Inspection on 30/06/06 for Pool Cottage Care Home

This inspection was carried out on 30th June 2006.

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

Other inspections for this house

Pool Cottage Care Home 06/01/09

Pool Cottage Care Home 21/07/08

Pool Cottage Care Home 30/05/07

Pool Cottage Care Home 23/01/06

Pool Cottage Care Home 26/09/05

Pool Cottage Care Home 09/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Pool Cottage Care Home Pool Road Melbourne Derbyshire DE73 8AA Lead Inspector Jo Wright Key Unannounced Inspection 30th June 2006 08:45 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 Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 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. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pool Cottage Care Home Address Pool Road Melbourne Derbyshire DE73 8AA 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) 01332 863715 01332 863715 poolcottage@clara.co.uk Mutebi Blessious Kalemeera Jennifer Susan Williams Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Pool Cottage is a detached property, which has been adapted and extended to provide personal care for up for up to 17 persons aged 65 years and over, and day care for up to 3 persons. The home overlooks Melbourne lake and is close to the town centre, local shops and a bus route. The home has 11 single and 3 double bedrooms located on the ground and first floor, 7 bedrooms have ensuite facilities. Access to the first floor is by stairs and a stair lift. There are 2 lounges, a conservatory and a dining room on the ground floor. The Home has a garden. Information about the service is provided through the Statement of Purpose and Service User Guide, both of which were made available to residents. Information included on the pre-inspection questionnaire received on 12/05/06 stated that the fees for the home were £353 to £368 per week, and that this information was also included on the contracts and terms and conditions Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, carried out by one inspector, and lasted 7 ½ hours. A review of the evidence available prior to site visit was undertaken, for example, the pre inspection questionnaire, resident surveys (8 surveys received) and notification of incidents, and used to identify areas to be examined during the site visit. The information available was used to identify those residents whose care was to be cased tracked. Records such as care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents) were examined in depth during this inspection. Time was spent taking with residents and staff on duty and observing the daily routine. A small selection of bedrooms was viewed during this visit. Other records such as medication records, staff files and service certificates were also examined. The registered manager was on duty during this visit and the findings of this site visit were discussed with her. What the service does well: Pool Cottage provides a comfortable and safe environment for the people who use the service. Residents and families were encouraged to personalise their rooms with their own possessions. The staff team are committed to providing a good standard of care for residents, and are supported to do this through a structured induction and training opportunities. Residents’ care was well planned, and car plans provided information about individuals prefered daily routine, and outlined areas where they required assistance from staff. Management and staff recognise the importance of providing opportunities for the people living in the home to join in with activities and entertainment. Social events and activities were well organised and provided variety and social stimulation for residents. The importance of maintaining links with family, friends and the local community was also recognised and supported. Residents were offered a choice and variety of meals, and residents comments that they enjoyed the meals. Quality assurance systems are beginning to form an integral part of the management of the home, and are being used to improve the quality of the care and services provided for people using the services of Pool Cottage. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 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 Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 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): 2, 3 and 4 (Standard 6 is not applicable in this home) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedures ensured that residents were assessed prior to admission, and the assessments provided staff with sufficient information to fully identify individuals’ needs and plan care. EVIDENCE: The files of two residents who had recently been admitted to Pool Cottage were looked at in detail during this site visit. Case tracking confirmed that a structured admission process was completed for all prospective residents, and provided reassurances that their individual needs could be met at Pool Cottage. The manager had visited the prospective residents prior to admission, and carried out an initial assessment of their care needs. The written assessment documentation was adequate and included information from other health care professionals involved in the residents care. Sufficient information, including individuals abilities, needs and preferences, was available to staff to ensure that they could meet the social, emotional and care needs of new residents. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 9 Information provided through the resident surveys supported that residents received enough information to decide if the home was the right place for them to live, and received contracts. Copies of the Statement of Purpose, and contacts between the home and the funding authority, or contracts between the home and individual resident and/or representative were held on individual files, and each resident received a copy of the Service User Guide. Residents spoken with indicated that they felt well cared for and that the home was able to meet their needs. The ongoing staff training programme provided staff with the necessary skills and experience to meet the needs of the residents. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care of residents was planned and given in a way that respected individuality and privacy. The record keeping around the administration of medication needs to improve in order to ensure that residents receive the medication that they are prescribed. EVIDENCE: Residents spoken with commented postively about living at Pool Cottage, and said if you can not live at home, this is the next best thing. Residents commented that the staff team were very good, and they were able to discuss any isuses or concerns with the manager. No issues around privacy and dignity were raised, and staff were observed routinely knocking on bedroom and bathroom doors, and speaking with residents in a respectful and polite manner. The files of two residents were looked at in detail during this site visit. The residents had provided information about their abilties and preferences, and been involved in planning their care. The manager was advised to make it Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 11 clear when residents had completed the paperwork themselves, as it explained why some sections were not completed. The care plans provided information about individuals prefered daily routine, and outlined areas where they required assistance from staff. Additional information about residents’ abilities and needs was gathered through risk assessments. The required risk assessments were in place, but not all had been fully completed, for example the falls risk assessment for one resident contained a hazard analysis but did not include details of action to be taken. The resident had been involved in monthly reviews of their care. The files supported that attention was paid to individual’s health care needs and access to other health care professionals facilitated as required. Residents spoken with also confirmed this to be the case. A review of the medication records for the previous four weeks was undertaken during this site visit. Staff had recorded the date when medication was discontinued, the name of the doctor who had ordered this, and recorded the information in the resident file. A number of gaps were found on the medication records. These were brought to the attention of the manager, as there is a potential for staff to be unsure whether the medication has been given or not. This issue was also highlighted at the time of the last inspection. The records did not always indicate whether staff had given one or two tablets when the dose of medication was variable. Comments from staff and the training records confirmed that staff responsible for administration of medication had received training. The requirement to fit a lock to the medication refrigerator has been met. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of suitable activities was being provided, which met the leisure and recreational interests of residents. The meals were good offering both choice and variety and catering for any special dietary needs. EVIDENCE: The routines at Pool Cottage were planned around the residents needs and wishes. Residents were actively involved in choosing activities and trips through residents meetings. Minutes of these meetings were displayed on the notice board. Residents spoke about activities and trips that had taken place in the home recently. Residents commented on how much they had enjoyed a recent trip out to the Arobretum at Alrewas and Cannock Chase, where they had visited the tea rooms. As not all residents wished to or were able to go on this trip, a theatre company had visited the week previously, and performed a summer show. Other activities included lunch out, a puppet show with resident participation, and a planned fashion show. Regular weekly activities take place, including exercises, bingo, knitting, tea and cake afternoon (open to the local community) and attendance at local clubs in the village. Individuals were encouraged and supported to maintain links with their church, Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 13 both withih the home and attendance at services outside the home. Links with the local community have been strenghtened through ongoing involvement in a local art project, for those residents who wish to participate, supporting fund raising events at the local school, and, and supporting the local carnival through advertising and watching the procession. Residents and families were kept fully up to date about events and activities through the regular monthly newsletter, and through information displayed on the notice board, such as the weekly list of events. Information about events in the local community were also displayed and residents supported to access community facilties as they wished. There were sufficient staff resources to support activities, and staff were supported by a small team of volunteers. Residents and staff confirmed that visitors were welcome at any time, and this was observed during the inspection. Visitors were made to feel welcome, and were offered refreshments. As the majority of residents living at Pool Cottage were part of the local community, visitors tended to know the majority of the residents, and were observed spending time speaking with them. Menus were varied and offered a choice of meals. There was sufficient dining space for residents, and dining tables were well presented with tablecloths, placemats, napkins, cutlery, condiments, glasses and jugs of water/juice. The lunch time meal was served in an relaxed manner, and staff support was provided as required for those residents who required assistance. Residents independence was encouraged by serving the vegetables in tureens and using gravy/sauce jugs. Residents spoken with spoke highly of the meals provided at Pool Cottage, and this was generally supported by the residents surveys. Minor concerns were raised about the choices available for vegetarian residents. The manager agreed to discuss this with the chef and the residents. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A satisfactory complaints procedure was in place with some evidence that people felt that their views were listened to and acted up. Staff had a good knowledge and understanding of adult protection issues which protects residents from harm. EVIDENCE: Residents spoken with commented that they felt safe, listened to and able to speak to the manager and staff if they were not happy about anything to do with their care. The complaints procedure was available to all residents and relatives and was included in the Service User Guide, which all residents had received. Staff spoken with aware of the complaints procedure and were able to describe how they would deal with any complaint that they received. The manager has dealt with two complaints since the last inspection and these have been resolved to the satisfaction of the complainant. Residents were protected from potential harm through staff knowledge and training. The required polices and procedures were in place, and staff spoken with had a good understanding of these procedures and confirmed that they had attended safe guarding vulnerable adults training. An introduction to safe guarding vulnerable adults was provided as part of the induction programme, prior to staff attending training undertaken by the local authority. Training records supported that the majority of staff had attended this training. The Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 15 manager reported that three recently recruited members of staff were to be booked onto the next available training day. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment was good providing residents with an attractive and homely place to live. EVIDENCE: Residents commented that Pool Cottage was always clean and fresh and this was supported by observation at the time of this site visit. All areas of the home were well maintained and decorated, with evidence to support that systems were in place for ongoing maintenance. Individuals liked their bedrooms, and were happy with the facilities in the home. Residents had unrestricted access to the well-maintained garden areas and were observed sitting out in the garden during this site visit. The rooms of the residents whose care was case tracked showed individuals had been able to personalise their rooms, and they were satisfactorily clean and well presented. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 17 Aids and adaptations were provided and satisfactory to meet the needs of the resident group. All equipment had been maintained within the specified timescales. A full audit of the building had been carried out and a programme of routine maintenance and renewal developed. Work carried out to date included redecoration of 8 bedrooms and the front of the house, thorough cleaning of all carpets, chairs thoroughly cleaned, dining tables and chairs revarnished, and replacement of some bedding and towels. Items bought include new garden furniture, sit on scales, refrigerator thermometers, food probe, and new information technology equipment. The plan identified work to be carried out for the remainder of the year, on a month by month basis. Residents spoken with were positive about the laundry service provided at the home. A small number of dedicated staff hours were provided for ironing. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home were cared for by staff who were trained and competent to do their jobs. However, inconsistent recruitment practices did not provide safe guards to offer protection to people living in the home. EVIDENCE: Comments on surveys suggested that generally residents felt that they received care and support when they needed it, as sufficient staff were available. Residents spoken with expressed no concerns about the number of staff on duty. Staff felt that they had time to meet peoples care needs, as well as being able to spend time with residents, socialising or organising activities. A competent and trained staff team supported residents living at Pool Cottage. The home has achieved the 50 target of care staff trained to NVQ Level 2 or equivalent, with another 6 members of staff due to start this training in September 2006. Staff confirmed that they were offered a range of training opportunities, and kept up to date with the mandatory training. New staff worked through an induction training that provided them with the necessary skills and knowledge to deliver the care that the home offers to provide. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 19 There was a stable staff team at Pool Cottage, although a number of staff were on maternity leave. Turnover of staff was low, with only three members of staff having left their employment since the last inspection. The manager reported that she was currently advertising for additional staff. Although robust recruitment and selection procedures were in place, these had not been adhered to. A review of staff files showed that not all of the required documentation had been obtained (2 written references) or placed on file (proof of identity which was obtained for the CRB but no copy available on file). Staff awaiting criminal record bureau checks were always supervised by other staff. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a well managed home, which benefits from quality assurance and quality monitoring systems. The manager was supported well by the staff team, and provided clear leadership throughout the home. EVIDENCE: Residents spoke highly of the manager and staff team, and commented that the manager would deal with any issues that they raised with her. Residents commented that although the owner had visited the home the day before the inspection, he had not visited the home for a number of months prior to that. This was supported by the lack of up to date monthly Regulation 26 reports. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 21 The manager continues to update her skills and knowledge through training, and has completed the Registered Managers Award. The manager stated that she hopes to the complete NVQ Level 4 in care by the end of 2006. Staff commented that the manager was approachable and that they felt able to discuss any issues as they arose. Quality assurance systems were in place. Residents were given the opportunity to contribute to the running of the home through residents meetings, and a resident questionnaire. A comprehensive review form has been developed to assist residents, representatives and staff with the six monthly review of care. Regular senior staff meetings take place, and a staff questionnaire was also in place. There has been no change to the system in place for safeguarding resident monies. The administrator managed this system and detailed records were available on computer. A staff training matrix was in place, detailing when staff had attended mandatory training. The training records and staff confirmed that they were up to date with mandatory training. A sample of service/maintenance records was examined (including equipment, gas and electricity services) and there was confirmation that equipment and services are properly maintained. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 3 Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP8 OP9 Regulation 13(4)(c) 13(2) 17(1a) Sch 3 Requirement Timescale for action 31/07/06 3 OP29 19(1)(b) (4)(b) 26 4 OP33 Risk assessments must be fully completed and include action to be taken by staff. The medication chart must be 31/07/06 signed following the administration of medication to the resident. The medication chart must accurately reflect the medication that the resident has received. (Previous timescale of 28/02/06 not met) All information as outlined in 31/08/06 Schedule 2 of the Care Homes Regulations 2001 must be on file for all members of staff. The person registered must carry 31/08/06 out the monthly unannounced visits and prepare a written report. This report must be provided to the registered manager and the Commission. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 24 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 The records should indicate whether staff have given one or two tablets when the dose of medication is variable. Pool Cottage Care Home DS0000061459.V293479.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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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