Inspection on 24/05/05 for Nightingale House

This inspection was carried out on 24th May 2005.

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

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

Other inspections for this house

Nightingale House 13/10/09

Nightingale House 14/09/07

Nightingale House 13/04/06

Nightingale House 01/10/05

Nightingale House 03/09/04

Nightingale House 19/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE NIGHTINGALE HOUSE 22 Elgin Road London N22 4UE Lead Inspector Peter Illes Announced 24th May 2005 @ 09:30 am 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 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. NIGHTINGALE HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service Nightingale House Address 22 Elgin Road, London, N22 4UE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8889 7885 Ms Renouka Devi Sisteedhur Mrs Vijaylaksmi Devi Sisteedhur PC Care Home 9 Category(ies) of PD, MD(E), OP, MD, PD(E) registration, with number of places NIGHTINGALE HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Limited to 9 people of either gender who fall into the category of old age (OP) 2. who may also have a physical disability (PD(E)) and who may also have a mental disorder (MD(E) 3. 3 of the 9 places may accommodate a person of either gender who is between the age of 59 years and 65 years who may have a physical disability (PD) 4. and may also have a mental disorder (MD). Date of last inspection 2/9/04 Brief Description of the Service: Nightingale House is a registered care home for nine older service users who may also have mental health needs. The home is not registered to accommodate service users with a diagnosis of dementia. The home is privately owned with the registered provider being the daughter of the registered manager. The home is a large converted three storey domestic premises. There are three single service user bedrooms and three shared. There is a single room, a double room and a toilet on the ground floor. The home has a lift to the first floor where there are two single rooms and two double rooms and a bathroom and toilet. The home’s communal areas are on the ground floor and consist of a large sitting room and separate dining area. The kitchen, utility room and a toilet are also situated on the ground floor The third floor consists of the staff sleeping in room/ office. There is a large pleasant garden at the back of the house. The home is situated in a quiet residential street and close to local shops, a library and a public house. It is also situated reasonably close to the larger range of shops and amenities in Muswell Hill Broadway. The stated objective of the home is to enable service users to live independent and fulfilled lives as far as they are able, with dignity and privacy in a tranquil and elegant environment. NIGHTINGALE HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took approximately six hours with the registered manager and the deputy manager being present or available throughout. There were eight service users accommodated and one vacancy at the time of the inspection. The inspection included: discussion with six service users, four of them independently; independent discussion with three care staff and with a community psychiatric nurse who visited the home during the inspection. The inspector also spoke independently by telephone to the relatives of three service users and the referring social worker for the latest service user to be admitted to the home. Further information was obtained from a tour of the premises, the pre-inspection questionnaire and a range of documentation kept at the home. What the service does well: Service users and relatives spoken to said that the care provided at the home was good and relatives spoken to said that the managers and staff kept them informed of what was going on. The home also communicates well with social workers and health staff that are involved with service users. One social worker said that she was pleased that staff from the home had attended review meetings, arranged by others outside of the home, for the service user she was involved with. Staff receive a range of training that helps them develop their own skills that in turn helps them meet service users needs more effectively. NIGHTINGALE HOUSE Version 1.10 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. NIGHTINGALE HOUSE Version 1.10 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 Standards Statutory Requirements Identified During the Inspection NIGHTINGALE HOUSE Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Prospective service users can be confident that their needs will be assessed at the point of admission to the home to ensure they can be effectively met. Service users needs are generally reviewed after they are admitted to the home to ensure that their changing needs will also be addressed although this process needs to be improved for one identified service user. EVIDENCE: One new service user had been admitted to the home since the last inspection. This service’s user’s file contained a full multi-disciplinary assessment relating to the time of her admission. There was also evidence of a trial period for this service user that included multi-disciplinary reviews of progress and a follow up care programme approach (CPA) meeting since her admission. The social worker for this service user stated that she was pleased that staff from the home had attended the multi-disciplinary reviews on the service user. The other two service user files inspected also contained a range of relevant assessment material. This included evidence that one of these service user’s needs had also been reviewed on a regular basis by both staff from the home and by external health and social care professionals. The registered manager stated that the third identified service user was privately funded so there was NIGHTINGALE HOUSE Version 1.10 Page 9 no referring agency review. She stated that the home did review the assessed needs of the service user but there was no evidence available at the inspection to verify this. A requirement is made that all service users assessments of need are kept under review and that a record is kept of this. The home does not provide intermediate care. NIGHTINGALE HOUSE Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Service users needs and aspirations are clearly set out in their care plans but some further attention is needed to ensure that the plan for one service user is kept up to date. Service users health needs are well monitored and service users are supported in addressing these with relevant health professionals although further recording of how this is achieved is needed regarding one identified aspect of health care. Service users receive sensitive support with their personal care from staff and are treated with respect by them. EVIDENCE: Three service user plans were inspected and were generally clear and up to date. The format of the care plan showed each identified assessed need or aspiration, the desired outcome of these and guidance to staff on how to achieve the outcome. The care plans were being reviewed by the home on a monthly basis and were seen to be informed by a range of multi-disciplinary reviews and relevant risk assessments. Examples of identified risks included specific risks from smoking, health and safety hazards in the home and from identified health conditions. One service user’s plan included an aspiration, recorded earlier in the year, as wanting to go to church on a Sunday. The plan gave guidance for staff on how to support the service user achieve this. On further discussion the inspector was informed that the service user had NIGHTINGALE HOUSE Version 1.10 Page 11 subsequently decided that she did not want to go to church and in fact had not been since the aspiration was recorded. The care plan indicated that it had been reviewed on two subsequent months since then and showed that there were no changes needed to the plan, which had not been altered regarding the church attendance. A requirement is made that changes in service users needs and aspirations must be recorded on the care plan at the time or at least when the plan is next reviewed. Evidence was seen that service users were supported to access external health professionals. It was noted that one service user, who had recently been admitted to the home was still waiting to be admitted on to a local GP’s list. Correspondence was seen on that service user’s file to indicate that she was being satisfactorily supported in this process by both staff from the home and from her social worker. The social worker confirmed this and agreed that the responsibility of identifying a GP for the service user was ultimately with the Primary Care Trust (PCT). Satisfactory evidence was seen on the other service users files inspected that they had regular contact with the GP that they were registered with. There was no evidence that any of the service users were suffering from pressure ulcers at the time of this inspection and the registered manager confirmed this. There was evidence that service users accessed a range of other health care professionals including mental health professionals, opticians and chiropodists. The registered manager also stated that a dentist visited the home to offer dental checks to service users. This was not however noted on any of the service user files inspected or on any other documentation available for inspection in the home. A requirement is made regarding this. The home had a suitable medication policy and procedures. The medication for two service users was inspected with the relevant administration records and was found to be satisfactory. The temperature of the medication cupboard was was satisfactory and there was evidence that the dispensing pharmacist that the home uses attends to inspect the storage and administration procedures on an annual basis. A community psychiatric nurse attended the home to administer long term medication to one service user and stated that he was satisfied that the home was appropriately monitoring the health needs of the service user he was supporting. All the service users were mobile at the time of the inspection. The majority needed prompting regarding their personal care with some needing some direct assistance with tasks such as washing their hair. Service users spoken to indicated that the way they received this support was sensitive and met their needs. Two relatives spoken to by telephone also stated that they were happy with the support offered to their service user including with their personal care. During the inspection staff were observed interacting with service users in a friendly and respectful manner. NIGHTINGALE HOUSE Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 The home provides a range of social activities to meet service users needs and wishes. The overall options available to them however would benefit from further review to maximise the service users opportunities for worthwhile activities. Service users are supported to maintain and develop relationships with their relatives and with others to the extent that they wish. The home supports service users to make as many decisions for themselves as they can including about their personal finances. The home serves varied and healthy meals that service users enjoy. EVIDENCE: The registered manager stated that the home welcomes visitors at any reasonable time and with the agreement of the service user. The times service users generally like to get up and go to bed are recorded in service users plans, as are their likes and dislikes generally. One service user attends an external day service three times a week and the registered manager stated that she enjoyed attending. Both service users and staff spoken to stated that service users are supported to go out with staff to local amenities such as shops, the pub and Alexandra Palace park that is within walking distance from the home. One service user stated that he enjoyed playing draughts and another that he particularly liked reading. In the inspector’s opinion however it appeared that many of the service users actively chose to do nothing for significant periods of the day. A recommendation is made that the home NIGHTINGALE HOUSE Version 1.10 Page 13 reviews the activities available to service users and investigates whether any other structured activities could be arranged that service users may enjoy and engage in. All the service users spoken to were clear that they were happy with their current daily routines. The home’s service user guide stated that the home is multi-denominational and service users who wish will be supported to visit any local place of worship. The registered manager confirmed that visits and contact with relatives and friends are actively encouraged. Five service users have regular contact with relatives and/ or friends with three having no contact apart from health or social care professionals. This was an active choice for one of the three latter service users. Evidence to support the above contact with relatives was gained from service users files, from discussion with service users and from relatives spoken to. The relatives indicated that they were always made welcome by staff at the home. One service user’s affairs are subject to the jurisdiction of the court of protection and clear documentation regarding this was seen on his file. Either service users themselves, their referring authority or their relatives manage service users finances. Satisfactory records were seen where the home hands over to service users their personal allowance. The home has a two week menu that showed a variety of nutritious meals and a copy of the menu had been sent to the inspector in advance of the inspection. Service users spoken to stated that they enjoyed the food at the home. One said with some enthusiasm “that the food was very tasty”. Service users spoken to also confirmed that the home would provide an alternative meal on request if they did not like what was being served on a particular day. One service user suffers from diabetes and there was evidence that this person received appropriate meals to meet their health needs. There was a variety of food stored in the home on the day of the inspection that was seen to be in date, appropriately stored and matched the menu. Fridge and freezer temperatures were recorded daily and seen to be satisfactory. A number of staff had been on food hygiene training since the last inspection and one of these staff was keen to show the inspector a number of improvements made to the kitchen equipment as a result of this. The improvements included a new system for storing kitchen knives and chopping boards as well as an improved meat thermometer that had recently been purchased. NIGHTINGALE HOUSE Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Service users and their relatives can be confident that any concerns they raise with the home will be effectively dealt with. Up to date adult protection policies and procedures, that staff are familiar with, are in place in support of protecting service users from abuse. EVIDENCE: The home had a satisfactory residents charter and complaints policy that were both seen clearly displayed in the home’s entrance hall, the complaints policy included the contact details for the Commission. One complaint had been made directly to the Commission since the last inspection and this was in the process of being investigated by the registered persons at the time of this inspection. No other complaints had been recorded at the home. Service users spoken to indicated that they could raise issues with the manager if they felt the need. Similarly, relatives spoken to by telephone stated that they were confident that they also could raise issues of concern with the staff and they would be acted on. One relative gave an example of this to the inspector. The home had a satisfactory adult protection policy and procedure. The inspector was pleased to see that the practical guidance for staff regarding this had been updated since the previous inspection and related to the local authority procedure the home is situated in. A copy of the latter was also available in the home. The registered manager and deputy manager had attended adult protection training by the local authority since the last inspection. The registered manager stated that she was waiting on further dates for training from the local authority and it was her intention to send NIGHTINGALE HOUSE Version 1.10 Page 15 more staff on the course when these were available. Staff spoken to were familiar with the adult protection guidance and evidence was also seen that this had been the subject of discussion at a recent staff meeting. The home also had a satisfactory whistle blowing policy. NIGHTINGALE HOUSE Version 1.10 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 standard(s) 19, 21 & 26 Service users live in a home that is safe, well decorated and well maintained. They have access to an adequate number of toilets and bathrooms with a range of equipment that meets their needs. The home was clean and tidy throughout creating a pleasant environment for service users, staff and visitors. EVIDENCE: The home is a converted three storey premises with three double and three single service user bedrooms on the ground and first floors with a lift connecting these two floors. Although somewhat limited by its design the home is well decorated, maintained, safe and meets the current service users needs. The home had undertaken a range of internal decoration and had a wheelchair accessible ramp built to its front door since the last inspection. There is a toilet on the ground floor and a toilet and separate bathroom on the first floor; all service user bedrooms have a hand washbasin. This meets the standards for homes registered before April 2002. The inspector was pleased to see that a grab rail in the first floor toilet had been satisfactorily refitted to the wall since the last inspection. NIGHTINGALE HOUSE Version 1.10 Page 17 The home was clean and tidy on the day of the inspection. The home has satisfactory laundry facilities and has an appropriate infection control policy and procedures that were seen and that staff spoken to were familiar with. NIGHTINGALE HOUSE Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The home has a well qualified and stable staff team, in sufficient numbers, to support service users and to assist in meeting their assessed needs. Service users are also protected by the robust recruitment procedure operated by the home. Staff are offered a range of relevant training to further assist them in their own personal development and in meeting service users needs. EVIDENCE: The home had a satisfactory rota that was seen that showed two care staff and a senior member of staff on duty on both the early and the late shifts. One waking and one sleeping staff cover the night shift. The staff on duty matched those recorded on the rota. The home also employs a part time cleaner and has sufficient staff to meet the needs of the current service users. The home currently has a relatively stable staff group that was familiar with the service users needs. One new member of staff had been employed since the last inspection and that staff member’s file was inspected. This showed evidence of an effective recruitment procedure and included: evidence of a satisfactory enhanced criminal records bureau (CRB) and protection of vulnerable adults (POVA) clearance; two references; proof of identity and a clear employment history. Seven of the eight permanent care staff employed had either attained NVQ level 2 in care or were in the process of undertaking it. Two care staff spoken to stated that they were in the process of being supported by the home to undertake NVQ level 3 in care. Evidence was seen of satisfactory induction and NIGHTINGALE HOUSE Version 1.10 Page 19 foundation training for staff. Evidence was also seen that a number of them have received refresher training since the last inspection in: food hygiene, first aid, health and safety and assessment of risk. Staff spoken to confirmed that they had attended the above training and felt that they had benefited from it. NIGHTINGALE HOUSE Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 36 & 38 The home has developed effective systems, including regularly consulting with service users and others, to contribute to the home being run in the best interests of service users including safeguarding their financial interests. Staff are well supervised and supported and this assists them with both their own professional development and in meeting service users needs. The home has clear health and safety procedures in place to protect service users and others that work or visit the home. EVIDENCE: The home uses a quality assurance questionnaire to formally seek the views of service users and relatives regarding how the service offered by the home could be improved. Copies of the latest questionnaires were not available for inspection as the registered manager stated they were currently being evaluated in order for the home to update its development plan. Both service users and one relative spoken to confirmed that they had received the NIGHTINGALE HOUSE Version 1.10 Page 21 questionnaire a little earlier in the year and that they appreciated this. Developments in the home over the past year have included implementing identified improvements such as further staff training, the decoration of identified areas of the building and the construction of a wheelchair accessible ramp to the front door of the home. The registered manager confirmed that one service user remains the subject of a court of protection order. The registered manager also confirmed that the home does not hold any service users money for them, their money is either managed by the service user themselves, their relatives or the referring authority. Satisfactory records were seen where the home receives and distributes the service users personal allowances to them and this included the service users signing to confirm receipt. Evidence was seen of regular staff supervision and those staff spoken to confirmed that this was on a one to one basis in addition to any informal day to day supervision they received. Minutes of staff meetings were also seen and minutes of a recent meeting included discussion regarding adult protection and dealing with challenging behaviour. A range of satisfactory health and safety documentation was seen including: the fire log that contained records of regular fire drills and fire point testing; fire alarm and fire equipment servicing; servicing of the home’s lift; the home’s accident book and both a current gas safety and electrical installation certificate. The inspector was pleased to see that since the last inspection the home has satisfactorily dealt with a wire that was too close to the central heating boiler and that parts of the home’s water storage system had been replaced and that the water system had been professionally inspected to assist minimise the danger of legionella. NIGHTINGALE HOUSE Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 3 x 3 NIGHTINGALE HOUSE Version 1.10 Page 23 No. Are there any outstanding requirements from the last inspection? 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. 2. Standard 7 8 Regulation 15(2) 13(1)(b) Requirement Timescale for action 30/6/05 3. 3 14(2) The registered persons must ensure that service users care plans are kept up to date. The registered persons must 30/6/05 ensure that a record is kept of all dental appointments that service users attend. The registered persons must 30/6/05 ensure that each service users assessment of need is kept under review and that a record is kept of this. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 12 Good Practice Recommendations The registered persons should review the range of activities available to service users and investigate whether any other structured activities could be arranged that service users may enjoy. NIGHTINGALE HOUSE Version 1.10 Page 24 Commission for Social Care Inspection North London Area Office Solar House, 1st Floor 282 Chase Road, London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI NIGHTINGALE HOUSE Version 1.10 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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