Inspection on 15/01/07 for Ranelagh House Residential Care Home

This inspection was carried out on 15th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Ranelagh House Residential Care... 09/07/08

Ranelagh House Residential Care... 04/06/07

Ranelagh House Residential Care... 03/01/06

Ranelagh House Residential Care... 19/10/05

Ranelagh House Residential Care... 28/10/04

Ranelagh House Residential Care... 14/04/04

Ranelagh House Residential Care... 26/11/03

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

CARE HOMES FOR OLDER PEOPLE Ranelagh House Residential Care Home 533 Aigburth Road Liverpool Merseyside L19 9DN Lead Inspector Peter Cresswell Key Unannounced Inspection 15 January 2007 9:25 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 Ranelagh House Residential Care Home DS0000025364.V300271.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. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ranelagh House Residential Care Home Address 533 Aigburth Road Liverpool Merseyside L19 9DN 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) 0151 427 4486 mailto:lil@RanlelaghHouse.com www.RanelaghHouse.com Prima Health Care Limited Margaret Lilian Martin Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 Brief Description of the Service: Ranelagh House is situated in the Aigburth area of Liverpool, close to local amenities and bus routes into the city centre. The home provides care for 26 older people. The residents have single rooms, with up to two rooms available for people who may want to share (for instance married couples). Most of the bedrooms have en suite facilities. The rooms are on two floors and the home has a passenger lift to the first floor. Three rooms on the first floor cannot be reached by the lift so residents have to either use the stairs or a stair lift. There is car parking at the side of the house and on the main road, and a secure, well-tended garden to the rear. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced site visit. On that visit the inspector looked at all parts of the home, spoke to four residents, the Registered Manager, three staff and a relative who was visiting the home. He examined documents, including care plans ,reviews, daily reports, fire safety documentation, accident reports and medication. The Registered Manager returned a pre inspection questionnaire before the site visit. What the service does well: What has improved since the last inspection? What they could do better: The Registered Person must ensure that gas and electrical safety checks are renewed promptly when they expire. Fire doors must not be propped open unless an approved device is used. Care needs to be taken with the administration of medication to ensure that all medication is recorded and accounted for. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 6 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. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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 Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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, 5. Quality in this outcome area is good. Ranelagh House’s pre-admission assessment procedures ensure that residents are appropriately placed and therefore receive care that meets their needs. EVIDENCE: All residents are provided with a statement of terms and conditions, plus a contract when they move in to the home. Residents can visit the home or have an overnight or trial stay before they move in permanently. The Registered Manager or one of the senior carers undertakes a full assessment on residents before they are admitted to the home, to ensure that their care needs can be met. Other professionals who know the resident – such as social workers - are also involved in the assessment. The completed document forms the basis of the resident’s care plan when they are admitted to the home. The home’s charges are £330 per week. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 9 Ranelagh House does not provide intermediate care, so Standard 6 does not apply, though the Registered Manager said that the home does sometimes provide respite care if there is a vacancy. Ranelagh House Residential Care Home DS0000025364.V300271.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, 11. Quality in this area is good. Care planning is good and the monthly reviews ensure that staff are aware of residents’ current needs. The system for organising medication is generally sound, protecting the welfare of the residents, though attention needs to be paid to the need for detailed and accurate recording. EVIDENCE: All residents have an individual care plan, which is drawn up when they are admitted to the home. Care plans are reviewed each month by keyworkers and are checked and signed off by the Registered Manager. Other staff also take part in the review process, which is well documented. Care plans are written manually and it would be easier to update them if they were kept on a computer. Care staff complete a daily record for each resident. Since the last inspection the Registered Manager has drawn up “Guidelines for writing residents’ daily reports”. The guidance includes advice such as the need to date and sign all reports and to document the state of any pressure areas. Care staff have signed to confirm that they are familiar with the guidelines. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 11 All residents have access to community and, if relevant, specialist NHS resources. Where possible residents retain their own GP when they are admitted to Ranelagh House but if necessary the Registered Manager will make arrangements for them to register with a local surgery or health centre. In the event of a resident requiring attention for a pressure area the Registered Manager and her staff contact a District Nurse immediately. During the inspection the inspector checked medication for three residents. Medicines were stored securely and the home uses a Monitored Dosage System in which most medication is provided by the pharmacist in special blister packs. Medication was on the whole well organised but in one case several prescribed tablets were not properly accounted or signed for. Also, one unidentified (but, as it turned out, relatively harmless) tablet was found loose on a coffee table in one of the lounges. It is important that the administration of all medication is recorded fully and accurately and the Registered Manager needs to remind staff of this. The home has limited supplies of one prescribed controlled drug which is appropriately stored, with its administration recorded in a bound CD register. All staff who administer medicine have been trained by the home’s community pharmacist. One resident looks after and administers her own medication. A risk assessment for this is kept on the file, and the resident has a secure location in which to store the medication. The Registered Manager audits residents’ falls on a monthly basis, and said that apart from persistent minor falls by one resident (the reason for which is understood) there is no evident pattern in the falls. At the last inspection the Registered Manager was asked to amend the home’s policy on Death and Dying to include ‘Ethnic and Cultural death rites’. She said that she has had some difficulty in identifying suitable material but confirmed that she would obtain appropriate information in individual cases when appropriate. At the moment there are no residents from black or ethnic minority groups in the home. The Registered Manager said that issues around death and dying are usually discussed with residents’ families. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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. Quality in this outcome area was good. Staff arrange a variety of activities to enhance the lives of its residents. The menu provides choices and meets the dietary needs of the residents. EVIDENCE: Residents are asked about their lifestyle, preferred foods, and the sort of social activities that they would like to take part in. The deputy manager and other care staff organise outings and activities, including tea dances in Sefton Park Palm House, games within the home, weekly visits to the pub next door for lunch and special trips out (such as to a circus, which residents who spoke to the inspector greatly enjoyed). One resident said that she had helped staff with the Christmas flower arrangements, having particular expertise in that area. The residents have regular meetings at which they discuss (amongst other things) the sort of activities and trips they would enjoy. Activities are recorded both on the individual files of those residents who joined in and in a special activities book. Ministers of religion visit the home every month and hold services for those residents who want to join in. Visitors are welcome in the home at any reasonable time and residents can entertain friends and relatives either in the communal lounges, or in their own bedroom. During the site visit the inspector spoke to the relative of one Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 13 resident and she said that she had been very happy with the way that her relative’s admission had been handled by the home and with the way she had settled in. Residents told the inspector that they enjoyed the food at Ranelagh House and were looking forward to lunch, which was either sausages or chopped luncheon meat (‘Spam’ to many of the residents) with egg and chips. The main meal is served at lunchtime and there is always a sweet. The evening meal is lighter but usually includes a cooked option. Residents have a choice of main course and can have something prepared individually if they do not like what is on offer. The cook said that she has tried some dishes which are perceived as more adventurous, such as lasagne or curry, but most residents are not keen. She does occasionally prepare some of these dishes for those residents who do like them. Residents can choose to have a full cooked breakfast and one told the inspector that she does so most mornings. Others said they have breakfast choices such as boiled eggs, toast or Rice Krispies. Some residents prefer to eat their meals in their own room rather than go to the dining room. The home buys its meat and vegetables from small local suppliers which ensures freshness and quality. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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, 17, 18. Quality in this outcome area is adequate. Procedures for complaints and adult abuse allegations are in place, providing protection for residents though the adult protection policy should be reviewed. EVIDENCE: There have not been any complaints since the last inspection. The home has an adult protection policy and a copy of the Liverpool are protocols and guidance on adult abuse. There was no evidence that staff had recently received training on adult abuse so the Registered Manager should make arrangements for this. The Registered Manager said that the adult protection policy had been reviewed by the Registered Person’s administrator last year but this was not evident from the policy itself, which refers to an Operations Manager and other posts which are not relevant to the management and ownership structure of Ranelagh House or its owners, Prima Care. The Registered Manager had a copy of the Liverpool area protocol on the protection of vulnerable adults. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. Ranelagh House provides a comfortable, clean and homely environment for its residents . EVIDENCE: The Registered Person carries out routine and planned maintenance on Ranelagh House and the building is homely, clean and well maintained. There were no unpleasant odours in the home, something which a visiting relative commented on. The home is on a main road which is well served by buses to Liverpool city centre, Speke retail park and the airport. Several small shops are within walking distance and there is a large pub/restaurant next door. A lift serves the first floor but because of the layout of the upstairs bedrooms, three rooms at one end of the house cannot be reached via the lift in normal circumstances. This part of the home has its own staircase and a stair lift. The stair lift is now quite old and when the inspector visited it had been out of action for some weeks. Although the stair lift is not an attractive feature it does help the three residents who have bedrooms in that part of the building. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 16 It should be repaired as soon as possible. If it cannot be repaired the Registered Person will need to give fresh consideration to how the home can meet the mobility needs of all of its residents. The National Minimum Standards state that all areas of the home should be accessible to all residents and stair lifts may be used ‘where they meet the assessed needs of service users and the appropriate requirements of the Environmental Health departments and the Health and Safety Executive.’ The carpet on the landing by the stair lift also needs to be cleaned or replaced. There are two comfortable lounges and a dining room which overlooks the large and attractive garden through French windows. The television in the end lounge is rather small given the size of the room and the Registered Person may wish to consider getting a bigger one. The home has sufficient bathrooms and toilets, including a Parker assisted bath on the ground floor. Several tiles on the kitchen floor are very badly cracked and could harbour dirt and germs. Any cracked tiles need to be replaced. If this cannot be done the floor would need to be replaced by a suitable impermeable, readily cleaned surface. Residents have single, lockable bedrooms unless they have freely chosen to share a room. At the moment one married couple have a shared room. Many of the rooms are light and spacious with good views. The rooms are clean and well furnished, many containing cherished personal items reflecting the personality and tastes of the resident. There is some damp damage in one bedroom and the corridor on the first floor and this needs to be made good. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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. Quality in this outcome area is good. Staff are properly checked before starting work, protecting the safety of the residents. A stable, well qualified and competent staff group meets the residents’ needs. EVIDENCE: Rotas showed that the home is adequately staffed to meet the needs of the residents. Residents spoke very highly of the staff and told the inspector that staff were always available to help them when they needed it. As well as the Registered Manager there is a deputy manager, seven senior care assistants, seven care assistants two domestic staff and a cook. The staff group is remarkably stable, some having worked at Ranelagh House for over 20 years. Only one new member of staff has been recruited in the past year and the Registered Manager had obtained written references and POVA (Protection Of Vulnerable Adults register) clearance before she started work. The copy of the Criminal Records Bureau certificate was not on file but there was evidence that it had been received and the manager said that she thought it must have been retained by the training agency with whom the member of staff had started. These documents must be retained in the home. Agency staff are used very rarely and the inspector pointed out that the Registered Manager needs to see checks carried out an all such staff as agencies providing care staff to residential homes are not registered for that function. 11 care staff have NVQ2 and a further three are studying for the qualification. Training over the last year has included courses on Diabetes and Dementia Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 18 Care but it was not very clearly recorded and it would be sensible to update the training matrix with dates so that it is apparent when refresher training (e.g. on manual handling and adult abuse) is needed. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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, 32, 33, 35, 36, 38. Quality in this outcome area is adequate. Staff morale is high in Ranelagh House, resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Safety checks are carried out to protect residents’ health and welfare but some of the systems need to be improved. EVIDENCE: The Registered Manager is highly experienced and has managed the home for nearly two years. She has not yet started her NVQ4 but said that she intends to do so in the near future. She places a great emphasis on teamwork and holds regular team meetings. There was a positive and open atmosphere in the home when the inspector visited. Staff do receive one to one supervision but this is not yet regular. The Registered Manager is discussing the possibility of supervision being conducted by senior carers. This would be a positive Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 20 development as it can be difficult for a manager to carry out all of the supervision in a home of this size. The Registered Person lives in the West Midlands but visits the home regularly. He or his administrative officer inspect the home and complete reports in accordance with Regulation 26 every month. The Registered Manager occasionally distributes questionnaires to relatives and residents but this is not a systematic part of a quality assurance system. The home did achieve Investors In People (IIP) status three years ago but the Registered Manager was not aware that this had been renewed. IIP is a nationally recognised quality assurance measure but it does need to be regularly reviewed. Where possible, residents look after their own financial affairs. Families of residents are consulted as regards bank accounts of their relatives. The water system has been tested for Legionella since the last inspection. Fire checks were carried out regularly but the home’s gas and electrical safety certificates had recently expired. These certificates need to be obtained as soon as possible and a system set up to ensure that they are renewed regularly. A number of fire doors were propped open during the site visit – one of them using a fire extinguisher. If a fire door is propped open it is ineffective as a barrier to the spread of fire. If a door needs to be kept open this should be done using an approved hold-open device, such as a ‘Dor-Gard’, which closes automatically if a fire alarm is sounded. Food stocks are checked regularly but the mince pies being used were just beyond their use-by date. These had evidently been bought only recently so the Registered Manager should have a word with the suppliers. The cook checks and records fridge and freezer temperatures every day. The Registered Manager may wish to contact the Environmental Health Officer with a view to introducing the Food Standards Agency programme Safer Food, Better Business. Accidents are properly recorded but the home’s Accident Book is not currently compliant with the Data Protection Act. The Registered Manager should buy one which allows the forms to be removed and filed separately once they have been completed. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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 x 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 3 x 2 Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 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 OP9 Regulation 13(2) Requirement The Registered Person must make arrangements for the recording and administration of medicine and must therefore ensure that each medication episode is accurately recorded and all medication can be fully accounted for. The Registered Person must keep the home in a good state of repair and must therefore: * Make good the water damage on the first floor leak; * Clean or replace the landing carpet near the stair lift; * Repair the stair lift or make other suitable arrangements for those residents who cannot use the passenger lift; * Replace the broken tiles in the kitchen or replace with an impermeable, readily cleaned floor surface. 3 OP38 23(4) The Registered Person must take 01/02/07 adequate precautions against the risk of fire and must therefore: * Obtain up to date gas and DS0000025364.V300271.R01.S.doc Version 5.2 Page 23 Timescale for action 17/01/07 2 OP19 13(4), 23(2) 01/03/07 Ranelagh House Residential Care Home electrical safety certificates; * Ensure that fire doors are only propped open by an approved device which closes the door if an alarm is sounded. 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 2 3 4 Refer to Standard OP18 OP30 OP38 OP38 Good Practice Recommendations The home’s policy on adult abuse should be reviewed and updated. The Registered Manager should keep an accurate record of staff training. The Registered Manager should buy an accident book which is compliant with the Data Protection Act. The Registered Manager may wish to contact the Environmental Health Officer with a view to introducing the Food Standards Agency programme Safer Food, Better Business. Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Ranelagh House Residential Care Home DS0000025364.V300271.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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