Inspection on 29/01/07 for Redcote House Residential Care Home

This inspection was carried out on 29th January 2007.

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

Other inspections for this house

Redcote House Residential Care... 11/06/07

Redcote House Residential Care... 03/04/06

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 Redcote House Residential Care Home Redcote Drive Lincoln Lincolnshire LN6 7HQ Lead Inspector Elisabeth Pinder Unannounced Inspection 29th January 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Redcote House Residential Care Home DS0000065539.V323798.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. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redcote House Residential Care Home Address Redcote Drive Lincoln Lincolnshire LN6 7HQ 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) 01522 500796 info@redcotehouse.co.uk 1st Care (UK) Limited Linda Gostelow Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Old Age, not falling within any other category (OP) 18 Mr Bhandal must comply with his Action Plan and the agreed timescales. 3rd April 2006 Date of last inspection Brief Description of the Service: Redcote House is situated in a quiet residential area to the south of the city of Lincoln. The home is within walking distance of local shops and close to a bus route into the city centre. The home is a large detached house, which has been adapted to provide accommodation for up to 18 people over the age of 65 years requiring personal care. There is a porch running the length of the front of the home, which provides outside seating for residents. Car parking facilities are to the rear of the property. The home has two floors and a stair lift to the bedrooms on the first floor. Ten of the bedrooms are single, three of them have an en-suite toilet. The current fee range for this service is £336£416 per week. Additional costs are to be paid for hairdressing, chiropody and escorting residents to hospital. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken by one inspector and formed part of a key inspection. The visit lasted five and a half hours and took into account previous information held by The Commission for Social Care Inspection (CSCI) including the homes pre-inspection questionnaire, previous inspection reports, their service history, records of any incidents that had been notified to the CSCI since the last inspection and any correspondence. No service user ‘Have your say about’ questionnaires were received, however, during the visit a conversation was held with a relative and comments have been included in this report. The site visit consisted of case tracking a sample of three service users’ records, talking to them and assessing their care. Some policies and procedures were seen together with some records concerning the safety of the home. A period of observation was undertaken whilst service users were getting ready for lunch and whilst medication was being administered. A general conversation was held with service users and two staff members were spoken to, one being the new manager. The site visit focussed on key standards and checking whether issues raised at the two previous random inspections had been addressed. What the service does well: What has improved since the last inspection? The manager has successfully registered with the Commission. The provision of activities has improved, those spoken to said they are given the choice regarding joining in with activity sessions and some said they enjoy them whilst others said they appreciated staff leaving them alone as they prefer their own company. Two service users said how much they enjoyed the church services and one spoke of having her nails painted and joining in with ‘armchair’ exercises. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 6 Arrangements are being made to improve the call system in the home and this will include call bells in communal rooms. 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. The summary of this inspection report can be made available in other formats on request. Redcote House Residential Care Home DS0000065539.V323798.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 Redcote House Residential Care Home DS0000065539.V323798.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 Standard 6 is not applicable Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Information about this home is not up to date and insufficient information is obtained prior to admission to ensure service users needs will be met. EVIDENCE: The statement of purpose and service user guide is not up to date and the requirement given during the random inspection has not been addressed. A discussion was held with the new manager in relation to the information required in these documents and although a photocopy of the National Minimum Standards (NMS) was available she did not have a copy of the Care Homes Regulations. The manager said that she does not give prospective service users written information about the home but invites them to come and have a look around. Records examined showed that pre-admission assessments had been carried out, however, information gathered was limited and there was no evidence to Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 9 show who was involved. The three files examined did not show that service users have been issued with a contract/terms and conditions of residency. Redcote House Residential Care Home DS0000065539.V323798.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is lack of detail written in care plans and risk assessments putting service users at risk if their care needs have not been identified. Service users are potentially at risk due to a lack of policies and procedures relating to medication. EVIDENCE: Three care plans were examined and these contained basic information, for example, personal hygiene gave no preferences regarding hair, bathing or choice of clothes and there was no information to show service users choice regarding intimate care. A letter in one file referred to ‘retinopathy screening’ but this was not mentioned in the care plan, another service user who is prescribed ‘warfarin’ medication had no plan of care for this. However, one service user spoken to said she felt her needs were being met and was full of praise for the staff. The staff member spoken to had a good knowledge of service users care needs and the action she needed to take to meet these. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 11 Body maps are being used to identify skin conditions but there is a lack of risk assessments. One risk assessment written had not been reviewed in the last nine months. Two service users with diabetes had not had nutritional assessments written, one had a dietary information sheet but this made no reference to diabetes. Care plans must also include information regarding social needs or the social stimulation to meet those needs. Reviews of care plans must be improved to include details of any changes required to the current care given and these should show that service users and/or their representatives have been given the opportunity to be involved. Care records examined did not give any information to show that service users had consented to care workers giving them medication and did not include information on medication to allow appropriate management of individual conditions. For example, not all admission information contained details about medication or on individual health needs. Medication administration record (MAR) sheets examined had been signed appropriately, however, the number of tablets given were not always recorded where the prescription identifies ‘one or two tablets’. This was brought to the attention of the manager who said she would address this immediately. Currently there are no service users who self-administer their medication. All staff administering medication have completed training and medication given during the visit was administered safety. However, it is recommended that photographs of service users should be held on medication record sheets. During the visit medication policies and procedures could not be located and the manager was asked to ensure these are available, up to date and relevant to the home. These must also be read and understood by all staff. All service users spoken to said they are treated with respect and felt their privacy and dignity are respected. Staff members were observed carrying out their duties with kindness and sensitivity towards the service users. Redcote House Residential Care Home DS0000065539.V323798.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users interests are generally accommodated and this has improved since the last inspection. Meals provided are well balanced and nutritional. Visitors are made welcome in this home and service users have choices as to how they lead their lives. EVIDENCE: Since the previous visit the provision of activities has improved and the manager is currently writing a weekly plan to put on display enabling service users to see what day it is and what is happening. Service users spoken to said they are given the choice regarding joining in with activity sessions and some said they enjoy them whilst others said they appreciated staff leaving them alone as they prefer their own company. Two service users said how much they enjoyed the church services and one spoke of having her nails painted and joining in with ‘armchair’ exercises. Others confirmed they are given a choice regarding what they preferred to eat and where they had their meals. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 13 Menus seen showed that a varied, well balanced diet is offered, a new menu is currently being written and the cook said she has taken into consideration service users likes and dislikes. Most service users spoken to said they enjoyed the meals although one specific comment was ‘the meals are sometimes small’. This was discussed with the manager who said she would look into this. One visitor spoken to said she visits every other day and is always made to feel welcome. Specific comments were; ‘everything is very good in this home, the staff are brilliant’. Redcote House Residential Care Home DS0000065539.V323798.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are protected from abuse and their concerns and complaints are listened to and acted upon. EVIDENCE: The complaints procedure is not included in the home’s statement of purpose, however, it is on display and service users spoken to confirmed that they would speak to the manager or a member of staff if they had any concerns. A visitor spoken to said she has raised issues with the provider and these are being addressed. No complaints have been received by the Commission since the previous inspection and the manager said she has not received any complaints since commencing her employment in the home last October. However, records of previous complaints and the action taken to address them could not be located and the manager was asked to ensure records are always available in the home. During the previous visit information was given about the Commission’s procedures for reporting complaints and the address and telephone number was given for the Central Registration and Compliance team (CRCT). However, the complaints procedure has not been amended to include this information. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 15 The Lincolnshire County Council safeguarding adults procedure was available and if necessary this procedure is followed to report any allegations of abuse. The manager and a staff member spoken to had a clear understanding of the term abuse and the correct reporting procedures. Staff confirmed that they had recently undertaken training relating to abuse. Since the previous inspection there has not been any safeguarding adult referrals made. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users living in this home live in a clean, pleasant and hygienic environment. EVIDENCE: During the visit the home was clean and well decorated. All furnishings are of a domestic nature and service users all said that they like the home and are happy with their bedrooms and felt that they are kept clean. Three bedrooms were seen, and these were individually decorated and furnished. Staff said they felt they worked in a safe environment and said that the providers’ brother continues to carry out all maintenance work. Whilst there was not a full tour of the premises, areas of the home seen which included the lounge, conservatory, dining area, three bedrooms and the laundry, were all clean and tidy. No unpleasant odours were noted. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 17 The manager said that arrangements are being made to have a new call system fitted, which will include call bells in communal rooms and a new central heating system is to be installed. The exterior of the home is poor, woodwork is in need of repair and re-decoration and this was raised with the manager. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate to meet the needs of service users currently living in the home. The recruitment procedure ensures, as far as possible, that residents are protected. Service users are supported by staff who are appropriately trained. EVIDENCE: Duty rotas examined showed that there are normally three care staff on duty from 08:00 – 22:00 hours. The manager’s hours are supernumerary but when necessary she works on the floor covering any shortfalls. During the visit one member of staff was on sick leave and those hours were being covered by the manager. Staff spoken to said they felt there are enough staff on duty to meet the needs of the service users currently living in the home and service users spoke highly of the staff with specific comments of ‘the staff are good, plenty of them’ and ‘all so good to you’. However, one service user said that sometimes he has to wait at night, having to press his bell two or three times before staff come to him. This was brought to the attention of the manager who said that she was unaware of this but will look into it. She confirmed that staffing levels had recently increased at night to two wakeful staff therefore this should not be happening. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 19 The files for two members of staff were examined, one contained all the necessary documentation to show that a robust recruitment procedure has been followed and the other only contained one reference. This was discussed with the manager who immediately took action to obtain a verbal reference, and a request for a written reference will be re-sent. One member of staff who commenced employment in December had not started induction and this was raised with the manager who said the member of staff is supervised at all times, however, a specific designated member of staff has not been appointed to mentor this worker. It was also recommended that all new staff are given a copy of The General Social Care Council (GSCC) code of conduct. The manager said that although only four staff have achieved the National Vocational Qualification (NVQ) at Level 2, 50 of staff have commenced this training. Training undertaken since the previous key inspection included; infection control, first-aid, adult abuse, moving and handling, fire and health and safety. No training has been received regarding equality and diversity and this was discussed with the manager who agreed to look into this. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Robust management systems must be in place to ensure peoples’ needs are met. There is a potential risk to service users as there are inadequate systems in place to monitor the quality of care provided and a lack of relevant policies and procedures. EVIDENCE: The manager has the necessary experience and qualifications to run this home, she recently registered with the Commission and is working to the basic principles set out in National Minimum Standards (NMS). Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 21 Although there is a manual of policies and procedures, the manager had difficulty in locating particular policies and a discussion was held around developing policies and procedures relevant to this service. The registered provider is aware of the need to develop a system for reviewing and improving the quality of care provided but to date this has not been put into place. Quality assurance systems should seek the views of all people involved in the service, for example; service users, relatives/representatives, General Practitioners (GP’s), district nurses and social workers. Services users said that although there have been many changes in management they really like the new manager and find her very kind and supportive. Staff also said the manager was always available and approachable. However, there are no procedures in place for staff supervision and this was raised with the manager who said she will address this. Service users currently living in the home all have family or representatives dealing with their financial matters. Only one person had any money held in safe-keeping and when checked this was inaccurate. Regular maintenance of equipment is carried out and those checked included fire equipment and stair lift. An environmental risk assessment completed in 2005 must be reviewed to ensure all risks are identified and action to minimise the risk is taken, this should also include the external parts of the home. Health and safety policies and procedures must also be relevant to this service. Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 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 2 1 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 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 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 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. Standard OP1 Regulation 4[1][a, b & c] [2] & 5[1][a, b, c, d, e & f] [2] 5[b][c] Requirement The statement of purpose and service user guide must contain all information required by regulation. Each service user must have a written contract/statement of terms and conditions of residency Pre-admission assessments should be in enough detail to ensure service users coming into the home will have their needs met. Information should be gathered from all people involved in caring for the person. Care plans must be in more detail and show that all risks are identified and clear actions are documented to minimise the risk. Reviews of care plans must be improved to include details of any changes required to the current care given and these should show that service users and/or their representatives have the opportunity to be involved. DS0000065539.V323798.R01.S.doc Timescale for action 28/02/07 2. OP2 28/02/07 3. OP3 14[1][c] 28/02/07 4. OP7 15[1][2][ a, b, c & d] 28/02/07 Redcote House Residential Care Home Version 5.2 Page 24 5. 6. OP7 OP9 7. OP9 8. OP9 9. OP16 10. 11. 12. OP16 OP19 OP30 13. 14. 15. OP30 OP33 OP35 16. OP38 Care plans should clearly record service users choice regarding intimate care. 13[2] Care plans must include details of medication used to manage individual conditions and health needs. 13[2] When medication is prescribed as 1 or 2 tablets, the medication administration record (MAR) must always record the amount given. 13[2] Policies and procedures must be in place to ensure safe handling of medication. These must include a suitable homely remedies policy. 22[5] [7a The complaints procedure must & b] be up to date and included in the statement of purpose. A copy must be given to each service user 17[2] Records must be available of all schedule complaints including the action 4 [11] taken. 23[2][b] The exterior of the home must be kept in a good state of repair. 18[2][a & A designated member of staff b] who is appropriately qualified and experienced must be appointed to supervise a new worker for the duration of their induction training. 18[1][c] All new staff must receive structured induction training 24[1][a & A system must be in place to b] [2]&[3] assess and review the quality of care provided at the home. 17[2] Accurate records must be schedule maintained of all money 4 [9] deposited by a service user for safe-keeping. 12[1][a] Policies and procedures must be developed and be relevant to this service. 12[1][2] & [3] 28/02/07 28/02/07 03/02/07 28/02/07 28/02/07 28/02/07 30/04/07 03/02/07 28/02/07 30/04/07 03/02/07 30/04/07 Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 25 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 OP9 OP29 OP30 OP36 Good Practice Recommendations It is recommended that photographs of service users should be held on medication record sheets. It is recommended that all staff have a copy of The General Social Care Council (GSCC) code of conduct. All staff should receive training regarding equality and diversity Formal supervision should take place for all care staff at least six times per year Redcote House Residential Care Home DS0000065539.V323798.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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