Inspection on 09/08/06 for Radiant Care Home

This inspection was carried out on 9th August 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

Radiant Care Home 27/03/09

Radiant Care Home 29/11/07

Radiant Care Home 22/02/06

Radiant Care Home 20/07/05

Radiant Care Home 30/06/04

Radiant Care Home 27/04/04

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

CARE HOMES FOR OLDER PEOPLE Radiant Care Home Highbury Road Bulwell Nottingham NG6 9DD Lead Inspector Steve Keeling Unannounced Inspection 9th August 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 Radiant Care Home DS0000045217.V306918.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. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Radiant Care Home Address Highbury Road Bulwell Nottingham NG6 9DD 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) 0115 975 3999 Mrs Lota Hopewell Mr Derrol Paul Hopewell Mrs Lota Hopewell Care Home 18 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (18) of places Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Radiant Home cares for up to eighteen older people, a maximum of ten beds are registered to accommodate people with dementia. The home is in a residential area close to local amenities and Bulwell town centre. The home is on two floors and there is a passenger lift. There are fourteen single bedrooms, one of which has an en-suite facility, and two double bedrooms. There are three day rooms. The fee currently charged at the home is £307.96, additional expenses such, as podiatry services, hairdressing and newspapers are not included in the fees charged at the home. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a 7 hour period and involved one inspector. The main method of inspection was case note tracking, this is a method of selecting residents within the home and discussing with them their expectations and experiences of living within the home environment. The case tracking method also analyses the records of the service users to ascertain if the residents identified needs are being addressed appropriately within the care home setting and that their safety and well being is being maintained. On this occasion two residents notes were case tracked. Also as part of the case tracking process a staff member within the home was informally interviewed to further evidence the quality of care afforded to the residents. The report indicates minimal comments from the residents, primarily due to the nature of the illness of those accommodated, although relatives were interviewed at the time of the inspection to glean further information as to the quality of care afforded to the residents. What the service does well: The residents spoken with at the time of the inspection enjoyed living at the home. Residents stated that the meals provided was of a high standard and the staff are very attentive to their needs. Residents stated that they felt comfortable and safe within the homely environment and that appropriate levels of privacy and dignity are maintained at the home. Residents and visitors to the home confirmed that a varied social activities programmed is provided at the home and within the broader community. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 6 Residents stated that they felt that any concerns or complaints would be listened to, taken seriously and acted upon by the manager and staff at the home. The home utilises an appropriate recruitment policy, which is adhered to thus ensuring residents are supported and protected. What has improved since the last inspection? What they could do better: Elements of care identified within the residents care plans had not always been addressed within the daily evaluation documentation. Residents or their representatives were not consulted in relation to the content of the care plans. The needs of the residents were not always re-evaluated effectively. Policies and procedures in relation to the management of medicines are not being followed. The complaints documentation was not stored securely at the home. The home stores mobility equipment within a lounge area which constitutes a risk of falls. The upstairs corridor carpet is ridged which constitutes a risk of falls. The laundry room was not locked when unoccupied and chemicals were evident within the laundry area. The hot water outlets within the home exceeded the recommended temperature of 43 Degrees Centigrade, which could place the service users at risk of scolding. The administration of documentation within the home was disorganised in relation to the training opportunities afforded to staff at the home. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 7 Staff training documentation requires reorganisation to ensure the training needs of staff at the home can be easily identified and met. 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. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 8 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 Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 9 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): 3, 6. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. A suitably qualified assessor performs effective pre-admittance assessments. The home does not provide intermediate care services. EVIDENCE: The pre-admittance assessments within the two case tracked notes were detailed in identifying the specific needs of the residents to maintain optimum independence and health within the home. The assessment process identified the physical and psychological needs of the residents and utilised a recognised assessment tools. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 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, 10. Quality in this outcome group is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans were formulated which addressed the identified needs of the residents on admission but the care plans were not re-evaluated effectively to address the changing needs of the residents. Policies and procedures in relation to the management of medicines were not being followed fully, which could compromise the safety of residents at the home. Residents are afforded appropriate levels of privacy and dignity at the home EVIDENCE: Elements of care identified within the residents care plans had not always been addressed within the daily evaluation documentation. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 11 The assessment documentation within one case tracked residents notes stated that due to the resident’s susceptibility to constipation a record of the resident’s bowel movements should be maintained and recorded on a daily basis. It was evident that this requirement was not being performed effectively as no records were evident from 1st June to 18th June 2006. Furthermore the residents Waterlow score (a tool designed to identify individuals susceptibility to pressure ulcer formation) had not been utilised since September 2004, at which time the resident was assessed as “medium risk” of pressure ulcer formation. The daily records appertaining to the resident’s dietary intake were not utilised effectively as the documentation evidenced gaps on 27th and 28th July 2006 and again between the 3rd August 2006 and 8th August 2006. The registered person is required to demonstrate that the care planning processes within the home will be improved and that elements identified within the care plans are documented within the daily progress documentation. Whenever possible, residents or their representatives should be formally consulted in relation to the care planning process so that informed consent can be obtained as to the content of the care plans. The two case-tracked care planning documentation did not evidence that this process was taking place. The registered person is required to demonstrate that a process is in place to allow residents or their representatives to be actively involved in the care planning process. It was evident that the temperature within the medication fridge had not been monitored effectively. It is good practice to monitor medication fridges on a daily basis to ensure that an optimum environment is maintained to prevent medication degradation. Although the facilities are in place it was evident that the procedure was not being followed. The case tracked residents Medication Administration Record (MAR) were examined at the time of the inspection and it was established that policies in relation to the administration of medicines had not been fully adhered to. The reason for omission of medication codes was not being used correctly, furthermore the MAR charts of a case tracked resident had gaps present with no explanation as to why the medication had not been given. The registered person is required to ensure that polices and procedures in relation to the receipt, storage, administration and disposal of medicine are followed and that staff are competent in relation to medicines management at the to ensure the residents safety is not compromised. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 12 Staff interviewed on the day of the inspection demonstrated an appropriate knowledge relating to the principles of privacy, dignity and respect and how to apply these principles to the residents at the home. Residents stated that they were very happy within the homes environment and were positive about the way staff spoke to them, residents confirmed that staff always knocked on the resident’s bedroom door before entering and also stated that the staff respected the residents privacy and dignity when bathing or performing personal care. The inspector witnessed interactions between residents and staff at the home at lunchtime and throughout the day, it was evident that the manager and staff within the home promoted the principles of respect and dignity at all times and displayed genuine care and compassion towards residents. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 13 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. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home provides social activities within the home and within the broader community. Residents are encouraged to maintain contact with their family and friends. Residents are encouraged to exercise choice and control over their lives. Residents are provided with a wholesome, appealing and balanced diet. EVIDENCE: A case tracked resident and relatives visiting the home stated that the home provides some social activities in which the residents can choose to participate in. Residents and visitors to the home confirmed that trips had been provided to safari park and it was also confirmed by residents and visitors that the home had recently arranged a B-B-Q within the grounds of the home, which residents said they particularly enjoyed. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 14 Other activities performed within the home include bingo, dominoes, darts, board games and movement to music. The case tracked residents and two relatives visiting the home stated that the staff at the home are very welcoming and they have no concerns in relation to the visiting arrangements at the home. Residents and relatives alike confirmed that the food in the home is of good quality, well presented and meets the dietary needs of residents. On the day of the inspection the lunchtime menu consisted of sausages in onion gravy with fresh vegetables and mashed potatoes followed by a fresh fruit and ice cream. It is good practice to display a weekly menu in a prominent position within the home so as to promote the residents choice in relation to meal provision. The daily menu should have a least two meal options displayed, this process was not being performed effectively and as such the registered person should ensure that a daily menu is prominently displayed so as to afford the residents an effective choice in relation to meal provision. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents feel that any concerns or complaints will be listened to, taken seriously and acted upon by the manager and staff at the home. Staff at the home require further training in relation to the protection of the vulnerable adult to ensure the safety of residents at the home. EVIDENCE: The manager stated that she operates an open door policy in which residents and relatives are encouraged to consult with her in relation to any aspects of care provision at the home. The open door policy was also confirmed by residents and visitors to the home. The complaints procedure is available in the home foyer for residents and their representative’s perusal. At the time of the inspection no complaints were being investigated at the home and no complaints have been received at the Commission for Social Care Inspection. The complaints book was on display within the homes foyer at the time of the inspection. The inspector informed the manager that having the complaints book on display and accessible to all residents and visitors to the home constitutes a confidentiality breach. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 16 A case tracked resident stated that she felt safe within the home and should she have any concerns or complaints she would discuss them with the manager. Relatives visiting the home also stated that they felt confident the manager would listen to any concerns or complaints they might have and address them effectively. A staff member was spoken with at the time of the inspection and it was evident that she was not fully aware of the appropriate actions to taken if she suspected adult abuse was happening in the home. To ensure that residents within the home are protected from abuse the registered person should ensure that all staff receive appropriate training appertaining to the protection of the vulnerable adult and that all staff receive training updates so as to ensure the residents safety within the home. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Minor concerns were identified which could compromise the resident’s safety within the home. The home is clean, pleasant and hygienic throughout. EVIDENCE: On the whole Radient house is well maintained, pleasant and safe, mobility aids and equipment are in place to meet the care needs of the residents with restricted mobility. A choice of communal spaces are available in the home which includes three lounges and a dining room in which residents can interact and meet relatives and friends it they choose. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 18 There are a number of toilets strategically placed around the home all of which were clean, odour free and safe The case tracked residents gave the inspector consent to examine their bedrooms. The bedrooms were found to be personalised, homely, safe and met the residents individual needs. The home benefits from a garden area, which at the time of the inspection was well maintained and provides a pleasant area for resident to enjoy. The inspection process identified four areas of concern in relation to the environment. It was evident that mobility equipment was being stored inappropriately within a lounge area that constitutes a risk of falls. The upstairs corridor carpet is ridged which also constitutes a risk of falls. The laundry room was not locked when unoccupied and chemicals were evident within the laundry area, given that some residents at the home have diagnosed dementia the laundry area should be locked when not in use to satisfy the Control of Substances Hazardous to Health (COSHH) legislation. The hot water outlets within the home exceeds the recommended temperature of 43 Degrees Centigrade, as such risk assessments should be performed to ensure the safety of residents and protect them from potential scolding. To ensure that residents within the home are safe the registered person should ensure that all the aforementioned issues of concern are addressed effectively. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staffing levels at the home are appropriate in meeting the needs of the residents. The home utilises an appropriate recruitment policy, which is adhered to thus ensuring residents are supported and protected. Staff receive appropriate training to do their jobs effectively to ensure that residents are in safe hands. EVIDENCE: The staff rota evidenced that an appropriate number of staff were on duty throughout the 24-hour period to address the needs of the residents. Throughout the day four care staff are on duty plus the manager of the home and throughout the night two carers are on duty. The recruitment documentation of two members of staff employed at the home was checked and found to be satisfactory. Both staff members had undergone appropriate Criminal Record Bureau (CRB) checks and had provided two written satisfactory references. The homes documentation relating to the recruitment process is well organised and clear. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 20 The manager stated that all staff receive an induction programme, which commences on the first day of employment and it was confirmed through conversations with care staff employed at the home that the induction process is performed. Both the manager and staff at the home stated that mandatory training is performed which includes Health and Safety, Moving and Handling, Infection Control, Protection of the Vulnerable Adults, Fire Training, Food Hygiene and First Aid training. Documentation and attendance certificates relating to mandatory training provision at the home was insufficient in establishing that staff have attended the aforementioned mandatory training so as to perform their roles effectively at the home. The registered person must ensure that documentation in the home clearly evidences the training undertaken in order to meet the needs of the residents. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 21 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, 33, 35, 38. Quality in this outcome group is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents or their relatives are afforded the opportunity to express opinions and concerns. Residents at the home are protected from financial abuse. Staff at the home receive appropriate formal supervision sessions. The health, safety and welfare of residents are promoted and protected. EVIDENCE: Residents, staff and visitors to the home all stated that the manager is very approachable and she operates an open door policy so that any concerns are Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 22 identified, listened to and addressed effectively. The manager has also initiated an effective consultation processes in which she operates an “open surgery” on Thursday afternoons at which time relatives can discuss any concerns they might have in relation to the care provision at the home. To ensure the residents at the home are protected prom financial abuse and operates a system which does not require the residents to have any personal monies at the home. The manager of the home pays for all additional costs incurred at the home or on day trips and relatives or the Social Services Department are invoiced appropriately. To ensure that the residents are safe within the homes environment a range of Health and Safety records were seen, all were found to be satisfactory. Although it is evident that all documentation appertaining to the routine maintenance within the home is well organised other documentation within the home is somewhat disorganised especially in relation to the training opportunities afforded to care staff at the home and would benefit form reorganisation. Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 23 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 24 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 OP30 Regulation 13 Requirement The registered person will establish a robust system that clearly demonstrates the training provision for all staff at the home. Timescale for action 31/10/06 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 OP7 Good Practice Recommendations The registered person should ensure after consultation with the service user, or a representative of his, prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. The registered person should ensure that the assessment of the service user’s needs is kept under review and revised at any time when it is necessary to do so having regard to any change of circumstances The registered person should make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home. The registered person should ensure that the complaints book is stored securely to ensure the resident’s DS0000045217.V306918.R01.S.doc Version 5.2 Page 25 2 OP8 3 4 OP9 OP16 Radiant Care Home 5 6 7 OP19 confidentiality is maintained. The registered person should ensure that mobility equipment was being stored appropriately. The registered person should ensure that the carpet on the upstairs corridor carpet is ridge free to reduce the risk of falls. The registered person should ensure that the laundry room is locked when unoccupied and chemicals and Control of Substances Hazardous to Health (COSHH) legislation is adhered to. The registered person should ensure that risk assessments are performed to ensure that residents are protected from potential scolding. The registered person should ensure that documentation in the home is organised especially in relation to the training opportunities afforded to care staff at the home and would benefit form reorganisation. OP19 OP19 8 9 OP19 OP37 Radiant Care Home DS0000045217.V306918.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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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