Inspection on 22/12/05 for The Shrubbery Nursing Home

This inspection was carried out on 22nd December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

The Shrubbery Nursing Home 21/06/07

The Shrubbery Nursing Home 17/01/07

The Shrubbery Nursing Home 25/07/06

The Shrubbery Nursing Home 05/09/05

The Shrubbery Nursing Home 08/02/05

The Shrubbery Nursing Home 18/07/04

The Shrubbery Nursing Home 03/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Shrubbery Nursing Home, The Birmingham Road Kidderminster Worcestershire DY10 2JZ Lead Inspector Andrew Spearing-Brown Unannounced Inspection 11:00am 22nd December 2005 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 Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 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. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Shrubbery Nursing Home, The Address Birmingham Road Kidderminster Worcestershire DY10 2JZ 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) 01562 822787 01562 68122 Minster Care Homes Limited Mrs Joy Tompkinson Care Home 33 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (33), of places Physical disability (33) Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th September 2005 Brief Description of the Service: The Shrubbery Nursing Home is a Grade II listed building set in large gardens and approximately half a mile from Kidderminster town centre. Care is provided for the physically and mentally disabled who require both nursing and personal care. Single and double rooms are available on the ground and first floor. The first floor is accessed via a passenger lift. The home has a secure rear garden which residents can access, via a conservatory. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken by two inspectors from the Worcester office of the Commission for Social Care Inspection commencing early morning and ending prior to midday a total of around 6 ½ hours inspection time. The last inspection at The Shrubbery Nursing Home took place during September 2005 making this inspection the second statutory visit during the 2005 – 2006 inspection year. At the time of this inspection 29 residents were residing at the home. Shortly before this inspection the CSCI received a complaint involving two individuals recently admitted into hospital. The registered manager had already forwarded copies of documentation as requested to the Commission. As a result of this complaint an emphasis was placed upon these areas of concern. A number of areas of serious concern were identified at the time of the inspection. An immediate notice was issued at the time, which was followed up by means of a letter. Prior to the completion of this report the registered manager has responded to the CSCI detailing the action implemented. These areas will therefore be reassessed as part of a forthcoming inspection. What the service does well: What has improved since the last inspection? This inspection concentrated on areas around care plans, risk assessments, the environment and health and safety. Shortfalls were found in the majority of areas re assessed following the last inspection, however some requirements were not re assessed and therefore it is not possible to determine whether these areas have improved. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 6 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. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 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 Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 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 and 5. Standard 6 is not applicable. Admissions without suitable assessments can be potentially dangerous and cannot ensure that care needs can be met. EVIDENCE: The documentation regarding a recently admitted resident was viewed. The admission took place as part of a hospital discharge agreement entered into by a local hospital and a number of local nursing homes. The information was provided over the telephone and via an assessment faxed to the home. The written assessment was insufficient to demonstrate care needs. No assessment on behalf of the home was possible due to the timeframe. As a result the registered manager was unable to demonstrate that the home would have the skills and experience to manage care needs. As the admission took place with little notice nobody had the opportunity to visit the home beforehand. The admission took place at 9.00 pm which is an inappropriate time to admit a new resident. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 9 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 Care plans and risk assessments were insufficient and inconsistent in that they did not give the necessary detail regarding residents care needs to ensure that care staff are able to provide the level of input required. This shortfall can leave residents at potential risk. In addition the systems for the administering and recording of medication are poor and potentially place residents at serious risk. The availability of some communal clothing, and lack of locks on doors demonstrated shortfalls in the upholding of privacy and dignity. EVIDENCE: As part of this inspection a random number of care plans were viewed. These included the care plans specific to the complaint made to the CSCI. Care plans seen were not reviewed and updated as necessary to provide the necessary information for nursing and care staff to meet identified care needs. The daily records were not sufficient in detail and did not therefore indicate the level of care given. Suitable documentation regarding weight loss was not in place. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 10 Risk assessments were either inappropriate and insufficient in detail or not suitably reviewed in a number of areas. These shortfalls included nutrition, the use of bed rails, skin damage and pressure prevention, mobility and smoking. The lack of bumpers or protective covers on bed rails is highlighted as part of standards 38 of this report. As part of this inspection a random number of MAR (Medication Administration Record) sheets were viewed. These demonstrated a number of serious shortfalls in recording whereby a full audit of drugs would not be possible. A considerable number of gaps were noted whereby no signature was in place to confirm administration or a suitable code to indicate why medication was not given. The section on the MAR sheet regarding allergies was on occasions blank; if no allergies are known this section must state ‘none known’. Variable dosages were not recorded. Handwritten amendments to MAR sheets were not always double signed On checking the controlled drugs register against a specific MAR sheet they were found to differ. Although the overall number of drugs held balanced it was evident that staff had signed the sheets incorrectly. A tub of sudocream was located in one of the bathrooms; this may demonstrate communal use of such items and can lead to cross infection. The tub did not have a date of opening written upon it. Standard 10.4 of the National Minimum Standards – older people states that ‘Service users (residents) wear their own clothes at all times.’ It was noted that a number of large storage boxes were located within one of the bathrooms stating ‘spare top clothes for men only’ ‘ ladies nightwear only please – not named for spare’ ‘ spare pyjamas for men only please’. This demonstrated that communal use of clothing was taking place. The registered manager has since notified the CSCI that these items were immediately removed, this standards will therefore be re assessed as part of a forthcoming inspection visit. Bed linen was also stored in bathrooms, which further detracted from a pleasant environment for individuals to bath. On a number of occasions it was noted that the locking mechanism was missing from bathroom doors, the result was not only a hole in the door but a lack of privacy offered to residents. Communal toiletries were held within the upstairs shower room and the downstairs bathroom. Other items such as talc and shaving foam were located in a cupboard under a sink in a sluice room. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 11 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): None of the standards in this section were assessed in any great detail as part of this inspection. As a result these standards will be assessed as part of a forthcoming inspection at The Shrubbery. EVIDENCE: The dining room was untidy and unwelcoming to residents who may of wished to have their breakfast within that area. It is however noted that this inspection took place the day after the resident’s Christmas party during which a water leak through the dining room ceiling occurred. Concern was expressed regarding bowls of porridge left on a serving area upstairs. It appeared to the inspectors that the porridge was waiting to be served to residents and therefore was clearly getting cold. A list of residents waiting to receive their breakfast was written on a paper towel. No other meals were seen during the inspection however records regarding food served were viewed as part of the complaint investigation. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 12 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): None of the standards in this section were assessed in any detail as part of this inspection. As a result these standards will be assessed as part of a forthcoming inspection at The Shrubbery. EVIDENCE: Part of this inspection was to investigate two complaints made directly to the Commission for Social Care Inspection. As these complaints were made directly to the CSCI no record regarding the complaint would have been made within the home. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 13 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, 22, 24, 25 and 26 Although many areas of the home are acceptable other areas are in need of replacement or repair in order to provide an environment that is homely and safe to live in. Shortfalls were noted in relation to some record keeping regarding bath temperatures, this can potentially leave residents at risk. EVIDENCE: The communal lounge and dining room on the ground floor were viewed soon after arriving at the home; these areas were generally found to be untidy. The dining table was in disarray. Crumbs were noted on the floor in the lounge and the waste paper bins were full. It was stated that the dining room was used for all meals including breakfast; no breakfasts were served there during this inspection visit. It is however noted, as mentioned on page 12 above, that this inspection took place after a residents party and after a water leak through the dining room ceiling had occurred. Work to repair the leak and attend to the Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 14 electrical fitting were water was seeping was taking place during this unannounced inspection. The carpet along one corridor was noted to have tape in place as well as showing signs of wear and tear. The carpet in the lounge / dining room and bedroom number 2 were stained. None of the bedroom doors were fitted with a lock. Since the inspection the registered manager has indicated her willingness to fit appropriate locks and has sought information into the types that are suitable. Notepads were provided within bathrooms to record bath temperatures. These were poorly maintained, the pad in one bedroom indicated that throughout the whole of 2005 only 6 baths had taken place. The recorded temperature was noted to be low (35.5° C – 37.7° C). The floor in one bathroom was dirty. A large conservatory provides a room where smoking is permitted. This area was cool on the day of the inspection A cupboard in the hallway on the first floor was seen to have an adequate supply of disposable gloves available for staff. Although clinical waste bins were seen in a number of areas a bin with a black refuse sack was seen containing plastic aprons in a bathroom. Two separate sluice areas were unlocked and cluttered. The storage of bed linen needs addressing. Sheets were stored in bathrooms and duvet cover in black bags on top of wardrobes. In addition wheelchairs and other items were stored within a bathroom, which was reported to be seldom used. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 15 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): None of the standards in this section were assessed in any detail as part of this inspection. As a result these standards will be assessed as part of a forthcoming inspection at The Shrubbery. EVIDENCE: It was noted that a considerable number of carers were sat together within the dining room partaking of their break. Staff breaks should be staggered in order that a sufficient number of staff remain available to residents; not just those sat within the lounge which is located next to the dining room. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 16 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): 38 Shortfalls regarding some other health and safety matters potentially left residents at risk. EVIDENCE: Only a small number of health and safety matters were assessed on this occasion. During a tour of the building it was evident that hoisting equipment is routinely serviced as required under the Lifting Operations and Lifting Equipment Regulations 1998. One hoist did however give some cause for concern in that it was purchased from another care home; the only evidence available showed that it was last serviced in excess of 6 months ago. Wheelchairs were observed with no footrests fitted this could be potentially dangerous. In order to prevent a risk of injury to residents all wheelchairs should be fitted with their footrests. Since the inspection the registered manager has written to the CSCI stating that any wheelchairs found without Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 17 footrests are to be taken out of service. In addition that staff were informed that they must not condom the practice of using chairs without footrests in place. On examining the accident book one incident due to a wheelchair was noted while another referred to a cut on a residents calf. Bed rails were observed in use with no protective cover, appropriate protective covers should be fitted to bedrails when in use in order to prevent the risk of entrapment. Similar to above the registered manager has written to the CSCI detailing the action, which has taken place. Concerns regarding wheelchairs and bedrails will be re assessed as part of a forthcoming inspection. Fire extinguishers were last serviced during August 2005. Monthly audits of accidents are carried out. Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 18 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 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 2 X 2 X 2 X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 1 Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 19 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 OP3OP53 Regulation 14 (1) Requirement The registered manager must ensure that residents are only admitted into the care home following a full needs assessment. Residents care plans must cover all aspects of health care needs and identified risks must be assessed and acted upon. (The previous timescale of immediate following the inspection on 05/09/05 was not met. Immediate improvement must take place with all care plans actioned by 02/02/06.) The registered manager must ensure that care plans are reviewed on at least a monthly basis and any changes in the resident’s condition must be included. (The previous report contained a similar requirement with a timescale of 05/09/05 – this requirement was not met. Immediate improvement must take place with all care plans actioned by 02/02/06) DS0000004143.V275164.R01.S.doc Timescale for action 22/12/05 2. OP7OP8 15 02/02/06 3. OP7 15 02/02/06 Shrubbery Nursing Home, The Version 5.1 Page 20 4. OP7 13 &15 Those residents identified as losing weight must have a care plan which reflects this current need, clearly stating actions to be taken to prevent further weight loss (The previous timescale of immediate following the inspection on 05/09/05 was not met. Immediate improvement must take place with all care plans actioned by 02/02/06.) 02/02/06 5. OP7 15 Wound and pressure sore documentation must be up to date and reflect the wound care needs of the resident (The previous timescale of immediate following the inspection on 05/09/05 was not met. Immediate improvement must take place with all care plans actioned by 02/02/06.) 02/02/06 6. OP8 15 The registered manager must ensure that suitable risk assessments are in place regarding nutrition, bedrails, mobility and smoking. Immediate improvement must take place with all risk assessments fully actioned by 02/02/06.) 02/10/06 7. OP9 13 (2) The registered manager must ensure that Medication Administration Record (MAR) sheets are completed adequately and at the time of administration. 22/12/05 8. OP9 13 (2) Medication Administration Record 22/12/05 DS0000004143.V275164.R01.S.doc Version 5.1 Page 21 Shrubbery Nursing Home, The (MAR) sheets must show all known allergies. In the event of ‘none known’ the MAR sheet must reflect this information. 9. OP9 13 (2) The registered manager must ensure that when a variable dosages is prescribed the actual dose given is recorded. The registered manager must ensure that any handwritten amendments to the medication administration record (MAR) sheets are checked dated and counter signed by a second member of staff. The registered manager must ensure that all prescribed items including creams and ointments are held securely and only used upon the person for whom it was dispensed. The registered manager must ensure that residents are afforded respect, privacy and dignity at all times. 22/12/05 10. OP9 13 (2) 22/12/05 11. OP9 13 (2) 22/12/05 12. OP10 12 (4) (a) 22/12/05 13. OP19 23 (2) (b) The registered manager must 28/02/06 ensure that all areas of the home are kept in good repair and good order. 14. OP22 23 (2) (l) (m) The registered manager must ensure that appropriate storage is available for items such as linen and equipment to prevent the use of communal bathrooms The registered manager must DS0000004143.V275164.R01.S.doc 28/02/06 15. OP24 13 (4) 30/04/06 Page 22 Shrubbery Nursing Home, The Version 5.1 ensure that residents have the opportunity (unless a risk assessment suggests otherwise) a key to their bedroom. Locks provided must be in line with those approved by the fire authority. 16. OP25 13 (4) The registered manager must ensure that accurate records regarding bath water temperatures are maintained Bath temperatures must be suitable to residents needs while remaining with safety limits. The registered manager must ensure that items, which could be classified as clinical waste, are disposed of in line with infection control procedures. Staff records must contain an up to date photograph of the person employed (This requirement was not assessed as part of the inspection held on 22/12/05. The previous timescale remains in place.) 18. OP38 13 The newly acquired hoist in the must have a current service certificate no older than 6 months old. The home must ensure that all wheelchairs are used with appropriate footrests fitted. The home must ensure that where bed rails are in use an appropriate risk assessment is in place and fitted with protective covers. Staff must receive fire training DS0000004143.V275164.R01.S.doc 22/12/05 16. OP26 16 (2) (j) 22/12/05 17. OP29 7,9,19 05/09/05 22/12/05 19. OP38 13 (4) 22/12/05 20. OP38 13 22/12/05 21. OP38 23 05/09/05 Page 23 Shrubbery Nursing Home, The Version 5.1 every three months (This requirement was not assessed as part of the inspection held on 22/12/05. The previous timescale remains in place.) 22. OP38 13 The nominated member of staff must have specific health and safety training (This requirement was not assessed as part of the inspection held on 22/12/05. The previous timescale remains in place.) 05/09/05 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 OP33 Good Practice Recommendations It is recommended the quality assurance audit includes other stakeholders such as professional visitors to the home; doctors, chiropodist, district nurse etc (This recommendation was not reassessed as part of the inspection undertaken on 22/12/05 and therefore remains in place. This recommendation will be reassessed as part of a forthcoming inspection.) Shrubbery Nursing Home, The DS0000004143.V275164.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. 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