Inspection on 10/11/05 for Mount Denys

This inspection was carried out on 10th November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mount Denys 26/11/07

Mount Denys 30/05/06

Mount Denys 26/04/05

Mount Denys 19/11/04

Mount Denys 18/05/04

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

CARE HOMES FOR OLDER PEOPLE Mount Denys 187 The Ridge Hastings East Sussex TN34 2HE Lead Inspector Judy Gossedge Unannounced Inspection 10th November 2005 11:00 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 Mount Denys DS0000041274.V249608.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. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mount Denys Address 187 The Ridge Hastings East Sussex TN34 2HE 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) 01424 421353 01424 421925 East Sussex County Council Vacant Care Home 31 Category(ies) of Dementia - over 65 years of age (31) registration, with number of places Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. A maximum of thirty-one (31) service users to be accommodated. That service users must be aged sixty-five (65) years or over on admission. That only service users with a dementia type illness are to be accommodated. That five (5) places will be available for service users between the age of fifty-five (55) and sixty-four (64). That one named service user who has been assessed as requiring nursing care be accommodated. That one named service user with mental health issues can be accommodated. 26th April 2005 Date of last inspection Brief Description of the Service: Mount Denys is a purpose built property run by East Sussex County Council (ESCC), adjacent to Pinehill Day Care Centre on the outskirts of Hastings and approximately two miles from the town centre. Mount Denys operates as a specialist service for older people with dementia in Hastings and Rother. Bexhill and Rother, and Hastings and St Leonards Primary Care Trusts commission the service, with the care managed by ESCC. Service user accommodation is on two floors and comprises of thirty-one single bedrooms on three units within the home. Two units of ten beds and one unit of eleven beds which provide accomodation for a mixture of long, short stay, respite care and periods of assessment. Each unit has a dining and lounge area for service users to use. Additionally there is a large lounge area on the ground floor and an additional separate lounge on the first. There are sufficent toilet facilities and assisted bathing facilities on each of the units. Level access facilitated in the home with the provision of a passenger lift. There is a garden at the rear of the home. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over seven hours on 10 November 2005. This is the second statutory inspection for the year and should be read in conjunction with the first inspection carried out on 25 April 2005 to give an overview of all the standards to be assessed within this period. At the time of the inspection the home was undergoing extensive refurbishment of the large downstairs lounge and garden, which are not accessible to service users whilst this work is being completed. This has not been an easy time for service users and staff with building work being carried out and restricted access to facilities. Where possible during this occupancy has been reduced. A partial tour of the premises took place including the remaining communal areas and a selection of service users bedrooms. Rotas and care records were also inspected. Twenty-six service users were resident and one was spoken with individually in a communal area. Due to communication difficulties it was not possible to speak to all service users individually, and so the opportunity was also taken to observe the interaction between staff and service users in the communal areas. The Manager, eight care workers, the agency catering staff and one relative a regular visitor each day to the home was spoken with. Comment cards were also left for service users and their carers and representatives to complete after the inspection if they wished. The CSCI has sent separate correspondence to the Responsible Individual for ESCC to raise concerns at the recruitment processes and lack of evidence of recruitment documentation in place on site for all its registered services. ESCC Older Peoples Services has gone through a re-structuring exercise and a new Manager started to work at Mount Denys in September 2005, moving from another ESCC residential home. The CSCI are awaiting an application for a Registered Manager for the home. The Manager stated she is in the process of reviewing systems and procedures in the home and it was not possible to evidence on the day all the required information. What the service does well: Staff were observed to deliver care with dignity and respect. The relative and service user commented that they were pleased with the overall care provided in the home. The relative also commented that staff are very welcoming, that staff always had time for them, and that they felt they were kept informed on the care provided to their relative. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 6 There was evidence that service users are enabled to have choice and flexibility in daily routines, meals and activities. There is a detailed complaints procedure in place which the service user and the relative felt comfortable about using if they needed to. What has improved since the last inspection? What they could do better: The Statement of Purpose, Service Users Guide and inspection reports need to be fully accessible in the home. The contract between ESCC and the service user must to be fully completed. Individual care plans need to be developed to give staff guidance on the care to be provided and ensure that all service users health and social care needs are met. Where medication is administered the recording to support this activity must be maintained. Bathrooms and toilets are made more homely and the décor, furnishings and carpeting is improved in the bedrooms. Service users are protected with the exposed hot pipes in the bathrooms being guarded. Recruitment procedures and staff information needs to be held in the home to evidence this is in place to meet requirements to ensure the safety and welfare of service users. Recording needs to be in place to demonstrate the health and safety training that staff have completed. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 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. Mount Denys DS0000041274.V249608.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 Mount Denys DS0000041274.V249608.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, 2, 3 and 6. There is detailed information about Mount Denys available to be viewed prior to any admission to the home. But this needs to be fully visible and accessible in the home for service users and their representatives to reference if they wish. To protect service users the written contract/terms and conditions should be fully completed. There are pre-admission procedures in place to ensure that service users on planned admissions are appropriately placed at Mount Denys. EVIDENCE: A detailed Statement of Purpose, Service Users Guide and a copy of the inspection report is available to view with other supporting information in the entrance to the home. The Manager stated that it is intended to decorate the entrance and have information displayed. This information needs to be more visible and accessible for service users and their representatives whilst this is being achieved. Feedback on the service provided from existing service users Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 10 and carers is in the process of being collated for prospective service users and their representatives to view and assist with their choice of home. ESCC has a written contract to be used between the home and the service user. The Manager stated that the contracts have not all had been completed as ESCC requires and is in the process of addressing this to ensure these are fully completed. The bedroom to be occupied is not always recorded and should be. Prior to admission to the home service users are assessed primarily by the Community Mental Health Team, or a Social Care Assessment is completed by staff from one of ESCC Social Services Department’s Assessment Teams. A copy of the assessment is then forwarded to the home. There was only one new service user at Mount Denys at the time of the inspection and the preadmission information had been received. Staff confirmed that they had also visited the service user prior to admission to gain information to help them provide the required care. Intermediate or rehabilitative care is not provided. Mount Denys DS0000041274.V249608.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, 9 and 10. Individual care plans need to be developed to provide staff with all the information they need to ensure that service users’ health and social care needs are met. ESCC has detailed policies and procedures in place to manage medicines, which need to be followed to ensure the protection of service users. The care service users receive ensures that their privacy and dignity is maintained whilst resident in the home. EVIDENCE: Using the initial assessment of need individual plans of care are compiled for each service user and a selection of these care plans were examined. Individual care plans viewed did always give staff guidance on all the areas of care as required or was detailed in supporting information. Where service users had been admitted with dietary needs there was limited information as to what their dietary needs would be during their stay. One care plan viewed did not have a falls risk assessment in place. The care plans should be Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 12 regularly reviewed to meet to identify any changing care needs of service users and this is recorded. It was observed during the inspection that personal care is provided with dignity and respect. The service user spoke very well of the care provided by staff in the home. The relative stated ‘I am very, very happy with the care provided. I do not think it will be as good as elsewhere.’ ESCC medication policies and procedures and those local to Mount Denys are in place are in the process of being reviewed. Staff are still in the process of receiving further medication training. The storage and a sample of the recording of the administration of medication was viewed, and on one unit the process of administration was also observed. A number of omissions in the recording of administration of medication were seen. This was discussed with the Manager and an Immediate Requirement Form was left for this issue to be addressed. Mount Denys DS0000041274.V249608.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): 13, 14 and 15. There is flexible visiting in the home and visitors to the home are welcomed. The meals in the home offer both choice and variety and special dietary needs can be catered for. EVIDENCE: The service user and relative spoken with confirmed that there is flexible visiting at the home, and that staff are always welcoming. The care and support provided was seen to enable service users were possible to exercise choice whilst at Mount Denys. An independent supplier of frozen foods is used to provide the lunch in the home. A seasonally varied rotating menu was seen. Staff had made a selection from the menu for service users at lunch-time. Staff have previously spoken of an awareness of individual likes and dislikes of meals provided and of the different textures of food which has been observed over a period of time, thereby allowing them to make appropriate choices where a service user is not able to do this for themselves. Lunch was sausages in gravy with boiled potatoes, swede and green beans, vegetable lasagne, apple crumble and Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 14 custard. Special diets are catered for. The lunchtime was unhurried and service users were observed to have sufficient time to eat their meal. They appeared to be enjoying their meal and several were being assisted by the care staff. The service user spoke well of the food provided. Mount Denys DS0000041274.V249608.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 and 18. There is a clear and effective complaints procedure in place which enables service users and their representatives to raise any concerns. There are detailed policies and procedures in place to protect service users from abuse. EVIDENCE: ESCC has a detailed compliments and complaints policy and procedure in place. Any complaints received are monitored through the line management arrangements in place within the organisation. No complaints have been received since the last inspection. The CSCI have not received any complaints in relation to Mount Denys. There are detailed policies and procedures in place in relation to vulnerable adults. Two of the care staff spoken with confirmed that they had received training in adult protection procedures. There has been one incident in the home which has been satisfactorily investigated under adult protection procedures. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23 and 25. The standard of the environment is generally poor and does not provide service users with a safe, attractive and homely place to live. EVIDENCE: The standard of décor, carpeting and furnishings are generally poor in the majority of the home. Since a requirement was made following previous inspections a plan of redecoration has been drawn up for this financial year 2005/2006. At the time of the inspection there were major building works taking place on the ground floor in the large lounge and garden both of which were not accessible. Additionally one of the downstairs units was due to be closed the following week to enable redecoration of the corridor. The CSCI have been informed that all corridor areas and kitchen/dining rooms and the entrance to the home are to be redecorated, the upstairs kitchen replaced and all corridors will also be re-carpeted. Currently there are no plans to refurbish the bathroom and toilet areas and bedrooms. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 17 There are thirty-one single bedrooms of which twenty do not meet the minimum space requirements. Service users are unable to control the temperature in their own bedrooms. The CSCI has been informed that the system in place does not allow for this facility to be provided. Several of the bedrooms were seen and reflected a range of individual styles and interests. All bedrooms have a call bell system linked to an alarm, which is turned off at the main control panel rather than in the service users bedroom. Additional to the large communal area on the ground floor are further kitchen/dining rooms and lounge space on each of the units. One bedroom has an en-suite facility, and there are sufficient toilets, and a selection of assisted bathing facilities in the home. Bathrooms and toilets are not homely and the décor is poor. Hot water was tested in nine wash hand basins and baths used by service users and were all close to the recommended safe temperature of 43°C. In two of the bathrooms hot pipes were exposed and an Immediate Requirement form was left. Confirmation has been provided that the Water Supply Regulations 1999 are met. The recording of routine fire checks undertaken was viewed and now details the checks undertaken. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29. There is a stabile staff team in the home, which has lead to consistency in communication and the care provided. Opportunities have been provided for staff to undertake the required NVQ training. ESCC recruitment policies and procedures need to be followed in order to protect service users. EVIDENCE: Staffing on the day was adequate to meet the personal care needs and staff spoken with and records viewed confirmed that this staffing level is maintained. There is a stable staff team and there has been no recruitment since the last inspection. All staff again spoke very well of working in the home, of a good staff team working well together and of good communication systems in place. The relative also confirmed that there appeared to be adequate staff on duty and of good communication. Staff spoke of the difficulties in providing care whist the building works are being completed in the home. But that staff had met as a group to discuss ways to minimise the disruption in the home. That next week when it is expected to be particularly difficult extra staffing and transport has been arranged to enable service user to go out on trips from the home. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 19 It was not possible to evidence on the day but the Manager has subsequently confirmed that fifty percent of care staff hold an NVQ level 2 in care. All recruitment is co-ordinated by the personnel section at ESCC’s head office, which the Inspector has visited and viewed sample documentation across the organisation’s registered services to support the recruitment process in place. Some gaps in the required documentation were found which need to be addressed. The Manager was not able to confirm that all staff now have a satisfactory Criminal Records Bureau (CRB) check in place. In future recruitment documentation will need to be available at the home as part of any inspection completed. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. The ESCC quality assurance plan needs to be fully implemented in the home to ensure the quality of the service is provided. Satisfactory arrangements need to be put in place to demonstrate that the health, safety and welfare of service users and staff is ensured. EVIDENCE: Following a recent restructuring within the organisation a new Manager from another ESCC residential home has recently commenced working at Mount Denys. The Manager has worked for East Sussex County Council for many years as a senior manager, and has completed the Registered Managers Award. Confirmation will need to be provided as to how the remaining training requirements will be met. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 21 Quality assurance plans are in place and the Manager stated and evidenced that she is now implementing this. There are opportunities for service users and carers to put forward their views about the home and the care that they receive. This feedback is in the process of being collated and available to view. A small ‘float’ is held for a couple of service users and the records to support this activity were adequate. Three care staff spoken with confirmed that they received regular individual supervision and that there are unit and staff meetings. It was not possible to evidence on the day that care staff had received the required health and safety training: Moving and handling, first aid, basic food hygiene and infection control. The organisation has put forward proposals to provide staff with fire training to meet requirements. The Manager had not received this information and as yet this has not been implemented. The Manager has stated that she is in the process of updating these records. The organisation has now implemented a system to evidence that the maintenance of equipment and services has been carried out. Following an ESCC Fire Officers visit to the home confirmation has been requested that areas highlighted have been addressed. A sample of the incident and accident forms completed were viewed. The Manager stated these are in the process of being collated to enable easier access and the ability to identify any issues or trends. Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 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 2 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X 3 X 2 X STAFFING Standard No Score 27 3 28 3 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 3 X 1 Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4 (2) 5 (1) (d) 5 (1) (c) 15 (1) Requirement That the Statement of Purpose, Service Users Guide and last inspection report are visible and accessible in the entrance hall. That the contracts are fully completed That a system is in place to ensure that a written plan as to how the service users needs in respect to their health and welfare are to be met is in place. These are subject to regular review and this is recorded. The recording of administration of medication is maintained. This issue is outstanding since 30.06.05. That a review is undertaken of the carpeting, decor and furnishings in the bathrooms, toilets and bedrooms. Where necessary redecoration, repairs or replacements to be effected. The CSCI will receive confirmation of how this will be addressed. That the exposed hot water pipes in the bathrooms are covered. DS0000041274.V249608.R01.S.doc Timescale for action 31/12/05 2 3 OP2 OP7 31/12/05 31/12/05 4 OP9 13 (2) 10/11/05 5 OP19 23 (2) (d) 28/02/06 6 OP25 13 (4) (a) 10/11/05 Mount Denys Version 5.0 Page 24 7 OP27 19 (1) (b) (i) That information required to demonstrate recruitment procedures is in place. That evidence is provided to confirm that existing staff have completed a satisfactory Criminal Records Bureau check. This issue is outstanding since 31.01.05 and 30.06.05. That confirmation is provided of how the Manager will meet the training requirements. That confirmation is provided that staff have received the required updates in moving and handling, basic food hygiene, infection control, and first aid. This issue is outstanding since 30.06.05. That suitable training in fire prevention is provided to all staff. This issue is outstanding since 31.01.05 and 30.06.05. That confirmation is received that the areas highlighted by the ESCC Fire officer have been addressed. 01/01/06 8 9 OP31 OP38 18 (1) (a) 18 ( c) (i) 31/01/06 28/02/06 10 OP38 23 (4) (d) 28/02/05 11 OP38 23 (4) (a) 28/02/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Mount Denys DS0000041274.V249608.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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