Inspection on 16/11/05 for St Anne`s Nursing Home

This inspection was carried out on 16th November 2005.

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

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

Other inspections for this house

St Anne`s Nursing Home 07/06/07

St Anne`s Nursing Home 02/10/06

St Anne`s Nursing Home 10/05/05

St Anne`s Nursing Home 01/02/05

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE St Anne`s Nursing Home 1 Lawn Road Portswood Southampton Hampshire SO17 2EX Lead Inspector Jan Everitt Unannounced Inspection 16th November 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 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. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Anne`s Nursing Home Address 1 Lawn Road Portswood Southampton Hampshire SO17 2EX 023 8058 5032 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) Pegmar Ltd Mrs Kathryn Dawn Imonikhe Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22), Physical disability (4), Physical disability of places over 65 years of age (22), Terminally ill over 65 years of age (22) St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of 4 service users can be admitted in the PD category. These service users must be between 50 - 64 years of age 10th May 2005 Date of last inspection Brief Description of the Service: St Annes Nursing Home is a care home providing nursing care for service users over 65 years of age. The home is registered to accommodate 22 service users, but the maximum accommodated at any one time is 20. The home is registered to provide nursing care to those with physical disabilities and those with life limiting diseases. There is a condition of registration that 4 service users may be accommodated in the category of Physical Disability who are between the ages of 55 and 65 years. Pegmar Ltd owns the home and is the only home owned by this organisation in the area. The home is located on the outskirts of Southampton city and is therefore close to all the local amenities and is accessible by public transport. The home is a large Edwardian House over two storeys and is to be completely refurbished within the next year following the building of a large extension being erected on the land adjacent to the present home, into which the existing service users will move whilst the alterations take place. The home has 10 single rooms and 5 double rooms of which none have en-suite facilities. A passenger lift is installed to give service users access to the first floor. The home has extensive, well-maintained gardens of which the back area is accessible to service users. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 16 November 2005 and was an unannounced inspection and the second inspection for this year. The inspector who attended the home was assisted throughout the inspection process by the registered manager, Mrs. K Imonikhe. At the time of the inspection 19 service users were in residence. During this inspection eighteen standards were assessed of which fourteen were core standards to be inspected over the current inspection year and other standards assessed were those the inspector chose to address from the previous inspection. Of the eighteen standards assessed fifteen met the standards, three standards had minor shortfalls with requirements made and one recommendation, all of which have been discussed in the main body of this report. The overall standard of care in this nursing home is good. The inspector toured the building and spoke with a number of service users and staff. There were no visiting relatives at the time of this inspection, but a number of comment cards had been received by the Commission prior to this visit and indicated a high level of satisfaction with the services provided in the home for their relative. From conversations with service users and staff, the home provides a homely environment that is conducive to the service users’ well being. One lady recently admitted to the home described her preadmission assessment and the process she undertook, along with her neighbour as support, to go into care, as very smooth and she was ‘very happy so far, I think I have fallen on my feet coming here’. The environment is being maintained to an acceptable level, with a number of rooms having been redecorated since the last inspection, until such times as the building of the new home is completed. What the service does well: The home has a homely atmosphere and staff are welcoming and friendly. The inspector observed good interaction between staff and service users with an acceptable familiarity of knowing service user’s needs and respecting their individuality and choices. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 6 The inspector observed that staff work well as a team and trained nurses on duty at the time of the inspection were displaying good leadership and supporting staff within their different roles. Care plans are well documented and reviewed appropriately. A senior carer maintains excellent records of service users social history and of their preferred social activities, which the home endeavours to provide. All records of the level of service user’s participation in activities are recorded on individual plans. Service users spoken with and who were able to communicate reported that the activities programme in the home met their needs. A service user reported enjoying the musical entertainment from a person who attends the home during the week. The home is clean and well organised. The environment continues to be maintained and redecoration has continued to take place even though the building is due for demolition within the next 18 months. What has improved since the last inspection? The manager has been on a training course and has now introduced a nutritional assessment tool. All service users will be nutritionally assessed on admission to the home and those at risk of malnourishment will have a care plan in place identifying a proactive strategy. All service users are weighed at appropriate intervals. The environment has been risk assessed to include the exposed radiators and pipe-work and the small slip mats that remain in place and could present as a trip hazard. The manager is recruiting trained nurses in anticipation of the increase in numbers when the new building works is complete. A more active training programme is taking place and a high proportion of staff, including housekeeping staff, have gained their NVQ level 2 award and a number are undertaking the level 3. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 7 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. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 11 The service user’s health, personal and social care needs are set out in individual plans of care. The policies and practices of the home would assure service users that at the time of their death staff would treat them and their relatives with sensitivity and respect. EVIDENCE: The inspector viewed a sample of 4 care plans. The plans are comprehensive and risk assessments are undertaken on tissue viability, moving and handling and mobility. Since the last inspection the manager has introduced a nutritional assessment tool and all service users are risk assessed on their nutritional status on admission to the home. The inspector evidenced that one lady who had been admitted recently had undergone this assessment and it had identified that she was nutritionally challenged and a plan was evidenced to monitor the situation. The inspector observed that a set of ‘sit-on’ weighing St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 11 scales had been purchased to enable the more frail service users to be weighed. A risk assessment is also undertaken to assess if bedrails should be in place and bumpers were also observed to be covering those in use. There was evidence by way of a signature, that service users and/or their relatives participate in the assessment and care planning process. Care plans were clear and comprehensive and would inform staff in their practices. All information to be retained about the service user and stated in Schedule 2 of the Care Home Regulations was documented in service user’s documentation. Discussion took place with the manager with reference to the supply of continence aids. She had recently received communication from the Trust that the number of continence aids supplied to each service user was being reduced and they were not prepared to accommodate newly referred people until the new year. The manager was advised to monitor the impact of this on service users and to contact the continence service if it resulted in the quality of service users’ lives being reduced. A newly admitted service user was spoken with. She reported that she was very settled at the home and had been seen by the chiropodist, hairdresser and GP following her admission and that she felt well cared for. The home is registered for the terminally ill category and this was discussed with the manager. She reported that the local hospice and the community palliative care team have provided training for her and all staff and are very supportive should the home be caring for a terminally sick person. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 14 Service users are encouraged to maintain contact with family and friends and the local community if they so wish. Service users are able to exercise choice and autonomy over how they wish to live their daily lives. EVIDENCE: The home has no restrictions on visiting times and the visitor’s book was observed to be well recorded and evidenced that the home has many visitors throughout the week. The atmosphere in the home is warm and friendly and visitors reported that they felt welcome in the home. Service users spoken with reported that they enjoy the visits from their relatives and friends but also from people from the community that visit the home to play music and also the PAT the dog visitor. The local vicar will attend the home if requested. Comment cards received by the CSCI from relatives/friends indicated that they were happy with their relative’s care and the home in general. Service users are encouraged to be as independent as possible and to make choices about how they wish to undertake their activities of daily living. The inspector observed that in some service user’s rooms pieces of their own furniture from home has been brought in and this is encouraged as long as it meets the health and safety regulations for space and fire safety. Service users have individualised their own rooms as they wish. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Service users and their relatives can be confident that the homes policies and procedures with regards to complaints means that complaints will be taken seriously and acted upon. The home has the adult protection procedures in place to protect service users from abuse. EVIDENCE: The manager reported that one relative does complain to her verbally quite frequently and she or the trained nurse in charge deals with these immediately. No complaints have been received by the CSCI since the last inspection. The complaints policy states timescales in which a response from a complaint will be dealt with and states the CSCI address and contact number. All staff have been trained in the Adult Protection procedure and the Whistle Blowing policy and are aware of what constitutes abuse. The manager reports that at the present time there are no service users who are verbally or physically aggressive but a policy is in place to guide staff should this occur. Bedrails are used in the home and are risk assessed and consent for their use is sought from the service user or discussed with the relative. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 14 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, 22, 25 & 26 The service users live in a safe well-maintained environment The home has appropriate specialist equipment to maximise their independence. The home is clean and hygienic. EVIDENCE: The general environment is pleasantly decorated. The first phase of the new build of the home is about to commence on the plot of land adjacent to the home. Once this is completed the existing service users will move into this and the existing home will be demolished and rebuilt to increase the number of beds. The time span for this is twelve to eighteen months, therefore the existing home has had some redecoration recently and some new carpets fitted to maintain the standards. The home has a hoist and a number of pressure-relieving mattresses. The inspector observed a number of service users sitting on pressure relieving cushions in their easy chairs. The manager reported that all new equipment will be purchased with the new building and that she is viewing a newly built St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 15 nursing home in the area to get information on the equipment she will need to purchase. The inspector advised that she try to get information and advise from an occupational therapist. The radiators and pipe-work around the home that are not covered have now been risk assessed. There are radiators in all bedrooms. On the day of the inspection the radiator in one of the ground floor rooms was switched off and that together with the fanlight being slightly open made the room cold, which was enhanced by the outside temperature being very cold. The service user, who was unable to communicate effectively, indicated that she was cold. This was identified to the manager who reported that her husband would attend to this immediately. There will be a requirement made from these findings. The home is clean and free from offensive odours. Infection control training is provided and certificates in personnel files evidenced this. Gloves and aprons are also available to staff to assist in the prevention and control of infections. Soap dispensers and paper towels for hand washing were available in the toilet areas. These are not available in individual rooms and the inspector observed one carer having to leave the room to find appropriate hand washing facilities. This situation will be addressed during the rebuild of the home. There was no evidence to suggest that this situation was of detriment to the service users and the infection control measures and procedures practiced by the staff evidenced a low incidence of infections present in the home. There will be a recommendation that this situation be monitored and reviewed regularly. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 16 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): 28, 29 & 30 Service users are supported and protected by the homes recruitment practices and are cared for by staff who have been trained and are competent to do their jobs. EVIDENCE: The inspector viewed a sample of recruitment files. Details stated in Schedule 2 of the Care Home Regulations were evidenced. It was observed that only one reference had been received in one of the files and therefore a requirement will be made to ensure all references are received before commencement of employment. CRB and POVA checks were evidenced in the files. The inspector spoke with a newly recruited staff nurse who reported that she was enjoying the job, the home was very supportive and friendly and that she was satisfied with her recruitment process. All care staff have achieved the NVQ level 2 award and also the domestic staff have undertaken this award. The home has three carers undertaking NVQ level 3 at the present time. Agency staff are not used in the home. The permanent staff are prepared to undertake extra hours should this be necessary. The home has a very active staff-training programme. The manager is about to introduce the new Common Foundation Standards for new staff. The manager evidenced certificates from a number of training events that she and her staff had attended, one of the most recent ones being that of nutritional assessment. The home does fund at least three training days per year. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 Service users live in a home that is managed by a person who is fit to be in charge, but has not yet gained a management qualification. Service users do benefit from the ethos and leadership approach of the home. The home is run in the best interests of the service users. Service users financial interests are safeguarded. The health and safety of the service users and staff are promoted. EVIDENCE: Mrs Imonikhe is the registered manager of the home and has been a nursing home manager for a number of years and has many years experience as a registered nurse. She has yet to undertake her NVQ level 4 in management award. This was discussed with her and she reports that she is fully aware that this must be achieved and that she will be commencing this in 2006. The manager undertakes regular and current updated training appertaining to the St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 18 client group she cares for and the inspector evidenced the certificates in her personal file. The registered manager is also the proprietor of a sister home and does have some responsibilities to that home. The manager is supported at St. Anne’s by an experienced dedicated team of nurses and carers, some of which have been caring at the home for some years. The home has recently employed another experienced staff nurse in anticipation for when the new home will be commissioned. The inspector was informed that staff meetings do not take place but that the staff communicate well and the manager is available should any of the service users, staff or relatives wish to see her. The inspector observed that the staff interaction with service users was good and the atmosphere in the home was warm and friendly and staff were working well as a team. Several staff were spoken with throughout the inspection and they commented that they were satisfied with their jobs and really enjoyed working at the home. The inspector had received a number of comment cards from families who all expressed positive remarks about the home and the care their relatives were receiving. The home does have a development plan and this is focused on the next two years and the building and extending of the new home. The manager reports that she audits the care plans and medicine charts three monthly. The inspector evidenced this on viewing a sample of these documents. Questionnaires have been distributed to relatives and service users recently and are waiting for them to be returned, to enable the nominated staff member to analyse them and report the results to the manager. The manager has commenced reviewing all policies and procedures in anticipation of the coming changes in the next year. The inspector spoke with a number of the service users and those who were able, reported a high degree of satisfaction with all the services. The staff were referred to as ‘kind’ ‘wonderful’ and observation of the work force and interaction between staff and service user would support these comments. One service user spoken with, who was about to be discharged home, stated that she wished she could stay at the home, she was happy and very well cared for and she was only going home because her husband wanted her home. The manager reported to the inspector that the home does not manage any of the service user’s money and if the service user incurs any extra expense, the home invoices the relative or representative. The manager has reviewed the health and safety policy, which is available to all the staff. The environment has been risk assessed and this includes all the radiators and exposed pipe-work throughout the home. Rugs identified as being trip hazards in the previous report have been replaced in all cases except in the dining area between the kitchen door and the door to the dining room. The manager reported that she has found it difficult to obtain a similar rug. This rug continues to remain a trip hazard to those mobilising into the dining area and must be included in the environmental risk assessment as such. The manager produced a training matrix, which identified that all mandatory health and safety training is available to all staff at appropriate intervals. The St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 19 inspector viewed the fire logbook, which evidenced that regular checks are undertaken on all the fire equipment and tests to the fire alarm system. The inspector viewed a sample of current systems servicing certificates. The kitchen was visited and found to be clean and well organised. The manager is aware of the health and safety implications of the alterations and building works that will be taking place next door that may create dust and noise. She has informed service users and relatives of the impending works and the implications this will have on the service users in the next two years and will endeavour to consult and inform those concerned of the plans for the home. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 20 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X 2 3 STAFFING Standard No Score 27 X 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 X X 3 St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 23(2)(p) Requirement You are required to ensure that all radiators are in working order and that the temperature of room is warm and comfortable for the service user. The recruiting manager must receive two written references before employment of an individual in the home can commence. The registered manager must undertake her NVQ level 4 in management and care, to commence within the next 6 months. The CSCI must be informed within the stated timescales that action has been taken and plans are in place. Timescale for action 24/12/05 2. OP29 19(4)c Schd. 2 24/12/05 3. OP31 9(2)(i) 30/01/06 St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 22 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 OP26 Good Practice Recommendations It is recommended that the manager monitor the incidence of cross infection, which could be caused by poor hand washing in relation to the lack of hand washing facilities for staff in each bedroom. St Anne`s Nursing Home DS0000061360.V254743.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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