CARE HOMES FOR OLDER PEOPLE
Orchard House Nursing Home 35 Hallmead Road Sutton Surrey SM1 1RD Lead Inspector
Alison Ford Key Unannounced Inspection 2nd May 2007 09:30 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 Orchard House Nursing Home DS0000019111.V338898.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. Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Orchard House Nursing Home Address 35 Hallmead Road Sutton Surrey SM1 1RD 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) 020 8644 5095 020 8641 4550 Mr Stephen Pittman Emma Jane Langbridge Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (0), Terminally ill (0), Terminally ill over 65 of places years of age (0) Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5 in the category of Day Care A variation has been granted to allow one specified service user under the age of 65 to be accommodated. A maximum of eight service users in the TI and TI(E) categories aged 40 or over. Two of the eight service users in the TI category may be aged 35 - 40. Date of last inspection 19th January 2006 Brief Description of the Service: Orchard House Nursing Home is a detached building in a residential area of Sutton, which owes its name to the presence of the orchard to the rear. It is registered as a care home providing nursing for up to 44 people. The majority of these would be over the age of 65 although they are able to provide palliative care for up to eight younger people. Accommodation includes bedrooms on the ground and first floors; there are 22 single and 11 double bedrooms. All have hand basins and five have en-suite facilities. A shaft lift provides access to all floors. Communal areas comprise three lounge diners, which can be divided for differing uses. There is also an additional quiet sitting area. As well as the main kitchen two pantry kitchens are provided which may be available for use by residents. The grounds are wheelchair accessible using a ramp and the garden includes a patio area, lawn and flowerbeds. Fruit trees supply fruit, which is picked and stored for use throughout the year. There is limited off street parking to the front of the property and in the road. Fees at the time of this inspection range from £600 - £1050 per week and some additional charges may be payable for services such as hairdressing. These would be discussed prior to admission. The homes Statement of Purpose and a copy of the latest inspection report can be obtained them. Inspection reports are also available from the Commission for Social Care Inspection via the internet. Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2007/2008. In writing the report consideration has also been given to information received throughout the year such as comments from people who use the service and reports of incidents and complaints. Prior to the inspection visit comment cards, routinely sent out by The Commission for Social Care Inspection, had been returned by six people, all reflecting their satisfaction with the service. The inspection visit was undertaken with help from the Registered Manager who was helpful, knowledgeable and very receptive to the inspection process. A tour of the premises was undertaken; many of the forty-two residents currently living in the home and several members of staff were spoken with. Three visitors to the home, including one who visits several other homes in the area, were also asked about their opinion of the home and the care that residents receive. Various records that the home is required to keep, as evidence of its commitment to the protection and health and safety of its residents, were seen and also a sample of care plans which identify the help and support that residents need and show how their assessed health care needs are met. Personnel files of new members staff were checked to ensure that they contained all of the necessary documentation that helps to ensure the protection of residents and staff training schedules were looked at to make sure that the training that is provided is relevant to their needs. Menus and kitchen records were seen and the lunchtime meal was observed during the visit. Two complaints made to the home since the last inspection had been resolved with promptly and appropriately and one investigation had been conducted under Protection of Vulnerable Adults procedures. No concerns had been raised about staff in the home as a result of this. What the service does well:
Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 6 It is judged that outcomes for the people who use this service are excellent in many areas and this was further confirmed by comments received from residents in the home and their relatives both prior to the inspection and during the visit. The home continues to provide extremely comfortable wellmaintained accommodation for its residents and all of those spoken with expressed their appreciation of the staff saying, “ how lovely” they were, “they were very obliging” and ” how well looked after they felt”. Activities for residents are varied and innovative providing both mental and physical stimulation for them. Music plays a very important role in the daily life in the home and Matron plays the organ and guitar at various events. Song sheets have been compiled of both hymns and popular songs and others are added to them at the request of residents. It is hoped that these will be bound into folders in the future. Spiritual needs are also given a high priority, some residents are able to attend local churches while other are visited in the home. Consideration has been given to those faiths about which care staff may have a limited knowledge and explanations of resident’s beliefs have been added to care plans in some cases. A varied and nutritious diet provides daily interest. Many favourable comments were received about the food and the chef is always available to talk to residents about their preferences. Menus are currently being revised along with cards identifying resident’s particular likes and dislikes. Comprehensive pre-admission assessments ensure that potential residents healthcare needs can be met. As many people who are thinking of moving into the home are too frail to visit first, an album of photographs illustrating some aspects of life there is taken along to show them. It includes samples of menus, pictures of staff members and of various activities that have taken place. The pre-admission assessment then forms the basis for future care planning which is undertaken to a very high standard and reviewed regularly. Residents or their relatives would be encouraged to participate in this process. Staff training is given a high priority in the home for both trained nurses and care staff and staff development is encouraged. There has been particular emphasis on training in issues around palliative care with the home participating in the community programme The Gold standard Framework. This focuses on providing best quality care for people in the final stages of their lives and for their relatives.
Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 7 Records, which provide evidence of the homes commitment to the health and safety of residents and staff, are all in order and quality assurance systems are in place to allow residents and their families the opportunity to influence the running of the home. What has improved since the last inspection? What they could do better:
Overall this home operates to a very high standard and no issues of concern were noted. Two recommendations were made at this visit. The home has benefited from a completely new kitchen since the last inspection however, it was recommended that a screen should be purchased for the kitchen window so that the window can be left open without flies coming in especially during the hot weather. There is no first aid kit in the kitchen. In order that all accidents are properly dealt with and recorded and any faulty equipment attended to, kitchen staff have to see a trained nurse if any accidents occur. While the theory behind this is acknowledged there were some concerns about the practicalities of this procedure and it is recommended that a basic first aid kit should be in the kitchen area. Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 8 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. Orchard House Nursing Home DS0000019111.V338898.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 Orchard House Nursing Home DS0000019111.V338898.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 excellent, This judgement has been made using available evidence including a visit to this service. The people who use this service can be confident that pre-admission assessments ensure that their healthcare needs can be met and that they will be given all the information that they need to decide if the home will suit them. This home does not offer intermediate care. EVIDENCE: There is a comprehensive pre-admission assessment tool in use in the home. The care plans, that were seen, showed that this had then been used as the basis to identify the residents subsequent care needs and the support they needed. As many people who are thinking of moving into the home are too frail to visit it first, an album of photographs illustrating some aspects of life there is taken along to show them. It includes samples of menus and pictures of staff members and of various activities that have taken place.
Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 11 In order to make sure that people have all of the information that they might need, a new Service User Guide has also been produced providing information about the home and the services that can be expected. This is attractively presented and a copy is in each resident’s bedroom. Although it does not contain a copy of the latest inspection report there is a reference to where it may be found and a copy will be left in the entrance hall. Two of the relatives spoken to, during the visit, confirmed that they had been given a great deal of help from staff in the home to help them make their choices and they agreed that they felt confident and happy to recommend the home to others. Orchard House Nursing Home DS0000019111.V338898.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): Standards 7,8,9,10,11 Quality in this outcome area is excellent, This judgement has been made using available evidence including a visit to this service. The people who use this service all have an individual care plan so that staff that are caring for them are aware of the help and support that they need. They are always treated with dignity and respect and medication policies and procedures are in place to protect them. EVIDENCE: Each resident has an individual plan of care providing evidence that personal and nursing care is being delivered to a high standard. Six of these were seen and they contained a considerable amount of information including risk assessments, manual-handling protocols, and monitoring of factors, which could lead to the incidence of pressure sores. Staff document all of the care that has been given and plans are regularly reviewed to make sure that any changing needs are identified. The training programme in place for staff
Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 13 ensures that they have the necessary skills to deliver care in the way that people prefer. Throughout the care plans there was evidence that residents and their representatives are consulted and able to influence the support that they are receiving. There are some residents whose spiritual beliefs may not be familiar to care staff and an explanation has been included in their care plans to ensure that they are respected. There were entries in the plans, to show that other healthcare professionals visit the home and give advice as necessary and equipment was seen in use throughout the home that is designed to minimise the risk of pressure sores. A communication sheet has been introduced since the last inspection so that contacts between the home and the resident’s representatives can be documented. It was considered that outcomes for the people who use this service exceed the minimum standard required. The residents that were spoken with during the inspection were all extremely pleased with the way that they were cared for in the home, commenting that ”someone was always there as soon as they rang the bell” and another that “everything was always done for them just how they liked it”. They all agreed how thoughtful and polite staff members were and carers were observed treating residents kindly and with a great deal of respect and consideration. Palliative care is provided in the home and it has participated in a community programme “The Gold Standard Framework” designed to offer the best possible care to people nearing the end of their lives and their relatives. Support is received from a local hospice, with which the home has strong links, and all trained staff have had some degree of training in palliative care. There are training sessions and weekly meetings for all staff to enable them to provide this care. Medication storage and administration was in order and is audited regularly by the pharmacist. Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 14 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): Standards 12,13,14,15 Quality in this outcome area is excellent, This judgement has been made using available evidence including a visit to this service. The people who use this service enjoy activities, which are suited to their preferences and abilities, and provide daily interest for them. Visitors are always welcome, so that relationships with friends and families can be maintained and some residents are able to go out and retain their links with the local community. A nutritious appealing and wholesome diet helps to add variety to resident’s days and, to maintain some independence, they are supported to exercise as much choice over their lives as they can. EVIDENCE: This home prides itself on offering a wide range of activities, which are suitable for the client group some of which are very innovative. Since the last inspection events have included shopping trips, a “princess party” at which residents wore tiaras and crowns and an Easter fun day complete with bonnets and bowling for Easter eggs. Nativity plays at Christmas always feature a live
Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 15 “baby Jesus”. Music is important in this home and Matron plays guitar or organ for various events. Song sheets have been compiled of both hymns and popular songs and others are added to them at the request of residents. It is hoped that these will be bound into folders in the future. Entertainers also visit the home regularly. Some residents are able to attend church while other are given the opportunity to worship within the home. A representative from the Christian Centre visits weekly and commented on how impressed they were with the home and that they would always recommend it. Residents are encouraged to make choices in their lives where it is possible while allowing daily routines to occur in order to maintain a degree of independence. Visitors confirmed that they are always made to feel welcome and kept informed of any changes that are happening. The lunchtime meal was served during the visit; it was well presented and portions were large. A choice was available and all those spoken to confirmed how much they enjoyed the food. A new chef has been employed since the last inspection and menus are currently being revised. Since staff have attended training in dementia awareness they have been encouraging residents to help to lay the tables at mealtimes. Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 16 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 people who use this service are confident that any concerns or complaints that they might raise would be dealt with promptly; they feel safe and sure that they are protected from abuse and neglect. EVIDENCE: The complaints book was seen and the two complaints detailed had been dealt with appropriately by the home. The Commission for Social Care Inspection has not received any complains since the last inspection. One event had been addressed by an investigation under local adult protection procedures however no concerns had been raised about any staff members. The residents and their relatives, spoken to during the inspection, were aware of the complaints process however they were confident that Matron would deal with any concerns, as they arose. The home has an Adult Protection Procedure, which has been seen at previous inspections and files of newly appointed staff showed evidence that Criminal Records Bureau clearance had been obtained. No members of staff have been referred for inclusion on the Protection of Vulnerable Adults Register. Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 17 Orchard House Nursing Home DS0000019111.V338898.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 excellent, This judgement has been made using available evidence including a visit to this service. The people who use this service live in an extremely well presented, wellmaintained and clean environment, which meets their needs and allows them to live in a comfortable homely atmosphere. EVIDENCE: The home is situated in a residential road close to local amenities. It is well maintained with an ongoing refurbishment programme and presented in good decorative order. Furniture and furnishings are homely, adaptations have been made throughout the home to ensure that it meets the needs of the residents and they have been encouraged to bring in items from home to personalise their rooms. Magnetic door closers have been put onto bedroom doors to ensure the safety of residents in the event of a fire. Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 19 The range of communal space means that there can be different activities happening throughout the home at the same time and there is a large rear garden, which is well used during the summer months. Limited parking facilities are available to the front of the property and in the road outside. The home was clean and free from odour on the day of the inspection and appropriate infection control measures are in place. Particular comments were made by one resident about how well the laundry was managed and the care that was taken with personal items. Orchard House Nursing Home DS0000019111.V338898.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 27,28,29,30 Quality in this outcome area is excellent, This judgement has been made using available evidence including a visit to this service. People who use this service can be confident that sufficient numbers of staff are always on duty and they are appropriately trained to meet their healthcare needs. The homes robust recruitment policies help to maintain the protection and support of its residents. EVIDENCE: Staff rotas confirmed that the home is always well staffed with both trained nurses and carers. Staff numbers exceed the minimum required however this allows high standards of care to continue, the needs of residents to be met and contributes to the overall quality rating of the home. Training for staff in this home is given a high priority; all staff now have an individual training profile and carers have either completed an NVQ qualification or are undertaking it. New staff have a comprehensive induction programme, which allows them to progress to study for an NVQ. Other recent training has included courses in infection control, food hygiene, venepuncture and first aid. Eight trained nurses have undertaken an assessor’s course.
Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 21 Of particular note was training that care staff have received in issues that lead to good outcomes for residents. An example of this is ” hair care” for residents so that ladies can be helped to put rollers in their hair after a bath or shower and look their best. Also sessions entitled “dignified dining” about how to lay the table, serve food to residents and clear away afterwards in a polite and dignified way. The files of three newly appointed members of staff were seen and they contained all of the documentation required to ensure the protection of residents. Orchard House Nursing Home DS0000019111.V338898.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): Standards31, 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 people who use this service can be sure that the home is managed by a suitably qualified and very experienced person who ensures that there is an open and inclusive atmosphere, which allows residents and staff to express their views and makes them feel valued. Effective quality assurance systems are in place to allow residents and their families to influence the care that they receive and there is evidence of a commitment to the health and safety of both residents and staff. EVIDENCE: The manager of this home is a registered nurse and has been employed there for some time. She has undergone additional training to equip her for her role and has completed the Registered Managers Award. Many of the residents and
Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 23 staff members that were spoken to during the inspection commented on her kindness and capability. The home has an annual development plan in place outlining future intentions of the management team. There are effective quality assurance systems in place to ensure that residents feel that they are kept informed of what is happening in the home and are able to influence the services that are provided. A suggestion box is in place in the home and there are regular meetings for residents and their families. Questionnaires are also sent out on a regular basis in order to monitor the satisfaction of residents and their families. Some money is kept on behalf of residents and records were well kept and accurate. There was evidence available to show that equipment and services are well maintained and that attention is given to the health and safety of staff and residents. Kitchen records were all in order and the home has benefited from a completely new kitchen since the last inspection. It was recommended that a screen should be purchased for the kitchen window so that the window can be left open without flies coming in especially during the hot weather. There is no first aid kit in the kitchen. In order that all accidents are properly dealt with and recorded and any faulty equipment attended to, kitchen staff have to see a trained nurse if any accidents occur. While the theory behind this is acknowledged there were some concerns about the practicalities of this procedure and it is recommended that a basic first aid kit should be in the kitchen area. Orchard House Nursing Home DS0000019111.V338898.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 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations It is recommended that a screen should be purchased for the kitchen window so that the window can be left open without flies coming in especially during the hot weather. It is recommended that a basic first aid kit should be in the kitchen area for treatment of minor injuries to those working there. 2 OP38 Orchard House Nursing Home DS0000019111.V338898.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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
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