Inspection on 02/04/07 for Ridgeway House

This inspection was carried out on 2nd April 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

Ridgeway House 01/04/08

Ridgeway House 10/04/06

Ridgeway House 14/09/05

Ridgeway House 24/05/05

Ridgeway House 18/01/05

Ridgeway House 17/05/04

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 Ridgeway House 2-6 The Avenue Lincoln Lincs LN1 1PB Lead Inspector Mr Doug Tunmore Unannounced Inspection 2nd April 2007 10:00 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 Ridgeway House DS0000002548.V334303.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. Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ridgeway House Address 2-6 The Avenue Lincoln Lincs LN1 1PB 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 530552 None Guardian Care Homes (UK) Limited ** Post Vacant *** Care Home 32 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (32) of places Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th April 2006 Brief Description of the Service: Ridgeway House is a care home situated close to the centre of Lincoln and is within easy reach of local facilities, including shops and a post office. It is a converted building with a single storey extension on the ground floor, providing care and accommodation for thirty five people. The home has a refurbishment programme, which complies with The Commission For Social Care Inspections standards. The registration is for a care home, providing care for older and for some who have Dementia. The homes statement of purpose states that when people work hard throughout their lives and have committed to helping others, we think they deserve extra cherishing. The home is owned by Guardian Care Homes (UK) Limited. The current scale of charges at this home is from £380.00 to £520.00. Additional costs are made for hairdressing, chiropody and newspapers. These are all private arrangements and the individual service users meet these costs. Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One regulatory inspector undertook this unannounced key visit to the home. This visit took into account any previous information held by The Commission for Social Care Inspection (commission) including the homes previous inspection reports, both key and random and their service history. The site inspection consisted of case tracking a sample of four residents records and assessing their care. The regulator spoke with three residents in private and spent some time with five other residents. The inspector also spent time with the newly appointed acting manager, the deputy manager, administrator/activities worker, the cook and one carer. One visitor was also spoken to and a community nurse was contacted. A full tour of the home and a review of a sample of the records were also included. What the service does well: What has improved since the last inspection? The provider has appointed a acting manager who will take up this post towards the end of April 07. The deputy manager stated that a number of the requirements made at the last inspections have now been addressed. She also commented that there is a more positive working relationship throughout the staff team and this was confirmed by interviews with a carer. Residents and Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 6 visitors seen made positive comments about the running of the home and the care that they receive. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 7 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. Ridgeway House DS0000002548.V334303.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 Ridgeway House DS0000002548.V334303.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 & 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Not all residents are admitted into the home only after a full needs assessment has been carried out, which would help assure that their care needs would be met. Residents are not aware of having the providers terms and condition of their stay which would advise them of the fees that they pay for services received. EVIDENCE: The home has a detailed admissions procedure, which identifies the needs of residents coming into the home. One visitor stated that the manager had visited her mother prior to her admission to this home and carried out a care assessment of his needs. One residents file did not contain a full assessment carried out prior to admission. Files also did not evidence that residents had Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 10 received a letter from the provider confirming that the home could meet their needs. Two of the three of residents seen, stated that they could not remember being visited prior to admission or receiving a letter from the home. One resident commented that he was seen by his social worker who visited him. Three residents files seen did not contain terms and conditions relating to their stay this home. This home does not provide intermediate care. Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 11 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. The general health and welfare of residents is met. Relatives/relatives are encouraged to take part in the plan of care to ensure that they agree with the care provided. Accurate accident records are not kept so as to monitor the health of residents. Accurate medication records are not kept so as to ensure that medication is given as prescribed. EVIDENCE: Daily entries had been made in care plans by care staff, which identified the care given. The homes accident book was seen and it was found that in one instance an accident occurring to a resident had not been recorded on the residents body map. This was brought to the attention of the deputy manager. Those residents who are able are encouraged to sign their care plans, evidence was seen that residents, relatives or carers sign care plans with the permission of relatives. One visitor said that she was aware of her relatives care plan and Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 12 her sister now deals with their mothers affairs. The visitor also stated that the home is gradually improving and her mothers needs are met and she is well cared for. She further commented that staff are good with her (mother) and are mindful of her dignity when checking on her need to go to the toilet. The carer demonstrated that she had knowledge of the homes personal care policy and confirmed that she had undertaken the induction process when she started work at this home. The homes night care records were seen and evidenced that residents are attended to throughout the night. All those residents seen confirmed that carers are ‘not too bad and I get on with them alright’. Others commented that ‘staff only help us partly with our personal care and they are very good that way’. One district nurse was contacted and stated that ‘communication needs to be improved in relation to carrying out procedures requested by myself in applying creams or other health care procedures for the care of residents’. However, she also commented that she has witnessed ‘very good care in staff looking after a resident near to death, he had a nice peaceful death’. The above comments were passed onto the new acting manager. A tour of resident’s rooms found that bumpers had been fitted to bed rails to ensure the safety of residents. The deputy manager confirmed that this had been undertaken after the last key inspection for those residents assessed as requiring bed rails. Files seen confirmed that health care professionals visit the home when required by the residents. One resident confirmed that he attends the doctors monthly for an injection and is accompanied by a carer. On the day of this visit a GP visited the home to attend to a residents medical needs. The pharmacist visited the home on the 06/05/05 and recorded that storage and administration records of medication is carried out appropriately. On the day of this visit medication sheets were found not to be order, with two signatures missing from medication given to residents. The deputy corrected this oversight immediately. Individual training files seen did evidence that all but one senior carer had undertaken a safe handling and administration of medicines course in 2006. Ridgeway House DS0000002548.V334303.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. 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. The home offers a set menu, which is chosen by residents and accommodates individual preferences. Relatives and friends of residents are made welcome in this home by carers. A range of activities are available to residents but they would benefit from a dedicated activities organiser. EVIDENCE: The home undertakes activities for those residents who wish to join in. The activities organiser confirmed that her duties have become more administration based and therefore she doesn’t spend the same amount of time with residents. However, two volunteers from the local college are working at the home for a month and were seen to be undertaking a variety of activities for clients during this visit. The new acting manager stated that he would address this issue within the next few weeks. Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 14 Two residents commented that they have been to the Pride of Lincoln recently and enjoyed music hall type of entertainment. They also stated that they take part in quizzes, puzzles, crosswords and recently a lady came and they did exercises whilst sitting in their chairs. Other residents confirmed that they don’t join in activities as they prefer not to. The minutes of a relatives meeting dated 24/01/07 was seen and evidenced that an ongoing activities programme was planned for the coming year. Relatives made positive comments about the bonfire party held in 2006. However, those residents seen commented that they have not had a residents meeting. The deputy manager also confirmed this. Both the visitor and the district nurse confirmed that they are made welcome at the home. The visitor said that the staff inform her sister of any changes or issues concerning our mother. Files seen did not demonstrate that residents are consulted about their likes and dislikes regarding all those aspects of their daily living. This was brought to the attention of the deputy manager who stated that this would be addressed. The regulator asked five residents during lunch about the quality of the meals. They all commented that the meals are very good and a choice is available. The cook stated that she was aware of residents dietary needs and produced a list of their likes and dislikes. Ridgeway House DS0000002548.V334303.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. 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. Residents are not empowered by the homes complaints procedure, which does not include their views of complaints made. The home has robust adult protection procedures and training for staff to ensure the safety of residents. EVIDENCE: A previous visit dated April 2006 found that the complaints form did not have a place for a complainant to sign to signify whether they agreed with the outcome or not. This visit found that no action had been undertaken to address this issue. Those residents and a relative spoken to confirmed that they were satisfied with the care provided with a resident commenting that ‘ I have no complaints, nothing to complaint about’. No complaints have been made in 2007. Previous visits have found that the home has Lincolnshires Adult protection procedures, as well as the homes whistle blowing policy. The deputy manager confirmed that she would inform the new acting manager if she had any concerns regarding the treatment of residents. Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 16 In 2006 two allegations were made regarding abuse of people by carers. One of these allegations was investigated by the social services adult protection team and the second by the home. In both cases no evidence was found and the carers returned to work. The training file was seen, which showed that seven carers including the deputy manager have undertaken safe guarding vulnerable adults training on the 03/05/06. The deputy manager stated that there are no current adult protection matters at the present time. Ridgeway House DS0000002548.V334303.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and tidy, with a pleasant smell throughout. Appropriate heating is not available in one bathroom to ensure the comfort of residents. Window frames are in a poor condition and are a risk to residents. EVIDENCE: The home has a rolling maintenance programme that shows ongoing work carried out, externally and internally at the home. The regulator accompanied by the deputy manager carried out a full tour of the environment. It was found that the toilets/bathrooms were spartan and cold in appearance and would benefit from brighter colours and brightly bath mats. Also paintwork and floors need attention. Window frames were also seen in bedrooms 2,6,7 & 15 and it was found that they were rotten, needing renovating or replacing. The home is Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 18 now required to undertake risk assessments of these windows and how this risk can be minimised until frames are replaced. All residents files have an individual risk assessment relating to the safety of service users in the homes environment. These risk assessments were more detailed in relation to those service users who were most at risk of falls. Previous visits dated 10/04/06 and the 10/10/06 found that one residents ensuite facility did not to have any heating. This room was reported as being cold in April 06. No action has been taken to the installation of a radiator. The new acting manager confirmed that this would be addressed in the near future. The home was found to be clean with no unpleasant odours detected. The training file did not evidence that the domestic workers had undertaken any training on infection control. Residents and visitors alike said that the home is clean and there are no unpleasant smells. Ridgeway House DS0000002548.V334303.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. 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. Care staff undertake induction training when starting at the home so as to ensure they are aware of residents care needs. The home carries out a thorough staff recruitment process so as to ensure the safety of residents. EVIDENCE: Two care workers personnel files were seen and evidenced that appropriate checks are undertaken for the safeguarding of residents. The home has distributed to all carers The General Social Care Council Codes of Practice, which sets out responsibilities as care workers looking after vulnerable adults. Previous visits to this home have found that the training plan was not to be up to date. This visit also evidenced that courses undertaken by carers had not been added to the training profile. There was a record of two carers who had undertaken NVQ (National Vocational Qualifications in care training) training. The deputy manager commented that there was no information available to show that NVQ training is being proposed for more carers at this home. Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 20 The training folder showed that some staff had undertaken, Dementia training, first aid, moving and handling, care planning and managing behavioural problems and dementia. A carer stated that she started work at this home and has done her induction training. She confirmed that she does not have an NVQ qualification. The carer also confirmed that she has not undertaken any training since commencing work at this home. The homes rota was seen and it was found that adequate staffing levels are maintained to meet the needs of residents. One carer stated that they are a bit stretched in the mornings. Two residents also felt that on occasions there are not enough staff usually in the mornings. The deputy manager stated that there are three night staff and four carers in the morning and afternoon. There is a handy man, two domestics and a laundry worker, two cooks and a kitchen assistant. She also said that a carer stay on duty from 4:00 pm to 10:pm and an extra carer from 7:00 am to 1:00 pm. Ridgeway House DS0000002548.V334303.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33,35,36, & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Records seen show that residents health and general welfare and safety are promoted. The manager does not ask the views of residents/visitors about the service which is on offer. EVIDENCE: A new acting manager is currently working half days at this home until he takes up the post full time at the end of April 07. There was no evidence available to show that the home conducts, on a regular basis, an in-house quality assurance check or report. The deputy manager Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 22 confirmed that the company had sent out questionnaires to all relatives regarding the care at this home. Relatives meetings are also being held with the minutes of the last meeting made available at this visit. One visitor confirmed that she attended the relatives meeting and that her sister has received a questionnaire from the provider. Residents commented that the home does not hold residents meetings. The deputy manager confirmed residents meetings have not been held. Supervision of care staff is undertaken on a regular basis. One carer on duty confirmed that she had undertaken supervision. Files seen evidenced that supervision and appraisals have been undertaken. The home deals with residents personal allowances and receipts are kept of monies paid to the hairdresser or chiropodist. The deputy manager and the administrator confirmed that they had undertaken a full audit of resident monies and there were no discrepancies. All funding is paid direct to the company by standing order or cheques. Residents monies were checked against the record of monies held on their behalf and it was found that an accurate record is kept. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks and fire alarm inspections have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. Certificates were available showing that hoists and the shaft lift had been serviced on a six monthly basis as required. All wheelchairs seen on the day of the inspection had footplates, which were in use. Ridgeway House DS0000002548.V334303.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 2 2 2 X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 x 2 x x x x 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 X 3 X X 3 Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 24 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 OP2 Regulation Requirement Timescale for action 23/06/07 2. OP3 3. OP4 4. OP19 5. OP21 5 (ba)(bb) The residents and or their (bc)(bd) representatives must be given a &(c) copy of their contract and the terms and conditions of their stay so that they are aware of the services that they pay for. 14(1)(a) Residents must have a full care (b) assessment undertaken prior to admission and for emergency admissions the homes policies and procedures must be followed to ensure adequate information is available in providing care for the resident. 14(d) Residents or their representatives must receive in writing a letter confirming that the care home is suitable in meeting the resident’s needs. 23 (2)(b) Windows must be replaced or repaired to ensure the warmth and safety of those who live and work in this home. 23(2)(p) The provider must provide heating suitable for residents in all parts of the home. (Timescale of 15/07/05 and 25/11/06 not met) with a new timescale being made at the homes additional DS0000002548.V334303.R01.S.doc 23/06/07 23/06/07 23/06/07 26/06/07 Ridgeway House Version 5.2 Page 25 visit. 6. 7. OP21 OP26 23 (b) 13(3) Toilets and bathrooms must be redecorated and repainted with stained flooring removed. A system must be in place, which ensures that domestic workers receive training relating to infection control to ensure that as far as possible the home is kept free from the spread of infection. The provider must hold residents and relatives meeting in order to seek their views about the running of the home. (Timescale of 25/06/06 and the 25/11/07 not met) with a new timescale being made. This requirement is partially met wilt relative meetings being held. The provider must undertake an effective quality monitoring system based on seeking the views of residents and visitors with the results of any surveys published for their information. (Timescale of 25/07/06 and the 25/11/07 not met) This requirement is only partially met with a new timescale being made. 23/07/07 23/06/07 8. OP33 24 26/06/07 9. OP33 24 (3) 26/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 26 Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 27 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. Extracts may not be used or reproduced without the express permission of CSCI Ridgeway House DS0000002548.V334303.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!