this member of staff took up post one month prior to this clearance being received. The manager acknowledged this was a mistake and that in normal circumstances staff take up post following clearances being received It was noted that a gardener handyman has been working at the home who is not known to the manager or staff; this person was brought to the home by the owners of the home. There was no file available regarding this person or any record of a CRB clearance. All staff must have had at least a POVA clearance before taking up post and then must work supervised until the full CRB clearance is obtained. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The lines of accountability between the registered manager and the proprietors are unclear; there is no annual development plan for the home. A staff supervision and appraisal system has been introduced but not fully implemented. EVIDENCE: The registered manager is qualified and experienced to run a care home and has received further training in adult protection, care of people with dementia and the management of medicines. All care staff who were spoken to were happy with their relationship with the manager and said they were confident in approaching her with any concerns they have. They felt that lines of accountability between them and the manager are clear. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 22 Since the last inspection the registered provider has made regular visits and has sent to the Commission monthly regulation 26 reports, however in discussion with staff in the home it is still apparent that communication between the home and the registered providers is still poor. Management meetings had been introduced to improve this, but since the last inspection these have not been regular and there were no records available regarding them or any outcomes decided. There has been some decorating carried out though previous needs identified for refurbishment such as new curtains and bedding have not been fully implemented. Currently when things that need replacing or repairing are identified only partial actions are taken to rectify them and there is little consultation with staff or residents. When repairs are reported there are long delays before any action is taken and the manager is unable to access anyone to carry out repairs. It is essential that the manager needs to be provided with the information and tools to effectively manage the home from day to day. There is still a lack of budgets available to ensure necessary repairs and renovations are carried out. No annual development plan was available at the inspection. There is a quality audit system in however the last audit took place some time ago. The home has received the Investors in People award, though their recent assessment for this states that the home needs a strategy to improve organisation and develop a clear purpose and vision. If the home is to be able to do this there needs to be a better coordination between the registered provider and manager of the home. There are systems in place to ensure any valuables and money kept on behalf of residents are kept safely and good records are maintained of this. The manager had previously begun a system of supervision and appraisal for staff, however at the time of the inspection there were no records available to show this was being carried out. Further input is required to ensure staff receive regular individual supervision and records maintained of this. From training records it was seen that there is training in safe working practices and there are policies and procedures in place relating to health and safety. A fire risk assessment is in place and maintenance records for electricity and electrical items were in order. Emergency lighting is regularly checked. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 23 Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 24 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 2 X 3 Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 25 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 OP7 Regulation 15(1) Requirement The registered manager must ensure the service users plan details how the service users assessed needs in respect of health and welfare are to be met The registered manager must ensure that medication procedure are followed properly and provide re training for staff administering medication The registered provider must ensure there is and effective programme of maintenance and renewal in place. The registered manager must ensure incontinence pads are disposed of appropriately and that suitable closed bins are provided for this. The registered manager must ensure that all persons working at the home have been appropriately cleared. The registered persons must ensure there is a development plan in place and that regular surveys take place The registered manager must ensure there is a programme of DS0000039455.V335140.R01.S.doc Timescale for action 31/05/07 2 OP9 13(2) 31/05/07 3 OP19 16(2)(c) 31/05/07 4 OP26 13(3) 31/05/07 5 OP29 19(1) 31/05/07 6 OP33 24 30/06/07 7 OP36 18(2) 31/05/07 Melrose Residential Home Version 5.2 Page 26 supervision in place and records maintained of supervision 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 OP3 OP12 OP31 Good Practice Recommendations Assessments should be more person centre and contain information about social and cultural background and needs. An appraisal of what activities can be offered based on a knowledge of the background and interests of residents should take place and appropriate activities provided. The registered manager should be given the information and tools to effectively manage the home. Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Melrose Residential Home DS0000039455.V335140.R01.S.doc Version 5.2 Page 28 - 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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