Inspection on 27/10/05 for St Paul`s Care Home

This inspection was carried out on 27th October 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 Paul`s Care Home 20/11/08

St Paul`s Care Home 23/11/07

St Paul`s Care Home 28/06/06

St Paul`s Care Home 19/07/05

St Paul`s Care Home 12/10/04

St Paul`s Care Home 13/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

Thorndene

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE St Paul`s 65 Albany Road St Leonards On Sea East Sussex TN38 0LJ Lead Inspector Liz Daniels Unannounced Inspection 27th October 2005 13:00 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 Paul`s DS0000014047.V250743.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 Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Paul`s Address 65 Albany Road St Leonards On Sea East Sussex TN38 0LJ 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) 01424-425798 01424-428885 New Century Care (Hastings) Limited Margaret Law Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25), Physical disability (25) of places St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is twenty-five (25) Service users must be aged sixty-five (65) years or over on admission Service users with a physical disability can also be accommodated Date of last inspection 19th July 2005 Brief Description of the Service: St. Paul’s is a detached property that has been converted and adapted as a Care Home in St. Leonards-On-Sea. It is owned by New Century Care Ltd and provides nursing and personal care for up to 25 residents of an older age, including those with physical disabilities. The accommodation is arranged over three floors, with a shaft lift providing access to all floors. There are three double bedrooms and the remainder are single. A large spacious lounge/dining room, with access to a patio area outside, provides communal space and at the front of the Home, there is a parking area for several cars. The Home is situated in a residential area of St. Leonards and is on the bus route for the shops at Silverhill or for the town of Hastings. St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of six hours beginning at 1pm. The Inspector met with the Registered Manager and Area Manager. The Operational Manager for the Company also visited the Home whilst the Inspection was underway. The Inspector undertook a tour of the Home meeting informally with several of the 22 residents currently living there and their visitors. There was the opportunity to chat privately with three residents, before inspecting a range of documentation and key records. This report should be read in conjunction with the report from the last Inspection on 19th July 2005. What the service does well: What has improved since the last inspection? The Home has demonstrated a commitment to reviewing its practise and has made excellent progress in meeting the Requirements and Recommendations made at the last Inspection. The concrete path to the front door has recently been extended across the front parking area to the footpath and roadway, enabling easier access for those in wheelchairs. This meets the Recommendation from the last Inspection. The Care Plans seen during the Inspection were very specific and reflected the particular needs of those residents. Assessments have been undertaken to determine the most appropriate type of drinking cup for individuals. The weekly fire drills are now separate from the fire alarm tests and are appropriately recorded. The staff rota now highlights when the Manager is supernumerary to staffing numbers, undertaking management duties or training, either at St. Paul’s or in one of the other Care Homes, owned by New Century Care. These were all Requirements of the last Inspection, which have been met. Staff are also now including consideration of the residents’ emotional needs in the daily record of care provided, as recommended at the last Inspection. St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 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. St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 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 St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 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): 1,4 and 5 St. Paul’s provides comprehensive information for current and prospective residents, which is being updated. This enables an informed choice about the suitability of the Home. Although a copy of the Commission’s Inspection Report is available on request, it should be made more readily available. Relatives and prospective residents are involved as far as possible in decisions about admission. EVIDENCE: St. Paul’s has a Statement of Purpose and a Service User Guide. The Statement of Purpose is comprehensive, but the Service User guide does not contain a description of the accommodation, or the qualifications of the staff. Both are given out to prospective and current residents and as such contain all the required information. The Service User guide seen by the Inspector needs amending to reflect the current Deputy Manager. The Manager assured the Inspector that new information is currently being printed and should be in the Home very soon. A copy of the new information will then be given to each resident. A copy of the updated information has since been forwarded to the Inspector. The Statement of Purpose and Service User guide are available in large print and are put onto ‘talking tapes’ for individuals if needed. A copy of St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 9 the Commission’s Inspection Report is available on request. It was recommended during the Inspection that this be made more readily available, either by including it with the Service User guide or by displaying in a public area such as the main entrance. Following an enquiry about the Home, prospective residents or their relatives are always invited to visit the Home wherever possible. If the admission is desired, the Manager undertakes an assessment, either in the prospective resident’s home or in hospital. When the decision about admission has been made, residents move in, initially on a trial basis. Emergency and unplanned admissions are avoided. The three residents who met with the Inspector had not visited prior to their admission but all are very pleased with their room and the Home in general. St Paul`s DS0000014047.V250743.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 and 10 The Care Plans reflect the health, personal and social care needs of the residents and by being regularly reviewed, remain contemporary. Residents or their relatives are included in formulating the Care Plans when possible. In general, staff are committed to promoting privacy and respect for residents but the lock on the bedroom door leading from the public bathroom does not protect the privacy of the resident who occupies that bedroom. EVIDENCE: St. Paul’s provides 24 hour nursing care and all the residents have a Care Plan that reflects the health and personal care they require. Two Care Plans were viewed in detail. There are Risk Assessments in place, which include, amongst others, an assessment of dependency, a nutritional assessment and an assessment of tissue viability to assess the risk of developing pressure sores. All are reviewed monthly. The Care Plans are also reviewed monthly and those seen had been updated to reflect the resident’s current needs. They were very specific, meeting the Requirement of the last Inspection. Although there was documentation in place where residents could sign to indicate that they are involved with their Care Plan, those seen by the Inspector had not been signed. When discussed with the staff, the Inspector was advised that residents, where capable, and/or their relatives if available, are involved in the St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 11 care planning process. A daily record of the care provided is kept. Staff are now including consideration of the residents’ emotional needs as recommended at the last Inspection. Any personal care or medical examinations are undertaken in private and screens are provided for those in double rooms. A telephone line is available in each bedroom and the residents can see their visitors either in private in their room, or in a communal area if they prefer. Each resident is offered a key to their room if they wish and there is a lockable facility in each room. One bedroom has a door leading into a bathroom that is used by other residents. The door cannot be locked from the bedroom and therefore can provide access for any resident to enter the room from the bathroom. This was discussed during the Inspection and alternatives are being explored. All the bedrooms seen had been personalised with possessions and, in some, small items of furniture. The term of address preferred by the resident is recorded in the Care Plan. During the Inspection, staff were observed to be attentive and considerate. St Paul`s DS0000014047.V250743.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 Relatives and visitors are welcomed at St. Paul’s and residents are encouraged to maintain links with the local community. The individual needs of residents have been assessed to determine the most appropriate type of drinking cup, meeting the Requirement of the last Inspection. EVIDENCE: Several of the residents have maintained links with the local community by belonging to clubs and attending a Day Centre. Visitors are welcome at St. Paul’s at any time and can meet their relative or friend in private in their room, downstairs in the lounge or enjoy the patio area outside. During the Inspection, several visitors were spending time with the residents. Although Standard 14 was not fully assessed on this occasion, it was noted that during the Inspection, afternoon tea and supper were served. Appropriate crockery for each resident was used. Since the last Inspection, new crockery has been bought. Assessments have also been undertaken to determine the most appropriate type of drinking cup to be provided for each individual. The aim is that this will be reviewed, as individual needs change: a copy of the assessment is on display in the office and in the kitchen for staff to reference. This meets the Requirement from the last Inspection. St Paul`s DS0000014047.V250743.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 There is a comprehensive complaints policy in the Home, which staff are aware of. It is well publicised for residents and their visitors and they have access to the contact details for the Commission. Residents have confidence that concerns will be followed through. EVIDENCE: No complaints have been forwarded to the Commission since the last Inspection. There is a complaints procedure in place that identifies the timeframes for managing the complaint and the people who need to be informed. All complaints and the action taken are recorded in a complaints log. Once the complaint has been investigated the complainant is informed in writing of the outcome of the investigation. No complaint has been recorded since 2004. The Home’s policy for the management of complaints is on display in the front entrance. It includes the details of how to contact the Commission, should the complainant wish to. All the residents and visitors seen demonstrated an excellent rapport with the staff. Those asked said they could talk to the Nurse in charge for the shift if they had any concerns and have confidence that their complaint will be listened to and acted upon. St Paul`s DS0000014047.V250743.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): 19,20,23,24 and 26 The Home is comfortably furnished. Some of the wall coverings and paintwork need re-decoration. Parts of the Home did not smell fresh. The lock on the bedroom door leading from the public bathroom should be revised to protect the privacy of the resident who occupies that bedroom. Steep steps to the basement store are a hazard to residents and staff: signage must be put in place to highlight this. Weekly tests of the fire alarm must be recorded. EVIDENCE: St. Paul’s provides comfortable accommodation over three floors, with a shaft lift enabling access for those with reduced mobility. There is level access to the front door: the concrete path has recently been extended across the front parking area to the footpath and roadway, enabling easier access for those in wheelchairs. This meets the Recommendation from the last Inspection. There is a large entrance area and a spacious lounge dining room as communal space. The furnishings and lighting are homely and the room allows enough space for some residents to watch television whilst others can be quieter and read, or talk with visitors. Doors open out onto a patio area. The bedrooms are comfortably furnished and each has a lockable storage space and St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 15 telephone point. Curtain screens provide privacy for those residents who share a double room. Magnetic door guards are on the bedroom doors enabling residents to choose to have their door open and each resident is provided with their own key if they wish it. One bedroom can be accessed from a bathroom used by other residents, as discussed earlier in the report. A range of equipment and aids are installed to provide support and promote independence. Adjustable beds are provided for those residents needing nursing care. Any significant maintenance is built into the Home’s Annual Development Plan. A full tour of St. Paul’s was undertaken during the Inspection. A storage area in the basement is accessed via steep stairs, protected by a door with a ‘Yale’ lock. At times the door has to be left unlocked whereby the steep steps present a risk for residents. This was discussed during the Inspection and a sign indicating the Hazard was subsequently being explored, for the door. Overall the decoration is now showing signs of wear and tear as some of the paintwork is chipped and the wallpaper scuffed. There was an odour of urine in some areas although the Home looked clean. This was discussed during the Inspection and the Inspector was assured that the carpets are shampooed when needed. However, St. Paul’s is due for refurbishment: the current plan is that this will be done within the next year. The call bell system has been upgraded and has failed on very few occasions since the last inspection. The Fire Risk Assessment was viewed: the specific action taken has been recorded and dated. This meets the Requirement of the last Inspection. The Manager advised that the fire alarms are tested weekly. The last test recorded was 17th September 2005. Fire Drills are also done weekly but are now separate from the fire alarm tests and appropriately recorded. The last fire drill was recorded as being on 21st October 2005. This meets the Requirement of the last Inspection. St Paul`s DS0000014047.V250743.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): 27 and 29 A team of care staff is employed to meet the health needs of residents and an appropriate skill mix is in place throughout the 24-hour period. Correct recruitment procedures are in place. EVIDENCE: Registered Nurses lead each shift supported by care staff. The staff rota in place covers the 24-hour period. 4 carers are rostered with a trained nurse during the day, 3 carers with a nurse for the afternoon and evenings and 2 carers with a nurse for the night shift. The Company employ 2 maintenance staff, and a gardener across their Care Homes in East Sussex. Also employed are an Administrator, who works part-time, an Activity Co-ordinator, laundry staff, housekeepers, 2 chefs and a kitchen assistant. The Manager works varying shifts over the 7-day period and is supported by the Deputy Manager. It is now clearly identified on the rota when the Manager is undertaking management tasks and is supernumerary to the staff numbers, and those days when she is working as a trainer for staff, either at St. Paul’s, or in one of the other Care Homes owned by New Century Care. This meets the Requirement of the last Inspection. Two staff files were reviewed. Photo identification is kept on file and copies of work permits if appropriate. Both contained references received prior to appointment. Recruitment checks had been applied for and staff are appointed once a POVA first check is received. Staff are then supervised until there is full CRB clearance. Staff who have had a recent CRB disclosure in their previous employment are appointed with that CRB. A new CRB is then applied for. This meets the Requirement of the last Inspection. Staff are issued with contracts, St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 17 the terms and conditions of the post and a job description, copies of which are kept on file. St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 18 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): 33 and 38 Good quality assurance processes are in place. The response from the recent survey shows an overall satisfaction with St Paul’s. Monthly water temperature checks must be recorded. Staff must have their mandatory training updates in Fire and First Aid. EVIDENCE: St. Paul’s undertakes its own ‘satisfaction survey’ to seek the views of residents and their visitors. The results of the most recent survey had just been analysed: graphs and charts enabling a clear understanding of areas of good performance and those needing improvement have been produced and will be publicised. The results demonstrate that there is overall satisfaction with St. Paul’s. No respondents had said they were dissatisfied. Documentation for safety checks was reviewed. The Fire Alarm system and Emergency Lighting were last serviced in August 2005. The last check ‘in house’ is recorded as being on 17th September 2005. The Fire St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 19 Extinguishers were last serviced in October 2005 and the last organised fire drill was on 21st October 2005. Risk assessments are in place for the environment, including the equipment in the kitchen. These had not been reviewed since April 04 but are currently underway. The Area Manager advised that PAT testing had been undertaken on 6th October 05 although the report had not yet been received by the Home. The Inspector found plugs labelled as having been tested on 6th October. The lift and chair lifts were serviced on 29th June 05 and equipment seen during the Inspection was all labelled as having been serviced this year. The Gas Boiler was serviced on 15th September 2005. A water chlorination check was undertaken on 13th December 2004. The Manager advised the Inspector that monthly water temperature checks are undertaken but no record was found since 14th April 05. However, since the Inspection a copy of the water temperature checks made on 1st November has been forwarded to the Inspector. The Deputy Manager at St. Paul’s is a trainer in Moving & Handling – all staff have had their mandatory update within the last year. All staff have also had training in Health & Safety. However, not all staff have had their mandatory fire training this year. The fire trainer that the Home accessed previously has recently retired. All staff have had at least one session of training this calendar year and as an alternative trainer has now been identified, plans are in place to ensure staff are updated as soon as is practical. Some staff have also not had their mandatory training in First Aid and have not been trained in Food Hygiene. A record of any accidents is kept. The log is regularly reviewed by the Manager to identify any trends. No accidents have been recorded since 20th July 05. St Paul`s DS0000014047.V250743.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 2 x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 2 3 x x 3 3 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 St Paul`s DS0000014047.V250743.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 OP1 Regulation 5(1)(d) Requirement A copy of the most recent inspection report must be included in the service user guide or be visibly available for intended and current residents. The lock on the bedroom door leading from the public bathroom must be revised to protect the privacy of the resident who occupies that bedroom. Weekly tests of the fire alarm must be recorded. There must be signage on the door accessing the steep steps to the basement store, to highlight it as a hazard. Monthly water temperature checks must be recorded. The premises must be kept free from offensive urines throughout. Staff must have their mandatory training updates in Fire and First Aid. Staff must be trained in Food Hygiene. Timescale for action 30/11/05 2. OP10 12(4)(a) 31/12/05 3. 4. OP19 OP19 23(c)(v) 13 (4)(a)(c) 13 (4)(a)(c) 16(2)(k) 18(c)(i) 30/11/05 30/11/05 5. 6. 7. OP25OP38 OP26 OP38 30/11/05 30/11/05 28/02/05 St Paul`s DS0000014047.V250743.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 OP19 Good Practice Recommendations Parts of the Home are showing signs of wear & tear and should be considered for re-decoration. St Paul`s DS0000014047.V250743.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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