Inspection on 10/07/07 for Ryelands

This inspection was carried out on 10th July 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

Ryelands 22/06/06

Ryelands 23/02/06

Ryelands 28/10/05

Ryelands 01/03/05

Ryelands 30/11/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Ryelands 15 Beddington Gardens Wallington Surrey SM6 0JF Lead Inspector Liz O`Reilly Key Unannounced Inspection 10th July 2007 9:30am 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 Ryelands DS0000007194.V345265.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. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ryelands Address 15 Beddington Gardens Wallington Surrey SM6 0JF 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) 020 8647 6837 020 8254 7047 home.wal@mha.org.uk home.fxg@mha.org.uk Methodist Homes for the Aged Mrs Patricia McIlvenna Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 Rooms to be used as Double Rooms for the use of husbands, wives, partners, brothers or sisters only. Room number 42 (Dementia Unit) size 19 Sq.m Room number 23 (Personal Care Unit) size 20.709 Sq.m Room number 25 (Personal Care Unit) size 23.256 Sq.m 22nd June 2006 Date of last inspection Brief Description of the Service: Ryelands is owned by a voluntary organisation ‘Methodist Homes for the Aged’ and is situated a short distance from Wallington town centre. The home is open to all regardless of gender, race, financial position or religious faith. The home is now registered to provide care to 48 older people sixteen of whom need dementia care. The site includes Ryelands a care home for older people and Brooklands a separate unit for people living with dementia. For the purpose of this inspection report both units are referred to as Ryelands. A block of supported independent living flats, Moorlands are part of the complex. The garden at Ryelands is shared with Moorlands. All service users’ rooms have en-suite facilities and a kitchen area. There is a lift serving all floors. The scale of charges is £550-£604 or £640 in Brooklands. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two regulation inspectors and included discussions with people who use the service and staff and a visit to the home. Survey forms were left for residents and staff at the time of the visit and surveys were also sent to a sample of relatives. Judgements in this report are made taking into account information received from all of these sources including observations made. It should be noted that the manager of the home who is relatively new to the post has been away from the home for some time prior to this inspection. This may well have impacted on the way the home has been operating. Discussions took place with the manager regarding the present conditions of registration(see above). A request will be made to the registration unit of the CSCI to have these conditions removed as they are no longer necessary. What the service does well: What has improved since the last inspection? What they could do better: Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 6 Further work needs to be carried out on the care planning system to ensure that all staff understand the principles of person centred planning and can put these into practice. More care needs to be taken in recording actions taken by staff to protect the health of individuals and reduce the risk of falls. To ensure the health and welfare of residents staff must keep up to date and accurate records of medication. The plans in place to improve introduce life story work and more reminiscence will provide benefits to residents and staff. A review of the meal times should be carried out to include how information is given, choices made, access to snacks and communication. Carpets in Brooklands need more regular cleaning. Consideration should be given to improving the environment in this unit. Staff need to be provided with on going training and information on up to date practice in dementia care. To ensure the safety of residents the recruitment procedure must be complied with and all checks carried out before anyone commences work in the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Ryelands DS0000007194.V345265.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 Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 5 People who use this service receive good quality outcomes in this area. Good information is available to prospective users of the service about the home. Assessments are completed before people move in to make sure that their individual needs can be met. EVIDENCE: Residents told us that they were provided with good information before they made a decision about moving in. A Welcome Pack has been compiled which gives information on the service and facilities. This is updated on a regular basis and is available on tape. Residents are encouraged to visit and spend time in the home to decide if this might be the right place for them to live. We spoke to people who had recently moved in that they confirmed that they had visited and found this useful in making their decisions. Before anyone moves in assessments are carried out to make sure the home can meet their needs. Copies of the assessments are available to staff and can be used to set up an initial care plan. Good information on the needs and strengths of individuals is provided through the assessment process. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 9 Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience adequate quality outcomes in this area. Care plans include basic information but are not detailed or person centred. Care plans are not reviewed on a regular basis across the service. Risk assessments are not being updated. The health care needs of residents are mostly met. Further work needs to focus on ensuring that medication is well managed. Residents told us that they feel they are treated with respect by staff and that their privacy is always respected. Care needs to be taken to ensure that health care visits and treatment are carried out in private. EVIDENCE: Each person who uses the service is supplied with a care plan. We found examples of staff including some good information on the personal needs and preferences of individual but overall care plans gave only basic general information. All plans were not being reviewed on a regular basis and little information was available on the strengths of individuals, outcomes or life story. The organisation has introduced a new care planning system. This system has the potential to provided person centred plans. Good guidance is available to Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 11 staff on what information should be included. However further work needs to be carried out to ensure that all staff have a good understanding of person centred care planning and how to complete the new plans. Consideration should be given to providing more opportunities for keyworkers to be involved in the care planning process. Residents are registered with local GP practices and are supported to attend health care appointments and check ups. We observed a health professional taking blood from a resident in the communal area of the home without any conversation as to where might be appropriate to carry out this task. Staff must take care to document any actions taken. We found assessments of skin condition showing a high risk of pressure sore development with no information on what action was taken. Food and fluid balance charts had been used but not completed and in one instance risk assessments were not up dated following falls. In order to safeguard the health and welfare of people who use the service staff must record actions taken to minimise risks. At the time of the last inspection a requirement was made for medication administration records to be correctly filled in at all times. We found a number of instances where medication had not been signed for. This requirement has not therefore been met. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good quality outcomes in this area. Residents are supported to develop and maintain personal and family relationships. Residents can get involved in a number of activities. Some residents felt that improvements could be made in this area. The menu is varied with choices available. Further work could be carried out to improve the choices available. Care staff are sensitive to the needs of those people who find it difficult to eat and are aware of the importance of helping people at their own pace. EVIDENCE: Residents told us that they can have visitors at any time and are encouraged to keep in contact with friends and relatives. Visitors told us they felt welcome in the home at any time. Activities coordinators are employed and a programme of various activities are provided for each unit. A Volunteer Support Group supports the organised activities and individual residents. Activities are on offer seven days a week. A volunteer brings two dogs to the home on a regular basis. The activities coordinators read the care plans but do not carry out individual evaluation. Residents felt that sometimes activity time is lost because the coordinator has to seek out residents who want to take part. This occurred on the day of the inspectors visit. Consideration should be given to involving all Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 13 the staff in making sure that those people who wish to get involved are supported to attend. We were informed that care staff keep an activities diary to plan and commit to individual activities with residents but none of the staff we spoke to were using these. The home plans to develop life story work, introduce head and hand massage and introduce more reminiscence activity over the next year. These additions plus the implementation of activities diaries will provide more opportunities for residents. The introduction of more person centred activities will also benefit individuals. Outings are arranged and recent trips have included a day out in Eastbourne and a trip to Whitehall in Cheam. Residents were also involved in the summer fair in June. Residents from the supported living unit can join those at Ryelands for lunch and on the day of this visit a coffee morning was being held in the supported living scheme. A church service is held in the home twice a week. Staff will also support those residents who wish to attend other places of worship for different denominations and faiths. Residents appreciated the care taken to support them with their spiritual needs and wishes. The majority of residents felt the food on offer was good. However some residents told us that the quality of the food was not consistent. The home can cater for those who need or wish to follow a special diet. Consideration should be given to improving the alternatives available for those people who are diabetic. This should be addressed by the manager. The menu for the day is written on a white board in each unit. Consideration should be given to providing the menu in different formats. Fresh fruit is available and staff confirmed that residents can get a snack at any time of the day or night. The manager should ensure that a snack is offered to all residents in the evening as some residents spoken to were unaware that they could get something other than biscuits after the last meal of the day. Meals were seen to be taken in a comfortable and relaxing environment. Further work could be carried out around meal times to allow residents to serve themselves with support and to encourage better communication particularly in Brooklands. Some staff were observed to communicate in a very positive way with residents at meal times. Other staff appeared less confident in communicating with residents. A review of the use of bibs should be carried out. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in these areas. The service has a clear complaints procedure. Residents felt that they were listened to by the staff and would feel comfortable in making a complaint if necessary. A full record of complaints is kept along with actions taken and outcomes. Training on safeguarding adults is provided for all staff. EVIDENCE: All complaints and compliments are recorded with copies of responses kept on file. The complaints procedure is available in the home and supplied to each resident when they move in. Residents felt confident that should they have a complaint senior staff would listen and deal with it quickly. All staff are provided with training on safeguarding adults. This ensures that they can recognise abusive behaviour and are aware of their responsibilities to report any concerns they may have to the appropriate persons. The home keeps copies of the organisations procedures for safeguarding adults along with the Local Authority procedures. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 & 26 People who use this service experience good quality outcomes in these areas. The home is well maintained and provides specialist aids and equipment to meet the needs of individuals. Bedrooms are only shared with the agreement of the individuals concerned. Residents are encouraged to personalise their bedrooms. People who use the service were pleased with the environment. Overall the standard of cleanliness is good. However the carpets in communal areas of Brooklands need more frequent cleaning. EVIDENCE: The home provides very comfortable, well maintained accommodation. Residents are provided with their own room with en suite shower and toilet. Each room is provided without furniture to encourage people to bring their own things when they move in. Furniture will be provided if necessary. Each individual room has a kitchen area with a fridge and sink so residents can make their own drinks and snacks if they wish. A doorbell is fitted for each room. All residents are offered a key to their room. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 16 The manager is looking to improve the separate bathrooms to make them more homely. We found the majority of the home to be clean, tidy and fresh smelling. However the carpets in Brooklands were in need of cleaning. Care needs to be taken to ensure that these areas are cleaned on a regular basis. One visitor to the home told us that there was on occasion a bad odour on entering the building. Consideration should be given to reviewing Brooklands to produce a more stimulating and user friendly environment for those people living with dementia. One visitor felt that residents should be provided with a means of getting back into the building when they have been out with friends or family. Their experience was that they often have to wait some time for staff to let them in the building. This is something the management should consider. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience adequate quality outcomes in these areas. All feedback from residents and visitors regarding the approach of staff was very positive. Sufficient staff are available to meet the present needs of individuals. Good opportunities are available for staff training. Further training needs to be provided on dementia care. Staff feel well supported in their roles. Work needs to be done to make sure that recruitment procedures are followed at all times. EVIDENCE: We received good feedback on the staff group. Residents described staff as “thoughtful”, “very nice”, “very agreeable”, “very helpful”, “caring” and “nice”. Visitors said that staff were “welcoming”, “patient” and “always cheerful”. Staff themselves felt they were well supported and worked well as a team. The management was described as “good” and “helpful if there are any problems”. Over 50 of staff have completed NVQ training in care. Agency staff are rarely used which provides continuity of care for residents. The numbers of staff available on each shift are adequate to meet the present needs of the residents. We were informed by staff that they received two days training with a test on dementia care. In order to improve the skills and knowledge of staff and ensure that they keep up to date with current good practice in dementia care staff need to be provided with on going training in this area. Consideration should be given to ensuring that staff have access to up to date publication, journals and web sites on dementia care. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 18 A sample of three staff files were examined. Criminal Records Bureau checks had been carried out for each member of staff. In two of the three files seen only one reference was on file. No details of the explanation for gaps in employment were on file. In one instance a member of staff had previously worked for another organisation in the care sector but records did not show that confirmation had been sought from the organisation on why they ceased employment there. An induction programme for new staff is in place. In one of the three staff files the induction record had not been completed. In order to ensure the safety of residents a review of the staff recruitment process must be carried out within the home. To make sure that all staff complete induction training a record of completion needs to be kept. We were informed by the manager that changes in the organisation of work will mean that a senior member of staff, well qualified in dementia care, will be available on Brooklands more frequently. We believe this will provide more guidance for staff and a more consistent approach for those living in this unit. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 People who use this service experience adequate quality outcomes in these areas. The manager has a significant amount of experience in the care sector and is suitably qualified. The home works in partnership with residents and their families or representatives. Care is taken to listen to the views of people who use the service. The organisation has produced sound policies and procedures but further work needs to be done to ensure that these are followed in the home. EVIDENCE: We are aware that the manager who was relatively new has recently been away from the home for some time. This situation may well have impacted on the monitoring of compliance with standard procedures. This is reflected in the judgement for these areas. Action needs to be taken to make sure that procedures are followed in relation to medication, care planning and recruitment. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 20 Facilities are available in the home for residents to deposit small amounts of cash for safekeeping. Accurate records were seen to be kept on all money deposited and any expenditure. Staff gave mixed feedback on supervision. Some staff said they received regular one to one supervision while others had not received supervision for some time. It was noted that senior staff had a significant amount of staff to supervise. Now that the manager is back it is hoped that a more consistent frequency of supervision will be available. Residents felt they were listened to by the management on an individual level and whey they attended monthly residents meetings. The organisation has produced quality monitoring systems to ensure that the home is meeting the needs of individuals and to look at where improvements can be made. Residents are involved in the assessment of quality. Staff felt that the manager was supportive and that the organisation was “good to work for”. Regular checks are made on the building and facilities to ensure the health and safety of residents, staff and visitors to the home. Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 4 X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 3 Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 15(1)(2) 13(4) Timescale for action In order to ensure the health and 25/09/07 welfare of residents care plans must include details of the needs and preferences of individuals. Reviews of the care plan and risk assessments must be carried out on a regular basis or more frequently should there be any changes. 2. OP8 12(1) In order to protect the health of residents staff must record actions taken should individuals be assessed as at risk of:• Pressure sores • Falls • Malnutrition • Dehydration To ensure the health and welfare of residents medication administration records must be up to date and accurate. Timescale of 22/06/06 not met. 4. OP26 23(2)(d) Carpets in Brooklands must be cleaned on a regular basis and DS0000007194.V345265.R01.S.doc Requirement 25/09/07 3. OP9 13(2) 25/09/07 25/09/07 Ryelands Version 5.2 Page 23 more frequently if required. 5. OP29 19 Schedule 2 ( 1-9) In order to protect the safety of 25/09/07 residents evidence that all appropriate checks have been carried out prior to anyone commencing work at the home must be available. These checks must include:• Two written references • Written verification of the reason why staff ceased to work in a position which involved contact with vulnerable adults or children • A full employment history, together with a satisfactory written explanation of any gaps in employment. 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 Refer to Standard OP7 Good Practice Recommendations All care staff should be provided with training on person centred care and planning. Consideration should be given to more involvement of keyworkers in the care planning process. A review of how activity sessions are organised should be carried out to make the best use of the time available. A review of meal times should be carried out to include:_ • Consistency of quality of food • Providing menus in different formats • The provision of a snack in the evening • The presentation of food • The choices available for special diets • Communication DS0000007194.V345265.R01.S.doc Version 5.2 Page 24 2. 3. OP12 OP15 Ryelands • 4 OP19 The use of bibs A review of the environment in Brooklands should be carried out with a view to making this unit more user friendly for people living with dementia. All staff should be provided with on going training in dementia care. Staff should be provided with access to publications, journals and web sites on dementia care to ensure that they remain up to date on good practice in this area. 5. OP30 Ryelands DS0000007194.V345265.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 - 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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