Inspection on 14/07/06 for Royal Care Home

This inspection was carried out on 14th July 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.

Other inspections for this house

Royal Care Home 19/07/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Royal Care Home 16-18 York Road St Annes on Sea Lancashire FY8 1HP Lead Inspector Phil McConnell Unannounced Inspection 14th July 2006 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 Royal Care Home DS0000066041.V300844.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. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Royal Care Home Address 16-18 York Road St Annes on Sea Lancashire FY8 1HP 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) 01253 726196 K. Whenmouth Limited (T/A Royal Care Home) Mr Paul Vivian Brotherton Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 29 service users in the category OP (older persons 65 and over) Date of last inspection Brief Description of the Service: The Royal Care home provides personal care and accommodation for up to 29 older people who do not require nursing care. The home is situated in St Annes, in a convenient location close to the town centre with a shopping area, local community facilities and resources. It is the policy of the registered provider; to encourage social interaction by ensuring service users remain integrated members of the local community. In addition in-house activities are arranged and the service users are free to choose as to whether they participate or not. All service user accommodation is located on the ground and first floor of the building and a stair lift is provided to ensure freedom of movement and ensure service users ease of access to all areas of the home. There are 21 single bedrooms and 4 double bedrooms of which 3 have been provided with an en-suite facility. However currently all double bedrooms are used as single occupancy. Individuals only share twin bedroom accommodation if they have made a positive choice to do so. The home has garden areas to the front of the building that are well maintained and easily accessible. The home is registered for 29 people, with 21 people being in residence at the time of the inspection visit. The current rate of charging is between £315.00 and £395.00. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assimilation of information, from questionnaires and comment cards from service users, relatives, GP’s and other professionals, (including the provider) since the last published report by the Commission for Social Care Inspection (CSCI) and an unannounced visit to the home, were all used to fully assess the key standards identified in the National Minimum Standards for older people. There was a really good atmosphere within the home during the visit and four service users were ‘case tracked’ which means that their files were examined with some discussion-taking place with them throughout the inspection. Discussions also took place with other service users, who were not part of the ‘Case tracking’ process. The registered manager and the registered provider were available throughout the day and there was the opportunity to have conversations with other staff members, including the homes chef, care staff, business administrator, the homes hairdresser and some of the service users’ relatives, who were visiting the home. Policies, procedures and all care documentation within the home were also examined. Feedback was given to the registered manger and the registered provider following the inspection visit, which lasted approximately seven hours. What the service does well: Service users are well cared for, with positive comments from service users, relatives and one from a GP, such as “Excellent care is provided”. One visitor to the home said of his wife, “When I come to visit she always looks like a new button”. Visitors to the home were complimentary about the staff in the home and particularly the welcome that is received when they visit, some of the comments were, “I am always made welcome and I am informed if any problems” another person said, “very pleasant place with friendly staff, who go out of their way to help” The home has a good pre- admission process in place, which helps to ensure that individuals assessed needs will be identified and met. The home is well managed and organised, with relevant training available to the staff team and there is a commitment to encourage staff members to Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 6 access further training that would benefit the individual member of staff and the service users. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Royal Care Home DS0000066041.V300844.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 Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 - (Intermediate care is not provided) “Quality in this outcome area is – ‘Adequate’. This judgement has been made using available evidence including a visit to this service”. A detailed pre-admission process is in place with sufficient information and guidance, to enable a prospective service user to make an informed choice. However, service users’ files need to have a photograph of the person, in order to avoid any confusion in care delivery. EVIDENCE: The homes policy and procedures with regards to the admissions process were examined and found to be concise and thorough. Four service users were case tracked’, including two of the most recent admissions to the home and all of their files contained full and relevant assessment documentation including: admission assessments, care plans, detailed social services assessments and up to date daily record sheets. However, some of the service users’ files didn’t contain a photograph of the person, which could potentially cause mistakes or confusion to occur. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 9 The service users and staff spoken to, were familiar with the pre admission process and all of the questionnaires returned, indicated that enough information about the home was given prior to moving in, with one person commenting “Very helpful and detailed information was given to me”, demonstrating that individuals are given sufficient information in order to make an informed choice. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. “Quality in this outcome area is – ‘Adequate’. This judgement has been made using available evidence including a visit to this service”. The care documentation is very good, helping to ensure that individuals assessed personal and health needs are satisfactorily met. The storage and recording of medication is appropriate, however, there is a need to address how the medicines are administered, in order to help eliminate any errors, which could endanger peoples health. Dignity and respect were actively demonstrated in the way that care was seen being provided to service users. EVIDENCE: The home uses ‘The Standex System’, which is a comprehensive, thorough and concise information and recording system, with all the necessary information and guidance contained in one file / document to meet a persons assessed needs including: Admission details with any medical diagnosis on admission, The service users’ long term assessment and ‘Care Plan’, GP’s notes and appointments, Individual risk assessments, Dependency profile, with a scoring Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 11 system, which highlights ongoing needs, Any specific dietary needs, Social activities plan, Any personal needs and Daily reports, which were up to date with relevant and appropriate information. The four ‘case tracked’ service users’ files were examined and were found to be up to date, with care plans being reviewed monthly, helping to demonstrate that individuals’ needs are regularly monitored and assessed, in order to ensure that their needs are adequately met. The medication is stored in an unobtrusive area in the dining room, with the medication cabinet being securely bolted to the wall. The service users’ medication records were examined and they were all up to date and recorded correctly, with only suitably qualified staff eligible to administer medication. Individual photographs were on each file, helping to avoid any confusion when administering medication. The administering of the mid-day medication was observed and the medication was left in pots with the individual service users’ whilst they were having their lunch. This secondary dispensing of medication was raised at a previous inspection and it was strongly advised then that this practice must cease. The management were informed that medication should not be left in pots and that the person administering the medication should observe the service user taking the medication. It was also suggested that medication could be given either before or after mealtimes, in order for people to have uninterrupted meals. An assurance was given that this practice would cease immediately. In observation throughout the visit, service users were treated respectfully and with dignity and some comments received from relatives were, “The staff have done wonders with my Dad, we know that he is being looked after properly, we would be able to tell if not” and “This is a pleasant place, everyone is friendly and the staff go out of their way to help my wife and I always think she is safe”. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 “Quality in this outcome area is – ‘Good’. This judgement has been made using available evidence including a visit to the service”. Visitors are made welcome to the home, demonstrating that relationships with family and friends are maintained and encouraged. The meals provided are adequate, with the food menus providing a balanced diet, helping to promote a healthy eating plan for service users. EVIDENCE: Comments from some of the service users, with regards their expectations being met were, “you can come and go as if it is your own home” “Its’ home from home” and one family member wrote “Royal rest home offers a home environment, delivering more than we originally expected”. With regards to activities, although there was an activities programme / chart observed at the home, the overall opinion of the comments received was that activities are infrequently arranged. Only one of the questionnaires stated that the activities were “varied and enjoyable”. There was a key worker (service users have a named worker) system in place; helping to promote trust and confidence between the service user and the staff Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 13 member, thereby, helping to ensure a service users’ changing needs are identified and acted upon as quickly as possible. The majority of the service users have their own representative or advocate who are acting on their behalf. Information was displayed on the homes notice board, advertising an independent advocacy service; giving people the opportunity to access an outside advocacy agency, in order to help and empower them to make decisions and choices, that affect their lives. The home has an open house policy with visitors to the home being made welcome and service users are encouraged to maintain relationships with their families and friends. One relative said, “If anything is wrong the staff phone us right away” another visitor said, “This is a very pleasant place to visit with friendly staff, who go out of their way to help”. There was a choice of menus available, which were seen to be nutritious, varied and appetising. There was the opportunity to have lunch with the service users and the meal was good and well presented. Staff were observed supporting service users in a calm, relaxed atmosphere, with sensitivity and gentleness. Some of the service users chose to have their meals in their own rooms, which demonstrated that mealtimes are flexible and service users’ wishes and choices are catered for. A discussion took place with the homes chef, who has been a chef for a number of years and has developed a good relationship with the service users in the home. It is planned for the chef to commence further catering training in September 2006; this will improve his skills and enhance his expertise, which will ultimately benefit the service users. Most of the comments from service users regarding the meals were satisfactory including: “We have lot’s of choices” “I like the sweets” and all of the questionnaires stated that they usually like the meals. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. “Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service”. Thorough satisfactory policies and procedures regarding the protection of vulnerable people are in place, helping to ensure that service users are protected from harm. Staff members are suitably and adequately trained, in order to manage any protection issues. EVIDENCE: The home had a comprehensive complaints policy and procedures in place regarding the safeguarding and protection of vulnerable adults. No complaints have been received since the last inspection. The home has a ‘Gold Book’ where minor concerns, queries and requests are recorded, with written evidence that these concerns had been acknowledged and dealt with appropriately. Questionnaires and comment cards received from service users and relatives all indicated that people are aware of the complaints procedure and how to complain if they need to. The service users, who were spoken with, knew whom they could speak to in the home if they had a complaint. They were also aware that the inspector for Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 15 CSCI (commission for social care inspection) could be contacted if they chose to do so. There was a thorough policy in place to deal with a suspicion or allegation of abuse. Some staff members were spoken to and they were fully aware of the procedures to follow in the event of any suspicion or alleged abuse and would be confident in the process, to ensure the protection of service users. It was also observed that ‘Protection of Vulnerable Adults’ training had been arranged for July 2006 for the newer members of staff, who hadn’t already attended the training. This highlights that the provider is committed to ensuring that staff are appropriately trained in the protection of vulnerable adults. Royal Care Home DS0000066041.V300844.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 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 hygienic, however there is a need to continue with the renovation programme, to help ensure that the environment is comfortable, pleasant and safe for those that live and work there. EVIDENCE: A tour of the home was carried out and it was observed that the recommendations that were made in a previous inspection report had been addressed, including: The kitchen has been redecorated with new flooring fitted, some bedrooms have been redecorated, the laundry is now located in an external building at the rear of the property, which provides extra space for 2 ground floor en-suite bedrooms. The home was clean and hygienic, with service users bedrooms containing personal possessions, demonstrating their own individuality and ownership. One service user commented, “My room is always nice and clean”. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 17 In discussion with the registered manager and the provider there was an agreement that there are still parts of the home, regarding the décor that are looking ‘quite tired’ and it was stated that there are plans in place for a ‘Redevelopment programme’, which will include amongst other things, redecoration to parts of the home, alteration to some rooms to include en-suite facilities and the replacement of the rotting window frames. These and other renovations will greatly improve the internal and external environment of the home. Royal Care Home DS0000066041.V300844.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. “Quality in this outcome area is – ‘Adequate’. This judgement was made using available evidence including a visit to the service”. The staff team have the necessary skills and experience to provide a good standard of care to vulnerable people. The home’s recruitment process is inadequate, failing to give the confidence that service users are protected and safeguarded. A satisfactory training and supervision programme are in place, which gives staff the encouragement and confidence to know they are trained, supported and equipped to deliver a good service to vulnerable people. EVIDENCE: The staffing levels were examined and found to be adequate and satisfactory, with the staff files containing information with regards to the experience, skills and training that staff have received with mandatory training being provided to all staff. Nearly 60 of staff have attained the national vocation qualification level 2 in care (NVQ) with some of the staff having also attained level 3. The home has 2 NVQ assessors with an ongoing rolling programme. Other appropriate and relevant training is also provided and some of the comments from staff regarding training were, “we have ongoing training and I enjoy it” “sometimes we have in house training and other times it is external, which is provided by ‘Voice’ (external training organisation) which is really Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 19 good and you meet different people” another said, “The home is improving all of the time and the training is really good”. Throughout the inspection / visit staff were observed demonstrating, a caring, sensitive, dignified and respectful approach to service users, with service users responding positively and it was evident that good relationships existed between service users and the care staff. The staff files were examined and they contained evidence that Criminal Record Bureau (CRB) checks had been carried out. However, only one of the three staff files that were examined contained 2 references, this shortfall in the recruitment process could potentially put people at risk. Supervision and training records were inspected and found to be satisfactory, helping to demonstrate overall that the provider is dedicated to ensuring that staff are regularly supervised and appropriately trained, in order to provide a good service to vulnerable people. Royal Care Home DS0000066041.V300844.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. “Quality in this outcome area is – ‘Good’. This judgement has been made using available evidence including a visit to this service” The home is well managed and organised, ensuring as much as possible that service users receive a good quality service. The health and safety certificates were up to date, helping to ensure that people are protected and safeguarded. The financial arrangements for residents were thorough enough to ensure that individuals’ finances were protected. EVIDENCE: The registered manger has over 29 years experience in providing care and has been the registered manger at the Royal Care Home for 18 months, having previously been a senior support worker for 2 years. He is in the process of Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 21 completing level 4 in the national vocation qualification (NVQ) and then he plans to commence studying for the Registered managers’ award. Most of the home’s policies and procedures had been reviewed and amended if needed in September 2005, helping to ensure that policies are kept up to date and relevant for the care and protection of vulnerable adults. For the 3rd year running the provider has maintained the ‘Investors in People’ award, which is an independent standard of quality assurance and a further external award with regard to quality assurance has also been maintained, for the 5th year, ‘The RDB Quality Benchmark Company Award’ and the provider has been accredited with 5 Stars, demonstrating that the provider is committed to providing a quality service for the benefit of the service users. There was documented evidence that all staff have received mandatory training, including: moving and handling, protection of vulnerable adults, (course arranged for July 2006) the control of substances hazardous to health (COSHH) and infection control, with refresher courses being available when needed. There was an up to date health and safety policy, with comprehensive, individual and corporate risk assessments, promoting the health, safety and independence of service users. All inspection certificates were in place and up to date, including: gas safety certificates, electric check certificates, fire extinguisher checks, stair chair lifts, lifting hoists and emergency lighting certificates, environmental health food hygiene certificate and inspection records were available with regard to the bacterial analysis for Legionella. There was sufficient evidence to demonstrate that the health and safety of service users and staff is promoted as much as possible, to help ensure that people live and work in a safe and healthy environment. A discussion took place with the business administrator and she was able to fully explain the procedures that were in place, regarding service users’ finances, with appropriate and adequate records being kept, helping to ensure that people’s finances are safeguarded. Royal Care Home DS0000066041.V300844.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NONE STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 (2) Requirement Timescale for action 14/07/06 2 OP29 19 (1) (C) Paragraph 5 of Schedule 2. The procedures for handling and the administration of medication must be adhered to. (Immediate and ongoing) Two written references must be 31/08/06 obtained for all employees; this will help to ensure that only suitable employees are recruited. 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 Refer to Standard OP3 OP12 Good Practice Recommendations A photograph of each service user to be placed on individual files in order to avoid confusion. Consideration should be given to providing a more varied activities programme. Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Royal Care Home DS0000066041.V300844.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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