Inspection on 10/01/06 for Pendlebury Manor Care Home

This inspection was carried out on 10th January 2006.

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

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

Other inspections for this house

Pendlebury Manor Care Home 27/01/10

Pendlebury Manor Care Home 04/08/09

Pendlebury Manor Care Home 05/08/08

Pendlebury Manor Care Home 10/01/08

Pendlebury Manor Care Home 03/07/07

Pendlebury Manor Care Home 09/05/06

Pendlebury Manor Care Home 07/06/05

Pendlebury Manor Care Home 16/12/04

Pendlebury Manor Care Home 30/07/04

Pendlebury Manor Care Home 24/05/04

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

CARE HOMES FOR OLDER PEOPLE Pendlebury Manor Care Home Lyme Green Park London Road Lyme Green Macclesfield Cheshire SK11 OLD Lead Inspector Denis Coffey Unannounced Inspection 10th January 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Pendlebury Manor Care Home Address Lyme Green Park London Road Lyme Green Macclesfield Cheshire SK11 OLD 01260 253555 01260 253041 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) Pendlebury Healthcare Limited Care Home 61 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (61) of places Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 61 service users to include * up to 61 service users in the category of DE(E) (dementia over the age of 65 years) requiring personal care only * up to 5 service users in the category of DE (dementia, aged between 50 and 65 years) requiring personal care only The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 7th June 2005 2. Date of last inspection Brief Description of the Service: Pendelbury Manor is a care home providenig care for up to 61 people with dementia who require personal care only. The premises are are divided into three units: the Lymes, the Villa and the Manor. Accommodation comprises of 50 single rooms and 6 double rooms. Dining and lounge areas are provided on each unit, and two passenger lifts are provided for access to the first floors. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a 4½ period that included a tour of the premises, speaking with visitors and staff, and inspection of care and service records. Denis Coffey and Helena Dennett, CSCI inspectors carried out the inspection. What the service does well: What has improved since the last inspection? What they could do better: The management of medicines would be improved by ensuring that all staff responsible for administering medicines to the residents have received satisfactory training in this, and that accurate records are maintained for all medicines administered. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 6 Practices need to improve in relation to the aspects of reducing and preventing the risk of cross infection occurring. The storage of substances subject to the Control of Substances Hazardous to Health legislation needs addressing to prevent these being used inappropriately. Social and recreational activities are provided on an ‘ad hoc’ basis. Residents would benefit from a structured approach to this aspect of care that takes into account their preferences and abilities. An increase in the number of staff with an NVQ (or equivalent) would enhance the knowledge and skills of the staff providing care to the residents. 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. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 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 the following standard(s): 1&3 Information is available for residents to enable them to know that their needs can be met. EVIDENCE: The home’s statement of purpose has been amended since the last inspection and now accurately reflects the categories and age range of people who can be accommodated at the home. The care records of two people recently taking up residency at the home were examined. Both contained a detailed pre-admission assessment that identified past medical information, and current needs/problems that were being experienced. Pendlebury Manor does not provide intermediate care, so standard 6 does not apply. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 9 Care plans were in place for the residents, but these need improving to ensure that all of the residents’ identified needs are addressed. Medicines were not managed well to ensure the safety and well being of residents accommodated at the home. EVIDENCE: The care records of five residents were examined at this inspection, three on the Manor and two on the Lymes/Villa. Manor All three records contained plans of care addressing the needs/problems of the residents, and evidence was seen of these being evaluated on a regular basis. Assessments were in place for nutritional needs, the risk of falls, and skin condition. There was however no plan of care in place for one resident addressing their personal hygiene needs. Lymes/Villa Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 10 Both of the records examined contained plans of care and assessments as described above. The plan of care for personal hygiene for one of the residents did not identify how their oral hygiene needs were to be met. Plans of care are devised into three sections; -1) Identifies the need/problem. 2) Is for the outcome to be achieved. 3) How the outcome will be achieved. Part 3 was comprehensively filled in for one resident detailing the interventions required by staff to achieve the identified outcomes in relation to specific needs. However, this section in the other resident’s plans of care described in detail the problem/need, and did not address how care was to be delivered. When reading the daily reports on the health and welfare of these residents, an entry for one resident dated 3rd January 2006 (6.20am) stated that the resident ‘refused to get out of bed’. Entries for the second resident dated 31st December 2005 (6am) and 2nd January 2006 (6am) both made reference to the resident ‘refusing to get out of bed’. One of the care staff spoken with said that when they came on duty at 8am all sixteen residents were up, washed and dressed. At the time of inspection five residents occupied bedrooms on the Villa, and eleven on the Lymes. Two staff are currently rostered to work at night, one on the Villa and one on the Lymes. When informed of this the manager said that only a small number of residents were up out of bed by 8am The manager was advised to speak with the member of staff making the above entries to clarify the situation, and to establish a record of when residents are got out of bed in the mornings. All of the residents are registered with a general practitioner and have access to the NHS facilities. Records were seen of healthcare personnel being involved in the care of the residents, e.g. dietician and community psychiatric nurse. The management of medicines was examined on all three units. Manor Medicines are supplied for a twenty-eight day period at a time, and at the time of inspection the medicines were in their second day of supply. There were gaps on the medicine administration record (MAR) sheets of two residents indicating that they had not received their medicines as prescribed. Two of the residents were prescribed medicines the doses of which are determined by blood analysis. These medicines had been signed as given but it was not possible to ascertain what dosage of these they had been administered, as this was not recorded. Lymes/Villa The majority of the residents’ MAR sheets were filled in correctly, but there were instances where a code letter had been used indicating that the Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 11 medicines were not given. There was however no reason given for these omissions. A bottle of a food supplement was found in the medicines trolley that had been partly used. This preparation has instructions printed on its container stating that once opened it should be stored in a refrigerator and used within fourteen days. The date of commencement of use of this had not been identified. A tube of cream in the trolley did not contain a label on it identifying whose use it was intended for, and the box it had been supplied in was not present. The senior carer on duty was observed dispensing medicines from the medicine trolley in the medicine room and then taking these in a container along with a tumbler of water to the residents in various parts of the unit. The residents’ MAR sheets were not taken when the residents were being given their medicines. The practice of walking around the unit with medicines in this manner should be discouraged as the member of staff could be distracted or could spill or drop the medicines. The medicine trolleys are designed to be portable and should be taken to where the residents are before medicines are dispensed. When asked what training they had received in the management of medicines the senior carer said that they had covered this when undertaking NVQ training in another care home. They confirmed that had not received this training whilst in this employment. The senior carer said that the deputy home manager had observed them carrying out two medicine rounds and judged that they did so in a competent manner. When assessing the quantity of medicines supplied of the prescribed food supplement described above, the inspector noted that there was only enough in stock to last ten days. When prescriptions are renewed they are picked up from the doctors’ surgery by the supplying chemist. The manager was informed of the need for these prescriptions to be delivered to the home prior to them being collected by the chemist so that they could be checked against what had been requested. The senior carer was not aware of the ordering procedure for new supplies of medicines. A copy of the home’s medicine policy and procedure could not be found on the unit. See Requirement 1 See Requirement 2 See Requirement 3 Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 & 15 A structured approach to the provision of activities is needed to provide stimulation and meet the interests of the residents’. Menus appeared varied, providing a nutritious diet for the residents. EVIDENCE: At the time of inspection there were thirty-six residents accommodated at the home. Agreement had been reached with the registered owner that an activities organiser would be employed when occupancy reached this level. The home manager said that this post was advertised in the local job centre but the response from this had been poor. There are no social and recreational activities provided for the residents in a structured way, and the care staff are currently providing by these in an ad-hoc manner. Three visitors were present at the time of inspection. One said that they were happy with the care their relative receives. The other two visitors said the same, and went on to say that the staff are excellent and nothing was too much trouble for them. Entries in the care records of residents’ accommodated on the Lymes/Villa would indicate that they do not have a choice about when they get up in the Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 13 morning. A resident spoken with on the Manor said that she was able to exercise choice in her daily life. The resident also said that they were happy living at the home. Lunch was a choice of shepherd’s pie or corned beef hash, both of which were served with cabbage and carrots. Fruit pie and custard was served for dessert. Standard alternatives to the menu include salads, baked potatoes and omelettes. See Requirement 2 See Requirement 4 Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 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 the following standard(s): 16 & 18 There is information available to residents, and visitors to the home on how to make complaints and how these will be dealt with. EVIDENCE: There have been no complaints recorded as being received at the home since the last inspection. The home has a satisfactory complaints procedure, a copy of which is included in the home’s statement of purpose. The home has a copy of the Department of Health’s document ‘No Secrets’ (this identifies the forms abuse may take and what to do if abuse is witnessed or suspected). The manager was currently devising an abuse/protection policy for the home and expects this to be completed within the next two months. All of the staff employed at the home have received adult protection training. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The environment of the home has been generally well maintained to offer accommodation to residents in a comfortable environment. Standards of practice regarding hygiene need addressing to reduce the risk of cross infection occurring. EVIDENCE: All areas of the home were visited at this inspection. Bedrooms were comfortably furnished and many of them had been personalised by the residents or members of their family. At the time of inspection a programme of refurbishment and redecoration was taking place on one wing of the Villa. There were signs of wear and tear in the décor and furnishings on the Manor, and the manager said that this was going to be addressed when the work on the Villa had been completed. It was noticeably cold in one of the bedrooms and a corridor on the Manor. The wardrobes in two bedrooms on the Manor were free standing and need to be attached to a wall to prevent them from being pulled over. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 16 A washbowl was found under a wash hand basin in one of the bathrooms on the Villa. This bowl was in a dirty condition, and when asked why it was there a member of staff said that soiled washcloths were put in the bowl prior to them being disposed of. It is not appropriate for soiled articles to be stored in this manner as such bowls could inadvertently be used when attending to the personal hygiene needs of the residents. Such materials must be stored in bins that have a lid that can be opened without touching the lid, and that are lined with appropriate disposable bags. Open packs of incontinence pads were being stored in both sluice rooms on the Villa and Lymes. Plastic washbowls were also found in these rooms, one of which had a dirty mop stored head down in it. Hand washing facilities were provided in both sluice rooms, but there were no paper towels in one of these to enable staff to dry their hands after washing them. Sluice rooms are designated as ‘dirty’ areas and must not be used as general storage areas. Two tubs of cream used in the personal care of residents were found in the rooms of residents for whose use they were not intended. All of the above observations need attending to as they pose cross infection hazards. See Requirement 5 See Requirement 6 See Requirement 7 Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 & 30 Recruitment procedures need to be more thorough ensuring that the residents are protected from any possible harm. Training is provided to enable staff to develop and maintain their skills in the delivery of care. EVIDENCE: A review of the staffing rotas showed that the agreed minimum staffing levels were being complied with. One of the care staff has an NVQ level 3, and another carer has an NVQ level 2. The manager said that another two of the care staff had enrolled to do the NVQ level 2 course. At least 50 of the care staff should have an NVQ level 2 (or equivalent). The personnel files of two staff were examined. Satisfactory protection of vulnerable adults checks had been received for both staff. One file contained a completed application form and a written interview assessment record. The application form in the second file contained information regarding the persons previous work experience, but did not include the dates of beginning or leaving each post. Such information is important to ascertain if there has been any unexplained gaps in a person’s employment history. Evidence was seen of staff receiving training in medicines, safe moving and handling procedures, adult protection and dementia. The deputy manager had Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 18 recently completed a moving and handling trainers course, and is now the designated person for provision of moving and handling training for the staff. See Requirement 8 See Recommendation 1 Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 38 The health and safety of the residents and staff is well promoted. This could be improved by ensuring that cleaning products are stored securely at all times. EVIDENCE: The manager is a trained nurse who is registered with the Commission as the registered manager of the home. Both the manager and deputy manager are accredited assessors for NVQ training. Records were seen of the fire alarm and emergency lighting systems being tested on a weekly basis. Both of these certificate was issued in April 2005, and the central heating boiler was serviced in September 2005. The cold water system was disinfected in March 2005, and samples of the water were tested in September 2005 and January 2006 for the presence of bacteria with Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 20 satisfactory results. Records were seen of the portable electrical appliances being tested recently. Two bedroom doors on the Lymes were found not to be closing to fully, and therefore could present a smoke/fire hazard in the event of a fire breaking out on the unit. Cleaning products were stored securely when not in use on the Villa/Lymes in a locked storeroom. However, it was observed that the cleaner’s trolley was left unattended for a period on the Villa. The products used for cleaning could prove harmful to the health of the residents’ if used inappropriately, and therefore must be kept secure at all times. The home had recently changed suppliers of cleaning products, but had not at the time of inspection received the safety information sheets for the new products. Some of the cleaning agents on the cleaner’s trolley had been decanted into plastic spray bottles, and the intended use for these was handwritten on pieces of plain paper that had been Cellotaped to the spray bottles. The name of the products were not given, nor directions for use or what action to take if these were used incorrectly. The accident records for the previous three months showed that the residents had sustained a total of twenty-three accidents. None of these required hospital treatment and responded to first aid interventions. See Requirement 9 See Requirement 10 Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 1 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Timescale for action Plans of care must be devised 15/02/06 and implemented that address the identified needs/problems of the residents. The registered person must so 15/02/06 far as is practicable enable residents to make decisions with respect to the care they receive. Suitable arrangements must be 15/02/06 made for the recording, handling, safekeeping and safe administration of medicines received into the home. Additionally, suitable training must be provided for all staff responsible for the administration of medicines. Arrangements must be made for 15/02/06 the provision of social and leisure activities for the residents that address their interests. Adequate heating must be 15/02/06 provided in all parts of the home used by residents. The wardrobes in the two 15/02/06 identified bedrooms must be made secure to prevent accidental injury to the residents occupying these rooms. DS0000018805.V265524.R01.S.doc Version 5.0 Page 23 Requirement 2 OP14 12 3 OP9 13 4 OP12 16 5 6 OP19 OP19 23 13 Pendlebury Manor Care Home 7 OP26 13 8 OP28 18 9 OP38 23 10 OP38 13 Suitable arrangements must be made to prevent and minimise the spread of cross infection at the home. Adequate arrangements must be made to ensure that qualified and competent staff are working at the home in such numbers as are appropriate for the health and welfare of the residents. Arrangements must be made to ensure that all fire doors at the home meet fire safety legislation. Suitable arrangements must be made for the safe storage and labelling of all materials subject to the Control of Substances Hazardous to Health legislation. Additionally, guidance information must be available on the course of action to be taken if an accident occurs with the use of such products. 15/02/06 31/03/06 15/02/06 15/02/06 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 OP29 Good Practice Recommendations The dates of previous employment should be ascertained and recorded for all prospective employees. Pendlebury Manor Care Home DS0000018805.V265524.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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