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Inspection on 19/09/06 for Risby Park Nursing Home

Also see our care home review for Risby Park Nursing Home for more information

This inspection was carried out on 19th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The standard of the accommodation was high, all the bedrooms are ensuite and the home is clean and well maintained. The manager is experienced and was described by staff and service users as approachable and supportive. There is a strong management team with two deputy managers and an assistant deputy manager. There are good monitoring systems in place and regular audits are undertaken to ascertain that the standards are being met and care is being delivered. A customer satisfaction survey is also undertaken to ascertain service users and relative`s views of the care. A summary report on the findings and actions taken to address the shortfalls identified is prepared and displayed. The home has two part time activity organisers who provide a good range of activities for service users. The homes newsletter, entitled "the Park Bench " provides an outline of the activities that are planned but also contains interesting articles by service users. The home has its own resident`s committee which meets regularly and service users are encouraged to participate and their contributions are valued. Staff recruitment is thorough and staff are supported to access training opportunities. Service users and visiting relatives who were spoken with on the day of the inspection reported that the staff were kind and helpful and very patient.

What has improved since the last inspection?

The management team within Risby Park has been strengthened with the appointment of a second deputy manager and a new assistant deputy. The home has the use of a new company minibus and service users have been able to visit local attractions and places of interest. The quality of the care plans continues to improve and those, which were examined, were detailed and informative about service users care and how their needs should be met. A new nutritional monitoring record has been introduced in consultation with the nutritionalist to built on the existing records and inform practice. A new path has been laid in the garden improving accessibility for service users. An awards system is in place to acknowledge the efforts and commitment of staff.

What the care home could do better:

The meal served to some service users in their rooms on the day of the inspection was difficult for them to eat without assistance. It was agreed with the manager that greater attention would be paid to this area and service users would in future be brought their meal on a tray with a drink napkin and cutlery. It was agreed that the use of disposable underwear would be reviewed and items individually labelled.

CARE HOMES FOR OLDER PEOPLE Risby Park Nursing Home Hall Lane Risby Bury St Edmunds Suffolk IP28 6RS Lead Inspector Cecilia McKillop Unannounced Inspection 19th September 2006 11:00 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 DS0000024481.V312372.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. DS0000024481.V312372.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Risby Park Nursing Home Address Hall Lane Risby Bury St Edmunds Suffolk IP28 6RS 01284 811921 01284 811950 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) Risby Hall Nursing Home Limited Ms Alison Rachel Lovelock Care Home 54 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (54), of places Physical disability (12) DS0000024481.V312372.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Risby Park was first registered in 1997 and currently operates as a care home providing nursing care for 54 service users. On the day of the inspection there were 49 service users in residence all aged over 65 years. The home is situated in Risby village West Suffolk and is adjacent to Risby Hall Nursing Home, which is also owned by the same proprietors, Risby Hall Nursing Homes Limited. The accommodation at Risby Park is on two floors and there is level access throughout the home with 2 shaft lifts connecting the ground and first floors. The facilities were purpose built and include 46 single ensuite rooms, and 4 double ensuite rooms, which can be used as single rooms or by couples. The accommodation is of a high standard and there is a variety of day and quiet rooms and a conservatory. The home overlooks pleasant gardens and farmland. The home registration has recently been changed to allow the home to accommodate up to 12 service users with Dementia, within the main body of the home. The current weekly fees range between £540 and £650 DS0000024481.V312372.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection, looking at all the core standards for care of Older People, took place on a weekday between 11am and 5.30pm. The manager Mrs Alison Lovelock assisted the inspector throughout the day. The care plans and daily records of four service users were seen. The file of a newly appointed staff member, the staff training programmes, staff supervision records, medication administration records, the duty rotas and quality assurance records were examined. A tour of the home was undertaken. A number of service users, visitors and staff were spoken with in the course of the day. Care practice was observed and the serving of lunch. The laundry was visited. There were 49 service users residing in the home on the day of the inspection What the service does well: The standard of the accommodation was high, all the bedrooms are ensuite and the home is clean and well maintained. The manager is experienced and was described by staff and service users as approachable and supportive. There is a strong management team with two deputy managers and an assistant deputy manager. There are good monitoring systems in place and regular audits are undertaken to ascertain that the standards are being met and care is being delivered. A customer satisfaction survey is also undertaken to ascertain service users and relative’s views of the care. A summary report on the findings and actions taken to address the shortfalls identified is prepared and displayed. The home has two part time activity organisers who provide a good range of activities for service users. The homes newsletter, entitled “the Park Bench ” provides an outline of the activities that are planned but also contains interesting articles by service users. The home has its own resident’s committee which meets regularly and service users are encouraged to participate and their contributions are valued. Staff recruitment is thorough and staff are supported to access training opportunities. Service users and visiting relatives who were spoken with on the day of the inspection reported that the staff were kind and helpful and very patient. DS0000024481.V312372.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. DS0000024481.V312372.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. DS0000024481.V312372.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 DS0000024481.V312372.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality for this outcome area was good. People who use this service can expect to be provided with information about the home, have their needs assessed and assurances given that they can be met prior to entering the home. EVIDENCE: The home has a statement of purpose, which has been amended to take account of the fact that the home now cares for service users with a diagnosis of Dementia. Additional training has been provided to care and nursing staff and the manager confirmed that further training is planned. All new service users receive a welcome folder when they are first admitted to the home, which contains key documentation about the home such as the statement of purpose, details of the homes complaints procedure and the service users guide. DS0000024481.V312372.R01.S.doc Version 5.2 Page 10 The records on two newly admitted service users were examined and there was evidence of a comprehensive assessment being undertaken prior to their admission. Families and service users are encouraged to visit and look around the home prior to an admission. Terms and Conditions of residence are provided to service users and the statement complies with the standards clearly outlining the fees payable and what is and is not covered. The home does not offer intermediate care. DS0000024481.V312372.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality for this outcome area is good. People who use this service can be assured that their care plan covers their assessed needs that the medication administration procedures will protect them and they will be treated with respect. EVIDENCE: A sample of care plans were examined as part of the inspection. These were found to be detailed, informative and outlined the actions required by staff to meet the service users health, social and personal needs. There was evidence of ongoing monitoring and reassessment of service users health needs. Service users at increased risk of pressure sores are identified and plans put in place to minimise the risk. Nutritional screening is untaken on admission and subject to regular review. A physiotherapist visits the home weekly and chiropodist on a regular basis. Service users are assisted to access NHS services as appropriate and an escort to appointments can be provided at additional cost. DS0000024481.V312372.R01.S.doc Version 5.2 Page 12 Risk assessments were in place with regard to manual handling and other perceived risks. There has been some recent changes to the homes medication administration systems with the introduction of a monitored dosage system. Staff have undertaken updating training and there was evidence of regular monitoring and auditing to ensure that staff were competent. A small sample of administration records and medication was examined at the inspection and was generally satisfactory. Controlled drugs were being stored securely and the medication tallied with records. Staff were observed responding to service users in a warm and caring manner and having due regard for their privacy and dignity. Doors were closed when personal care was being provided. An issue was however identified with the use of “net ”underwear, which the inspector noted was not labelled. The manager said that the staff work with the Macmillan nurses and the Hospice staff to provide care and support to service users who are dying. A number of the staff have undertaken palliative care courses and one of the deputy managers is working with other agencies on “end of life care”. Times of funeral services are displayed thereby making it earlier for those service users who wish to attend to pay their respects. DS0000024481.V312372.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality for this outcome area was good. People who use this service can expect to have access to a good range of activities, a wholesome diet and be enabled to maintain contact with family and friends. EVIDENCE: The home has 2 part time activity co-ordinators who provide a range of social and recreational activities throughout the week. Trips out are organised in the new minibus and there is a good variety of in house activities including crafts musical sessions and readings. On the afternoon of the inspection bingo was taking place in the dining room. One to one time is spent with service users who are frail and not able to attend group activities. The home has its own informative newsletter called the Park Bench, which provides service users with details of what has been happening in the home over the last few months, forthcoming events and details of special occasions. DS0000024481.V312372.R01.S.doc Version 5.2 Page 14 Regular resident committee meetings are held, which are chaired by a service user and to which the manager of the home is invited. Minutes are taken and agreements made as to how items raised will be taken forward. Bedrooms had all been personalised by service users and the home had accommodated service users requests for items such as fridges, computer and a pet bird. Relatives who were spoken to as part of the inspection reported that they were welcomed into the home and visitors were observed coming and going throughout the day. Service users were able to receive their visitors in private. Staff were observed offering service users choices and there were evidence in the care plans of service users choice and independence being promoted. One service user had recently been supported to move out of the home and into Supported living in the community. The menu was on display and a copy had also been provided in each of the service users bedrooms. A choice is available at each meal. The dining tables were attractively laid and the lunch served on the day of the inspection consisted of either toad in the hole with vegetables or chicken curry with rice. There was a separate pureed meal for service users who required this, however alternatives were also available and one service user had requested a baked potato with cheese and this was accommodated. Staff were observed assisting service users to eat and this was undertaken in a sensitive and unhurried way. A number of service users had their meal in their bedroom, which was brought to them by care staff. The inspector observed staff taking the meal to service users with the knife and fork sitting on top of the meal, with no napkin. One service user who was eating in a bedroom had been served with toad in the hole, which he was unable to cut up, and staff had left the meal before resuming their duties. A drink had not been provided with the meal. The manager met with a number of staff on the afternoon of the inspection to discuss the lunchtime serving arrangements and the shortfalls. It was agreed that service users eating in the rooms would receive their meal and a drink on a tray in future. DS0000024481.V312372.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality for this outcome area is good. People who use this service can expect to find that complaints are taken seriously and service users are protected from abuse. EVIDENCE: The home has a complaints procedure, which is outlined in the welcome pack, and, is provided to service users on admission. The commission has not received any formal complaints about this service since the last inspection. The manager had received two complaints over the last year and comprehensive records were available relating to the homes investigation. Relatives who were spoken with as part of the inspection confirmed that they were aware of the procedure. Service users right to participate in the political process are upheld while residing at the home and service users are assisted to vote. Details of advocacy groups are displayed on the homes notice board. The manager confirmed that training is provided to staff on the protection of vulnerable adults as part of their induction to work at the home. There are procedures in place relating to vulnerable adults. There are sound procedures in place with regard to the recruitment of staff and the arrangements for the storage and safekeeping of service users money was examined as part of the inspection and found to be satisfactory. DS0000024481.V312372.R01.S.doc Version 5.2 Page 16 DS0000024481.V312372.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality for this outcome area is good. People who use this service can expect to live in a clean comfortable and assessable environment. Service users can have access to a range of equipment to maximise their independence EVIDENCE: Risby Park has 46 single rooms and four double bedrooms, which are suitable for couples, but which were being used as single rooms on the day of the inspection. The home is assessable for wheelchair users with level access and automatic doors at the entrance. The home is organised over two floors, which are connected by a shaft lift. The home is surrounded by gardens and accessibility has recently been improved with the laying of a path. The home is well maintained and there was evidence of ongoing refurbishment and renewal of items. The home was clean tidy and smelt fresh. The accommodation is of a good standard and all rooms are ensuite. The DS0000024481.V312372.R01.S.doc Version 5.2 Page 18 communal areas were all very pleasant and there was sufficient space to manoeuvre wheelchairs. One of the lounge has been adapted into an activity room for service users and contains a range of craft materials and mementoes. The temperature through out the home was comfortable. The water temperatures at one location were tested on the day of the inspection and were within the recommended levels. Service users had personalised their bedrooms with items of furnishings, pictures and mementoes. A number of service users had small fridges in which they were able to store snacks and cold drinks. The home has a range of specialist equipment to assist service users promote their independence as well as aids to assist staff with moving and handling. Service users are able to shower or bath and the inspector was informed by a service user that they could have one shower and one bath each week. The laundry contains 3 industrial washing machines and 2 dryers. The floor and walls were washable and hand-washing facilities were located nearby. DS0000024481.V312372.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The quality for this outcome area is good. The home is staffed by an adequate number of staff, who receive ongoing training. Service users are protected by the homes recruitment practices. EVIDENCE: The staffing rota was examined as part of the inspection and the rota took account of periods of high and low activity. On the afternoon of the inspection there were 10 members of staff plus one member of agency staff on duty. Two newly appointed members of staff were working on a supernumerary basis. The staffing levels on the day of the inspection were adequate and staff were observed responding to requests for assistance promptly. The inspector was informed that a number of staff had recently left for a variety of reasons and while new appointments had been made, the home was for a short period reliant on agency staff. At the time of the inspection there were two care staff vacancies. Service users informed the inspector that the recent staff changes were unsettling but overall they felt well cared for. The recruitment records for a newly appointed member of staff were examined at part of the inspection and there was evidence that the home follows sound procedures and takes up references, CRB checks and Pova first checks. DS0000024481.V312372.R01.S.doc Version 5.2 Page 20 Staff receive an induction on their first day at the home which covers fire and other key procedures. New staff work on a supernumerary basis for the first two weeks of employment, shadowing more experienced staff. The home has a mandatory training programme for new staff, and the manager confirmed that this corresponds with the skills for, care programme. Dementia training is provided for all staff and the manager and training coordinator are due to undertake a diploma in dementia care. The staff interviewed as part of the inspection reported that they had good access to a wide range of training opportunities. The numbers of staff accessing National Vocational Qualifications has risen since the last inspection. Seven staff have obtained an NVQ qualification and another is nearing completion. Seven staff have recently started the process. DS0000024481.V312372.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,38 The quality for this outcome area is good. The home is managed by an experienced manager who provides clear leadership and support to staff. Service users are safeguarded by the financial procedures and safety procedures within the home. EVIDENCE: The manager is a qualified nurse who has significant management experience, however she is also currently managing another home within the group on a part time basis. The management arrangements have been strengthened at Risby Park to accommodate this, with the appointment of a second deputy manager. There are now two deputy managers and an assistant deputy in post. The staff and service users spoke positively about the management of the home. Staff described the management team as supportive and service users reported that the senior staff were approachable and helpful. DS0000024481.V312372.R01.S.doc Version 5.2 Page 22 The manager undertakes monthly audits on a number of areas to monitor care practice and insure that staff are working in a consistent way. Records on the audits are maintained by the home and were seen as part of the inspection. The quality assurance manager who is also based in the home undertakes Quality Assurance audits on a regular basis. The last audit was undertaken in May 06. Questionnaires are sent to service users and their families asking for their views on the quality of the service. The questionnaires are sent out on a yearly basis and results are collated and published. The home formally responds to any issues, which are identified, and outlines any changes to be made as a consequence. The home has its own resident committee, which is chaired by one of the service users and the minutes are put on display for other service users and relatives to read. The minutes indicate that the meetings are well attended, the discussions wide ranging with clear matters to take forward. Staff who obtain qualifications are invited to the staff award presentation ceremony. There is also a staff awards scheme and staff can be nominated by colleagues. Staff confirmed that they receive regular training on a range of areas including first aid, infection control and vulnerable adults. The manager and the training coordinator are due to commence the Diploma course in Dementia Care. Supervision agreements were in place in staff files and staff receive supervision on a eight weekly basis. The Manager confirmed that following consultation with the fire officer selfclosing devices were being fitted on all doors. The homes health and safety polices have recently been updated. The water temperatures were tested during the inspection and found to be within the recommended levels. There is clear and accountable system in place for the safekeeping of service users finances. A certificate of public liability is on display in the entrance of the home. The Homes Terms and Conditions of residence outlines the terms of the home insurance policy and service users are advised not to bring items of significant value into the home. DS0000024481.V312372.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 3 3 3 4 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 3 3 3 N/A 3 DS0000024481.V312372.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP15 Regulation 16 Requirement The manager is required to review the serving of meals to service users in their bedrooms and ensure that the meals provided are suitable for individual service users to eat. The manager is required to review the use of “net underwear” and ensure that where it is being used it is labelled for individual service users Timescale for action 01/11/06 2 OP10 12 01/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000024481.V312372.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 DS0000024481.V312372.R01.S.doc Version 5.2 Page 26 - 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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