Inspection on 03/10/07 for Olive House

This inspection was carried out on 3rd October 2007.

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

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

Other inspections for this house

Olive House 06/02/07

Olive House 06/02/06

Olive House 05/09/05

Olive House 06/12/04

Olive House 12/08/04

Olive House 15/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Olive House New Line Bacup Lancashire OL13 0BT Lead Inspector Mrs Christine Marshall Unannounced Inspection 10:00 3 October 2007 rd 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 DS0000036431.V345752.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. DS0000036431.V345752.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Olive House Address New Line Bacup Lancashire OL13 0BT 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) 01706 874048 01706 877667 Lancashire County Care Services Mrs Doric Hilda Davis Care Home 44 Category(ies) of Dementia (16), Dementia - over 65 years of age registration, with number (16), Old age, not falling within any other of places category (22), Physical disability (6), Physical disability over 65 years of age (6) DS0000036431.V345752.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 44 service users to include: Up to 22 service users in the category of OP (over 65 years of age, not falling into any other category) requiring personal care Up to 16 service users in the category of DE(E) (Dementia over 65 years of age, not falling into any other category) requiring personal care. Up to 16 service users in the category of DE ( Dementia, under 65 years of age, not falling into any other category) requiring personal care Up to 6 service users in the category of PD(E) (physical Disability, over 65 years of age) requiring personal care Up to 6 service users in the category of PD (Physical Disability, under 65 years of age) requiring personal care Date of last inspection 6th February 2007 Brief Description of the Service: Olive House is a large detached building set in it’s own grounds. It is part of Lancashire County Care Services and is registered to provide care and accommodation for up to 44 older people. It is located on New Line Road close to local shops, a library and other amenities in the town centre of Bacup. It is situated on a main bus route that offers transport to all towns in the Rosendale area. There are 4 separate living units that have different functions and provide different levels of care. A fairly new building extension provides service users with a spacious dining area, lounge, conservatory, and modern garden decking that overlooks the local bowling green. Many bedrooms are en suite and there are assisted bathrooms, shower rooms and toilets for service users throughout the home. The service also operates a rehabilitation unit for 6 service users and this is separately staffed. DS0000036431.V345752.R01.S.doc Version 5.2 Page 5 A well-attended day care service is situated in the building. Prospective service users receive a copy of the homes service user guide and have access to the Statement of Purpose. At the time of this visit, the fees ranged from £324 - £366 per week. There are extra costs for hairdressing, newspapers and toiletries. The registered manager is Doric Davies. DS0000036431.V345752.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process of Olive House included a site visit to the home which was completed in one day, and unannounced, which means that the manager, staff and residents did not know it was taking place until the inspector arrived. Shortly before this visit, a thematic inspection visit took place, which was a special observation of people with dementia. This special inspection showed that the people who live on the dementia unit were well cared for. A report about this special themed inspection was written and sent to the home. Time was spent sitting and talking with people who use the service and observing the day-to-day routines of the home and care staff, as they provided support. A tour of the home was undertaken and included bedrooms, lounges and dining areas, toilets and bathrooms. This was to assess whether the home provided a comfortable, homely environment for the enjoyment of everyone, and to ensure their safety. The manager completed a pre-inspection Annual Quality Assurance Assessment (AQAA) questionnaire before this key visit, which gave good information about the operational management of the home and helped in the planning of the visit. Comment cards were sent out for staff, residents, relatives and visiting professionals to fill in and a good number were returned to the Commission; these showed that there was a general satisfaction with the care at Olive House. Comments from the residents included – “I am looked after properly here.” “It is very nice.” “I am doing well.” Discussions took place with two assistant managers and members of the care staff and administration records were looked at. Everyone at the home was friendly, welcoming and co-operative throughout the visit. DS0000036431.V345752.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? New care planning systems have been introduced that are very informative, personal and reviewed regularly. This means that the residents are given care that is recorded and reflects individual needs and strengths thus promoting a good quality of life. Residents are treated with dignity and respect and are provided with a nourishing and well-presented diet, particularly those diets that are pureed or liquidised. The Commission’s Pharmacy Inspector has checked medication systems and all of the requirements and recommendations were being addressed as matters of urgency, thus making it safe for residents to be given their medicines, or for them to be responsible for looking after their drugs themselves. DS0000036431.V345752.R01.S.doc Version 5.2 Page 8 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000036431.V345752.R01.S.doc Version 5.2 Page 9 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 DS0000036431.V345752.R01.S.doc Version 5.2 Page 10 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): Standards 1, 3 & 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home gathers enough information about prospective residents to ensure that their needs can be met. EVIDENCE: Although Standard 1 was not fully assessed on this visit, it was found that although the Statement of Purpose gave good information about the home, it needed to be reviewed to reflect the current availability of bedrooms and also to provide more information about the services that are provided for people with dementia, plus any special considerations that might be in place for the people whio want to live at the home. DS0000036431.V345752.R01.S.doc Version 5.2 Page 11 A requirement has been made in respect of this at the end of this report. Pre-admission assessments were looked at and were completed satisfactorily; they include all aspects of physical, social and psychological care. These assessments are done by a delegated social worker and agreed by the resident and/or their family. The residents were unable to say that they knew about these assessments, but they said that they were happy about being in Olive House. Members of staff aslo knew about the assessments and what was in them. The rehabilitation unit was well staffed with good aids and adaptations for rehabilitating people. There was evidence of input from relevant visiting professionals such as physiotherapists and occupational therapists, to meet the assessed needs of the people on this unit. DS0000036431.V345752.R01.S.doc Version 5.2 Page 12 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs are met and people are treated with dignity and respect at this home. Residents are supported and protected in their daily lives. EVIDENCE: Care plans are written records that describe the care that is given to each resident. Three of these were looked at and found to be very individual, personalised and person-centred in approach. All of them were reviewed and updated. These care plans should be commended for the improvement that has been made since the last inspection visit. The staff members on duty said that they knew about the care plans and that these reflected the care that was being given to each person. DS0000036431.V345752.R01.S.doc Version 5.2 Page 13 The residents were mostly unable to say that they knew about their care plans, but they did say that they were not really interested in them because they were well looked after. Health care opportunities are offered to all residents and there are records of GP, chiropody and physiotherapy visits. The pharmacy inspector visited the home on the 1st October 2007 and his reporting is as follows – The visit lasted three and a half hours. Samples of medicines records and the medicines storage facilities were inspected in all of the units. Eight residents and five care staff were spoken with. What they do well Written medicines policies and procedures are detailed and up to date, this helps ensure care staff administer medicines in the right way. What has improved since the last inspection Regular checks (audits) on the medicines are now carried out by the manager, this helps ensure care staff are administering medicines correctly. What they could do better Medicines must be administered at the right time in relation to food intake. Receiving medicines at the wrong time can affect the health and well being of residents. Arrangements for residents that look after their own medicines must be improved to ensure they receive any support they might need. Records of all medicines received into the home must be made to ensure they are administered to residents correctly. Findings Written procedures and policies are in a place that supports the safe handling of medicines, these were available in all units and are generally being correctly followed. Residents that are looking after their own medicines are not fully supported to do so. Written risk assessments and supporting care plans are not always up to date. Having up to date records and care plans is important to ensure residents receive any support they might need. DS0000036431.V345752.R01.S.doc Version 5.2 Page 14 Medicines are not accurately recorded on receipt into the home and so it is not always possible to carry out checks on all medicines to show whether they are being administered correctly. However checks on some stock found that medicines are usually given as prescribed. Paperwork, particularly handwritten records, is not always accurate, important information is routinely left off the records making them untidy and unclear, this could lead to mistakes when giving medicines. Care staff and residents said that most medicines are administered during or just after mealtimes and this was confirmed by looking at the records. Records showed and staff said that several medicines that should be given before food are usually given after; this could affect the way they work and can increase the chances of side effects. Medicines prescribed as “when required” or, as a “variable dose” have clear written instructions for care staff to follow to ensure they are given correctly. This is a recent improvement that is particularly important for residents that are suffering with pain or who are agitated and have difficulty communicating. The manager said, and carers confirmed, ‘all relevant care staff have received medicines handling training’. Staff are assessed as competent to give medicines but no recorded evidence of this is made. Managers carry out weekly audits and these are being developed further, this is important to ensure medicines are given to residents correctly and to ensure staff remain competent. Requirements and recommendations were made by the pharmacist in respect of the medicines. It is fair to say that there had been rapid responses to the pharmacist’s comments and the requirements and recommendati0ons had already been attended to by the time this visit tool place two days later. The residents were treated with respect, privacy and dignity, and there was a good personal interaction between resident and carer. Those residents who were able, and visiting relatives said that they were happy with the care given at the home. DS0000036431.V345752.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported so as to promote the quality of their daily lives. EVIDENCE: There were records of activities programmes for the residents that included gardening club, themed parties, quizzes, church visits, board games, a dog regularly visits the home for Pet Activity Therapy (PAT), ball games, beadthreading, one to one quiet times, and outings. A new garden was being created with the help of a £1000 donation to the home, and this will really benefit all who live there. All residents are treated equally in that they were offered activities, therapies and outings, regardless of their level of understanding or mobility. DS0000036431.V345752.R01.S.doc Version 5.2 Page 16 Some residents were able to say that they enjoyed the activities, others said they were not really bothered and liked a quiet life. All residents seemed to be supported in their contact with the community, and a religious minister was at the home on the day of the visit. The home provides meal choices and nice dining areas. There was equality of opportunity, facility and choice for those residents on the dementia unit, who were served their meal in a nice dining room, with table settings and the same choices of food as those residents on the general care side of the home. The lunchtime meal was presented in an appetising way and the mealtime was relaxed and unhurried. The residents generally said that the food was good and that they had choices. When asked their comments included – “Yes, very nice dear.” “The food is good.” “No complaints from me about the food here.” There were menus in place that were varied and nutritious. The kitchen was kept extremely clean, having won a Certificate of Food Excellence in July of this year. Diabetic and vegetarian diets are catered for thus again providing equality of choice for all residents. DS0000036431.V345752.R01.S.doc Version 5.2 Page 17 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): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s policies, procedures and practice make sure that residents are supported and protected. EVIDENCE: There were policies and procedures in place for complaints, whistle-blowing and adult abuse issues, and staff said that they were aware of these. Residents who were able, and visiting relatives confirmed that they knew about the complaints policy and had no complaints whatsoever to offer. There were policies and procedures in place for the protection of residents from abuse and any allegations are dealt with according to the Local Authority Adult Safeguarding protocols. Training files showed that every member of staff has had abuse awareness training on induction to the home and staff confirmed this. DS0000036431.V345752.R01.S.doc Version 5.2 Page 18 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): Standards 19 - 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean and hygienic environment and bedrooms are personalised. This means that residents feel at home with their belongings around them. EVIDENCE: Whilst registration is approved for 44 people, at this present time the home can only accommodate 42, because two of the bedrooms are used as office space. The assistant managers explained that there are planned changes by the local authority that may make the rooms available again for residents. DS0000036431.V345752.R01.S.doc Version 5.2 Page 19 The Commission has requested information about this from Lancashire County Care Services at County Hall Preston. This must be addressed in order to comply with the home’s conditions of registration, which states that the home can accommodate up to 44 people when, at this moment in time it can only provide bedrooms for 42 people. A requirement has been made in respect of this at the end of this report. A tour of the home showed that the general environment was good; furnishings were comfortable and there are aids and adaptations in place to give acces to all areas of the home and to help with the residents’ toilet and bathing needs. This makes sure that there is equal access for those residents who suffer from mobility problems or who have difficulty with bathing routines. Bedrooms were personalised and comfortable and a number of residents were able to say that they were happy with their rooms. Policies were in place for the prevention of any cross infection. The dementia unit however, was in need of review as there was a malodour in the dining and lounge area and this may be due to the lounge carpet needing replacement. This would also benefit the residents as the current carpet is patterned and research has shown that this may further confuse the dementia sufferer. A recommendation to fit a plain carpet in the unit has been made at the end of this report. DS0000036431.V345752.R01.S.doc Version 5.2 Page 20 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): Standards 27 – 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents care needs are met through mostly adequate levels of appropriately trained and experienced carers. EVIDENCE: Staff provision includes male, female and overseas personnel, showing that there is equality of opportunity at this home. The level of care staff with National Vocational Qualifications (NVQ) at the home above the 50 required level. There is a plan for other staff to take this qualification. Staff had been given Dementia Awareness and Abuse Awareness training along with mandatory training in Moving and Handling and Fire Safety. DS0000036431.V345752.R01.S.doc Version 5.2 Page 21 All staff training records that were examined confirmed that induction and training programmes were in in place. All records that were examined in the staff recruitment files were satisfactory and staff siad that they had undergone all of the employment checks before starting work at the home. The duty rota showed that in one of the lounge areas there are very basic levels of staff on duty. Although the assistant manager is always on duty, there is only one member of staff in that lounge at certain quiet times of the day. Staff said that there were tims when they were concerned in case any emergencies arose and there would only be one carer in the lounge; they did add that they had procedures for the event of emergency and that they would be able to access help fairly quickly. None of the residents said that they had to wait for assistance or that they thought there should be more staff on duty. However, a recommendation in respect of increasing staff levels in this area has been made at the end of this report. DS0000036431.V345752.R01.S.doc Version 5.2 Page 22 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): Standards 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by an experienced manager and there are quality systems in place to make sure that they are protected. EVIDENCE: The manager is very experienced in managing care homes and holds the Registered Managers Award. DS0000036431.V345752.R01.S.doc Version 5.2 Page 23 There were quality monitoring systems in place including the Investors in People (IIP), and regular quality surveys were undertaken. The results of these surveys, including graphs and a sample of stakeholder comments, will be posted on the home’s notice board for residents and visitors to see. There are regular staff and resident meetings and staff confirmed that they had meetings. Records of residents personal monies that are kept at the home and monitored by the manager. Staff supervision programmes are in place and staff also confirmed that they had regular supervision. The AQAA showed that the manager was aware of the responsibilities of maintaining all health and safety certificates of service for fire, equipment, electric, gas and call systems. It was noted that the front door did not have any form of security system and this should be addressed to further safehuard the people who live at the home. A recommendation in respect of this has been made at the end of this report. However, as stated under the set of standards 1 to 6 and 19 to 26, the home is registered to accommodate 44 residents but the use of 2 rooms for administration purposes means that only 42 people can actually be accommodated. Information in respect of this has been requested from the Lancashire County Care Services County Hall, Preston. DS0000036431.V345752.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 2 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000036431.V345752.R01.S.doc Version 5.2 Page 25 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 Standard OP1 Regulation 4 Requirement An up to date Statement of Purpose must be developed that includes information about accurate registered numbers and categories, including dementia care, and any special services and facilities that are provided. The registered manager must ensure there are risk assessments for service users who self-administer medication Medicines must be given to residents at the right time in relation to food intake, receiving medicines at the wrong time can affect their health and well being. Accurate records of medicines received into the home must be maintained so that they can be regularly checked to ensure they are being administered to residents correctly The registered person must review the registration of the home and either provide adequate numbers of bedrooms for 44 people as registered and DS0000036431.V345752.R01.S.doc Timescale for action 01/12/07 2 OP9 13 01/12/07 3 OP19 10 01/12/07 Version 5.2 Page 26 stated in the Statement of Purpose, or make application for the registered numbers to be reduced to 42 people. 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 OP9 Good Practice Recommendations Patient information leaflets should be used for all medicines kept in the home to ensure medicines are administered correctly. All handwritten medicines records should be an exact copy of the pharmacists dispensing label, which should be double-checked and countersigned, this should help prevent mistakes. A record of staff assessment of competence should be made to show they are competent when administering medicines. 2 OP19 It is strongly recommended that a replacement plain carpet be fitted to the dementia unit lounge, to reduce the malodour and also to reduce distress or confusion that a patterned carpet might cause. It is strongly recommended that staff levels be reviewed to make sure that there are adequate carers during quiet period, for example mid afternoon. It is recommended that a security system be provided at the front door to safeguard the people who live there. 3 4 OP27 OP38 DS0000036431.V345752.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 DS0000036431.V345752.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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