Inspection on 24/08/06 for Southleigh

This inspection was carried out on 24th August 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Southleigh 31 London Road Kettering Northants NN16 0EF Lead Inspector Mrs Helen Wilson Unannounced Inspection 24 August 2006 15:10 th DS0000067877.V304365.R01.S.doc Version 5.2 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 DS0000067877.V304365.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 Adults 18-65. 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. DS0000067877.V304365.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southleigh Address 31 London Road Kettering Northants NN16 0EF 01536 511166 01536 515705 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) Minster Pathways Limited Mrs Hilary Jane Shatford Care Home 14 Category(ies) of Learning disability (14), Learning disability over registration, with number 65 years of age (3), Physical disability (6) of places DS0000067877.V304365.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No one falling within category PD may be admitted to Southleigh where there are 6 persons of category PD already accommodated in the home No person under the age of 25 years to be admitted to Southleigh No persons to be admitted to Southleigh under category LD(E) when there are 3 persons in total of this category already accommodated within the home The maximum number of persons accommodated within Southleigh is 14 Not applicable Date of last inspection Brief Description of the Service: Southleigh is a residential home providing care for 14 adults whose primary care need is due to a Learning Disability; there are additional conditions to enable the home to provide care for 3 older people with Learning Disabilities, and 6 people with physical disabilities in addition to their Learning Disabilities. The home is situated close to Kettering town centre within easy reach of local amenities including shops, General Practitioners surgery and public transport facilities. Southleigh has open plan communal areas downstairs including a dining area and 2 separate lounge areas. Bedrooms are based on 2 floors with a semi independent flat on the second floor. The home has specialist bathing and shower facilities on the ground floor suitable for people with physical disabilities. There is a small garden area to the side of the building with ramped access and car parking available to the rear. The current range of fees is £556.97 to £901.25. DS0000067877.V304365.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is on outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care they receive, a review of their records, discussions with the care staff and observation of care practices. The people who live at Southleigh have learning difficulties, some with additional physical disabilities or disabilities relating to their elderly status, for example dementia, and communication for some is difficult. Establishing that service users have choice and are helped to make informed decisions is dependent to a large extent on observations of staff actions, service users’ relationships with staff, and the quality of shared communication. Feedback obtained from service users in this report was mainly through observations of their relationships with staff and also through interpretations of their general levels of satisfaction with their routines. Discussions were held with the staff member in charge about the care of service users. Although this is the first inspection of the home under the company’s new limited name, Minster Pathways Ltd, the home’s operation has continued uninterrupted and with the same Registered Manager in post. Issues that were highlighted at the last inspection for action have been rechecked during this inspection and the home’s progress in resolving matters evaluated. What the service does well: The admission and assessment procedure sets out a process that is suitably flexible and informative. There was an easy relaxed rapport noted between staff and Southleigh service users. The service users were at home on the inspection day and were relaxing doing puzzles, drawing or watching television. The Registered Manager follows a robust procedure for safe-keeping service users’ personal monies and bankbooks and for agreeing cash and receipts. Valuables such as bank books, passbooks, etc, are held in a secure locked facility. DS0000067877.V304365.R01.S.doc Version 5.2 Page 6 Several of the service users currently at Southfield have needs for high levels of care and support from staff. The home has three carers and one senior staff member rostered on duty throughout daytime hours and two waking night staff. The Registered Manager confirmed that should the care needs of service users alter there would be additional staff brought in. The home has a monthly monitoring visit on behalf of the owners to check on operational standards. A maintenance man is employed to carry out minor repairs. The company has a training programme for all staff and the Registered Manager said that a plan for core training of staff has been set up. Two newly recruited staff have started their National Vocational Qualification Level 2 assessments. What has improved since the last inspection? What they could do better: There was no written evidence of professional guidance from an occupational therapist relating to the use of a reclining armchair and restraining lap strap that were being used for one service user. There was no written evidence that this equipment had been specifically recommended for use for the particular service user leaving a potential for physical injury. There also was no consent for this apparatus from care managers, health professional such as the GP or the family. By 1st September 2006 a written recommendation for the armchair and lap strap had been obtained retrospectively from a qualified DS0000067877.V304365.R01.S.doc Version 5.2 Page 7 occupational therapist and permission in writing from the family had been given. Following the inspection the Registered Manager has also sought consent for the equipment’s use from health professionals and the care manager. A care plan must be in place for the use of a recliner chair and restraining strap by a particular service user. The internal dividing wall between the ground floor shower room and bathroom continues to show wide symptoms of damp with the paintwork blistering. This is a health hazard to service users and was highlighted to the company in the last inspection report for urgent remedy. The Registered Manager said that only recently professional advice was obtained regarding this section of wall that is thought to require rebuilding work. The Registered Manager said that there has been no progress made in setting up a quality assurance and quality monitoring system review in the home that involves the responses of service users and other parties. This formal monitoring review should be undertaken as soon as practicable to establish a development plan for 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. DS0000067877.V304365.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000067877.V304365.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information available to prospective service users and their families is sufficient to judge the suitability of the home. Service user’s individual needs and goals are assessed prior to their admission. EVIDENCE: No new service users have recently been admitted to the home. Most of the service users have lived together for many years and have a family type relationship. The admission and assessment procedure sets out a process that is suitably flexible and informative and would enable prospective service users and their supporters to make an informed choice about the home. Both case files examined showed that contract/terms and conditions had been signed between the home and the service users and/or families. DS0000067877.V304365.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There has been good progress made in reviewing service users’ care plans that give clear guidance to staff on delivering personal care. There was however a failure to seek professional advice about specialist seating for one service user. EVIDENCE: Following the last inspection the Registered Manager has reviewed and revised care plans and risk assessments for all service users; from the two case files specifically checked it could be seen that these care plans had taken any identified risks into account and the resulting care plans gave clear guidance to staff about personal care tasks and support necessary for each person. The staff member in charge said that she had found the plans to be much improved and informative. There was however no written evidence of professional guidance from an occupational therapist relating to the use of a reclining armchair and restraining lap strap that were being used for one service user leaving a potential for physical injury. There also was no consent for this apparatus from care managers, health professional such as the GP, or the family. An DS0000067877.V304365.R01.S.doc Version 5.2 Page 11 Immediate Requirement was made of the Registered Providers that evidence in writing be forwarded to the Commission for Social Care inspection by Friday 1st September 2006 that this equipment had been specifically recommended for use for the service user and that written consent for its use had been obtained from the service user’s health professionals, care manager and family. By 1st September 2006 a written recommendation for the armchair and lap strap had been obtained retrospectively from a qualified occupational therapist and permission in writing from the family had been given. Consent from the health professionals and the care manager has also been sought by the Registered Manager. A care plan must be in place for the use of the recliner chair and restraining strap. The service users were at home on the inspection day and were relaxing doing puzzles, drawing or watching television. Service users continue to go to day centres and one person helps at a local charity shop. Records kept of service users’ personal monies and bankbooks held for safekeeping were clear and cash and account totals agreed. There is a robust system for receipting each entry that gives protection to each individual. The Registered Manager stated that valuables held by the home for safe-keeping for service users such as bank passbooks and individual’s passports are now held in a secure locked facility. Observations showed that relationships between staff and service users are warm and enabling and individuals are valued in their own right. Service users’ self-esteem is recognized as an important aspect of care and is promoted. DS0000067877.V304365.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are helped to maintain ordinary lifestyles by staff and continue to attend day centres and work opportunities according to their varying abilities. EVIDENCE: Service users are supported to continue with day centres, work at a local craft workshop, Teamwork, etc. Several service users are now ageing and have a physical disability that restricts full participation in the community and spend time at the home in quieter activities such as television, puzzles, etc. The Registered Manager said that recently one of the more elderly service users had visited a local forest and had enjoyed the overhead walkway. Relationships with family members are good; records and staff confirm that individual service users have regular contact with their family both visiting and taking people out for trips. One family have decorated a bedroom in the home for a specific service user. DS0000067877.V304365.R01.S.doc Version 5.2 Page 13 Daily routines fit around service users’ needs with people rising late if they wish and going out individually with staff for personal shopping. Staff talk to and interact with service users and rapport is good. Following the last inspection, menu plans now show the meals planned and details any alternative food given to specific service users. One service user has a separate range of meals due to a food intolerance. DS0000067877.V304365.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate personal and healthcare support is given to service users. EVIDENCE: The range of service user care needs has clearly extended due to the ageing of people at the home in addition to their original conditions of learning disabilities. The staff and manager are dedicated to maintaining long-term placements for service users however the extent to which the home can do this should be regularly reviewed and considered. In recent months staff at the home were able to provide support and dignity to an elderly service user through a deteriorating terminal illness. Service users have wheelchairs and walking aids where needed to maintain independence. One service user has specialised sensory equipment in a bedroom. Medication records are appropriately signed off by staff and evidenced the administration of the prescribed medication. In one case file the record of current medication needed to be updated to show recent changes. DS0000067877.V304365.R01.S.doc Version 5.2 Page 15 Both case files examined showed that regular contact is made with local GPs, community nurses, dentists and where necessary psychiatrists. The district nurse visits the home to provide community nursing care to one person. The healthcare records for this person are dated in 2005 and need to be updated for the home by the district nurse; the Registered Manager has asked the nurse to revise the record. DS0000067877.V304365.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures in place that potentially give protection to service users. EVIDENCE: There was an easy relaxed rapport noted between staff and Southleigh service users. The home has a process for service users and others to make complaints and raise issues that concern them. Staff said that they were able to talk about any concerns with the people living at Southleigh and there have been no major concerns. The Commission for Social Care Inspection has not received complaints about the home in the last four months. DS0000067877.V304365.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27 and 29 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home overall is homely there has been a failure to protect and safeguard service users by ensuring equipment is suitable and the building in good repair. EVIDENCE: The internal dividing wall between the ground floor shower room and bathroom continues to show wide symptoms of damp with the paintwork blistering. This is a health hazard to service users and was highlighted in the last inspection report for urgent remedy. The Registered Manager said that the company has only recently obtained professional advice regarding this section of wall that is thought to require rebuilding work. Urgent remedial work is required to this wall to protect and safeguard the service users. There was no written evidence of professional guidance from an occupational therapist relating to the use of a reclining armchair and restraining lap strap that were being used for one service user. There also was no consent for this apparatus from care managers, health professional such as the GP or the family. DS0000067877.V304365.R01.S.doc Version 5.2 Page 18 An Immediate Requirement was made of the Registered Providers that evidence in writing be forwarded to the Commission for Social Care Inspection by Friday 1st September 2006 that this equipment had been specifically recommended for use for the service user and that written consent for its use had been obtained from the service user’s health professionals, care manager and family. By 1st September 2006 a written recommendation for the armchair and lap strap had been obtained retrospectively from a qualified occupational therapist and permission in writing from the family had been given. Following the inspection the Registered Manager has also sought consent for the equipment’s use from health professionals and the care manager. In April 2006 the company was asked to replace some bedroom carpets, repair or replace bedroom furniture and ensure wheelchairs were fitted with footplates. Action has been taken to address these issues. DS0000067877.V304365.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust recruitment procedure that protects service users and rapport between staff and service users is good. Supervision for staff has commenced. EVIDENCE: There was an easy relaxed rapport noted between staff and Southleigh service users. Each staff member had undergone a thorough recruitment process including Criminal Record Bureau checks. Individual staff confirmed they had received a job description and were clear about their responsibilities. The home has three carers and one senior staff member rostered on duty throughout daytime hours and two people work waking night shifts. Currently there is a vacancy for a night shift worker. Several of the service users currently at Southfield have needs for high levels of care and support from staff. The Registered Manager confirmed that should the care needs of service users alter there would be additional staff brought in. DS0000067877.V304365.R01.S.doc Version 5.2 Page 20 The Registered Manager stated that she has begun a process of staff supervision to monitor that each staff member gives support and personal care to service users in an appropriate and competent manner. The company has a training programme for all staff and the Registered Manager said that a plan for core training of staff has been set up. Two newly recruited staff have started their National Vocational Qualification Level 2 assessments. DS0000067877.V304365.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The day to day operation of the home is satisfactory. EVIDENCE: Staff reported that the management style in the home is relaxed and open. Shifts are led by senior staff with the Registered Manager overseeing the running of the home and also covering vacancies on the duty roster. Case file records eg care plans and risk assessments have been fully reviewed following the last inspection and therefore up to date information is available to direct staff in delivering consistent care. Notifications are made to CSCI of accidents, incidents and events where necessary. DS0000067877.V304365.R01.S.doc Version 5.2 Page 22 The home has a monthly monitoring visit on behalf of the owners to check on operational standards. A maintenance man is employed to carry out minor repairs. The Registered Manager said that there has been no progress made in setting up a quality assurance and quality monitoring system review in the home that involves the responses of service users and other parties. This formal monitoring review should be undertaken as soon as practicable to establish a development plan for the home. DS0000067877.V304365.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 2 28 x 29 1 30 x STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 2 X X X x DS0000067877.V304365.R01.S.doc Version 5.2 Page 24 Not applicable Are there any outstanding requirements from the last inspection? 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 YA29 Standard Regulation Requirement Timescale for action 01/09/06 12(1) The Registered Persons are 13(1,4,5,6,7,8) required to provide written evidence that the particular service user’s needs for specialist equipment has been professionally assessed by a qualified Occupational Therapist. This was an Immediate Requirement made at inspection on 24 August 2006. 12(1) 13(1,4,5,6,7,8) 2 YA29 3 YA29 The Registered Persons are 01/09/06 required to provide written evidence that the equipment, eg the electrically powered recliner armchair and a restraining strap, is recommended as appropriate and suitable by the qualified Occupational Therapist for use by the particular service user. This was an Immediate Requirement made at inspection on 24 August 2006. 12(1) The Registered Persons are 01/09/06 13(1,4,5,6,7,8) required to provide written DS0000067877.V304365.R01.S.doc Version 5.2 Page 25 4 YA29 13(8) evidence that written consent has been given by the service user or her family, and from health care professionals involved in her care such as the service user’s General Practitioner, Consultant, Consultant Psychiatrist or Care Manager that a recliner chair and restraining strap are appropriate and acceptable to be used in the care of the particular service user. This was an Immediate Requirement made at inspection on 24 August 2006. A care plan must be in place 08/09/06 for the use of the recliner chair and restraining strap. The dividing wall between 30/09/06 the ground floor bathroom and shower room must be repaired to protect the health of service users. 5 YA27 13(3,4) 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 YA39 Good Practice Recommendations A quality assurance and quality monitoring system review should be undertaken and should involve the views of service users and their representatives. DS0000067877.V304365.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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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