Inspection on 28/09/05 for Stambridge Meadows

This inspection was carried out on 28th September 2005.

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

The inspector 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

Stambridge Meadows 01/04/10

Stambridge Meadows 05/10/09

Stambridge Meadows 16/04/09

Stambridge Meadows 09/10/08

Stambridge Meadows 04/05/08

Stambridge Meadows 09/01/08

Stambridge Meadows 23/08/07

Stambridge Meadows 15/01/07

Stambridge Meadows 03/05/06

Stambridge Meadows 31/01/06

Stambridge Meadows 01/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Stambridge Meadows Stambridge Road Great Stambridge Rochford Essex SS4 2AR Lead Inspector Mrs Michelle Love Unannounced Inspection 20th September 2005 08:30 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 Stambridge Meadows DS0000015554.V251143.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. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stambridge Meadows Address Stambridge Road Great Stambridge Rochford Essex SS4 2AR 01702 258525 01702 258229 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) Ashbourne Holdings Ltd Manager post vacant Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (49), Terminally ill (2) of places Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Terminal illness to include persons over the age of 55 Date of last inspection 1st June 2004 Brief Description of the Service: Stambridge Meadows is a care home with nursing for up to 49 older people. The home also has a terminal illness category and can care for up to two residents. The home is situated approximately three miles from Rochford Town Centre and is set in pleasant country surroundings. The home has 40 single bedrooms, 33 with en-suite facilities and 5 double bedrooms, 2 of which have en-suite facilities. The home has three lounges, one of which has a designated dining area. The home also benefits from a visitors lounge area on the ground floor. The spacious grounds are well maintained, with several paved areas. The home is in good decorative order with high quality accommodation for residents. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by three inspectors, Michelle Love, Carolyn Delaney and Sarah Buckle. The inspection took place over 8.5 hours and totalled 25.5 hours of inspector time. At this visit a tour of the premises took place, five care plans/risk assessments and staff employment files were inspected. At the time of the visit the registered manager, several members of staff and residents were spoken with. This is the home’s first inspection since Ashbourne Healthcare took over the home’s registration. What the service does well: What has improved since the last inspection? What they could do better: The registered manager needs to ensure that the home’s care planning systems are consistent and provide detailed information for care staff/nursing staff to provide quality care which meets the individual needs of residents living at the care home. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 6 Systems for the recording and administering of medication to residents must be improved upon and where necessary additional staff training and auditing systems must be implemented to ensure safe practices. The registered manager must ensure that all staff working at the care home receive additional training to enhance existing skills and training. All staff must receive an induction based upon their previous experience and/or skills. For those newly appointed staff who have not previously worked within a care setting, the registered provider must ensure that a more detailed induction is carried out. A more robust recruitment procedure must be adopted and all records as required by regulation must be obtained. All staff must receive formal staff supervision. Staffing levels/deployment of staff must be improved upon if the registered provider is going to ensure residents safety and ensure good care delivery from staff. The registered manager needs to spend time looking at the way staff work, if and how they speak to some residents, and how staff actually spend their time during the day. It should be arranged that staff are able to be in the lounges with the residents and provide wherever possible 1-1 time with residents and developing good relationships. 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. Stambridge Meadows DS0000015554.V251143.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 Stambridge Meadows DS0000015554.V251143.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): 2, 3, 4 and 5 Information is readily available to allow prospective residents to make a decision about moving into Stambridge Meadows. Prospective residents are assessed prior to admission. Prospective residents and their representatives are given an opportunity to visit the home prior to admission and offered a trial period. Residents are provided with a Statement of Terms and Conditions. EVIDENCE: Each resident is issued with a copy of the home’s Service User Guide. Information pertaining to the home is displayed within the home’s main reception area. Pre Admission Assessments were completed for the two newest residents to be admitted to the care home. A dependency profile was completed for both residents. Both residents had been admitted from hospital and assessments from here were readily available. One Pre Admission Assessment detailed that the resident was at risk of falls. This was not transferred and detailed onto the resident’s individual care plan. The Pre Admission Assessment did not verify as to whether or not the resident’s relatives visited Stambridge Meadows prior to their member of family’s admission. Staff training records evidence that care staff need specific training pertaining to the care and conditions of older people. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Care plans and risk assessments are devised for all residents. The quality of information recorded is inconsistent and in some cases insufficient. Medication records showed practices were not safe. Staff deployment needs to be reviewed. EVIDENCE: On inspection of five resident’s care plans, risk assessments and associated documentation, it was evident that some care plans are more detailed than others e.g. one care plan re: sexuality detailed that the resident did like to wear trousers, detailed the jewellery preferred by the resident and also confirmed that the resident prefers a female carer to provide personal care. This was seen as good practice and evidenced the home had taken into account the resident’s personal preferences and wishes. Another care plan detailed that the resident had a poor appetite/weight loss. No specific information was recorded identifying their personal preferences, likes and dislikes. No formal pressure sore assessment was evident for one resident with a pressure sore. The care plan did not include details relating to the size of the wound and/or how this was being treated. Dependency profiles were not available within all care files inspected. It was evident that one resident was not weighed weekly by care staff as documented within their care plan. It was positive to note that a formal nutritional assessment had been completed. Not Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 10 all care plans had information relating to individual’s funeral/terminal care arrangements. Risk assessments were not devised for all areas of risk e.g. One resident’s care plan made reference to them being at risk of pressure sores, requiring to be turned/repositioned hourly and requiring a gluten free diet. None of these provided information detailing the specific nature of the risk or how care staff were to keep the resident safe. The medication storage systems within the home were observed to be appropriate. Policy and procedure on medication, including the guidelines issued by the Royal Pharmaceutical Society on Medication in Care Homes were available. Several omissions were observed within individual resident’s medication administration records, whereby the qualified member of staff had not signed the records to indicate that medication had been administered to and received by residents. On the day of inspection one resident’s medication, could not be found by the member of staff administering medication. After further investigation the resident’s medication was located by one of the inspector’s. Recording within the controlled drug book for residents was unsatisfactory and inaccurate. An Immediate Requirement was given to the registered manager at the time of the inspection with a view to the registered provider improving the quality of the medication administration and records. Throughout the inspection lounge areas were monitored to ensure staff deployment was appropriate. On several occasions the lounge areas were left unsupervised. Some staff were very slow to answer call alarm facilities for residents and on two occasions staff response times to answer call alarms were very slow (4/4.5 minutes). An Immediate Requirement was given to the registered manager at the time of the inspection. Two residents confirmed that on occasions they have had to wait a long time for care staff to attend to their needs. Another resident stated that at weekends the main telephone is often not answered/relatives are unable to speak to their member of family as staff, are too busy completing other tasks. Additionally morning tea at weekends is sometimes not served until quite late. Some members of staff were observed to speak to and interact well with residents, whilst other staff members did not. One resident was overheard for a period of time to shout out “please help me, I need someone to help clean me up, any nurse please help me”. Care staff were observed to ignore this resident’s plea for assistance, until an inspector requested that someone provide help. Staff advised that this resident always calls out and that was the reason why no staff, were attending to her. This is unacceptable and must be reviewed for the future as it showed an unwillingness to attend to someone’s needs just because they called out frequently. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Until recently the home provided a good activity programme for residents. Resident’s personal preferences relating to activities/hobbies are documented. Arrangements for visitors were satisfactory. Resident’s receive a varied and appealing diet. EVIDENCE: Until recently the home had an activities co-ordinator employed for 30 hours per week Monday to Friday (This equates to approximately 20 minutes of activities per person each week). Of those care plans inspected these were noted to contain information relating to resident’s individual preferences pertaining to activities/hobbies. A montage of photographs were observed depicting a range of activities undertaken by residents i.e. gardening, holy communion, BBQ, baking, Hyde Hall gardens, Priory Park, Stambridge Primary School visit, exercises, old fashioned high tea, Chinese take away supper, external entertainers and the mobile library. The August/September 2005 activities schedule detailed that some residents had participated within cookery, garden walks, manicures, letter writing, church, mobile library, bingo, scrabble and mobile shop. The activities co-ordinator left Ashbourne Healthcare’s employment on 22nd September 2005. The registered manager advised that the post for a replacement is to be advertised. Residents spoken with during the inspection spoke very highly of the activities person and the range of activities provided. Residents spoke of their wish that any newly appointed person would be as good as the last co-ordinator. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 12 The home operates a four weekly roster of menus. The menu’s appeared varied and offered resident’s a choice of food items at all mealtimes. On the day of inspection an agency chef was at the home. It was positive to note that the chef had a general awareness of individual resident’s special diets i.e. diabetic/gluten free. On the day of inspection the food provided to residents was observed to be plentiful and appealing. Food was seen to be served by the chef from the heated food trolley. The atmosphere within the dining area was relaxed and the meal unhurried. Resident’s comments relating to meals provided were mixed. Several residents stated that the choice of meals provided had declined since Ashbourne Healthcare had become the registered provider. Nutritional records were muddled and disorganised. In some cases records were incomplete and these did not detail food eaten by residents. Not all residents were observed to have a formal nutritional risk assessment. Some `eating and drinking assessments` were observed to be detailed and comprehensive. Stambridge Meadows DS0000015554.V251143.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): Standards 16, 17 and 18 were not inspected on this occasion EVIDENCE: Standards relating to Complaints and Protection were not inspected on this occasion. Stambridge Meadows DS0000015554.V251143.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, 21, 22, 23, 24 and 25 Stambridge Meadows is well maintained and homely for residents. Minor health and safety issues were highlighted. EVIDENCE: All areas of the home were observed to be clean, tidy and well maintained. The home provides adequate toilets and bathing facilities for residents. In addition to residents individual personal bedroom space there are adequate communal facilities i.e. visitors room, dining and lounge areas. Residents were observed to have access to specialist equipment/adaptations e.g. walking frames, hoists and slings etc. Four health and safety issues were highlighted at the time of the inspection pertaining to 1x high voltage cupboard not being locked, the phone cupboard not being locked, 1x sluice cupboard not locked and cleaning fluids being easily accessible and 1x side exit door being propped open. Residents could have easy access to the car parking areas and to the main driveway unnoticed by care staff. Hand washing facilities were not easily accessible for staff within the ground floor sluice. A few bins within bathroom areas were without lids and does not provide adequate infection control measures. The home’s room where Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 15 oxygen is stored was seen to be locked and appropriate signs displayed. One resident’s care plan pertaining to oxygen lacked specific information. Resident’s bedrooms were seen to be personalised and individualised and many residents spoken with were complimentary regarding their own private space. Stambridge Meadows DS0000015554.V251143.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, 28, 29 and 30 It was unclear as to whether or not staffing levels within the home were appropriate for the needs/numbers of residents. Recruitment procedures within the care home do not protect residents. Staff training to meet the specialist needs of residents is inadequate. It was unclear as to whether or not some staff received an induction. EVIDENCE: On inspection of staff rosters it was unclear and difficult to decipher start and finish times for some staff and/or if sickness had been covered. In addition the staff roster detailed that some staff did not complete a full shift e.g. 5 hours worked by one member of staff. The deployment of staff between the ground and first floors was unclear. Eight staff recruitment files were inspected. Five of the files inspected did not have all records as required by regulation e.g. Criminal Record Bureau check/POVA First check, two written references and evidence of training and qualifications, Proof of ID and photograph. Additionally one qualified member of staff’s file did not confirm their NMC details (Pin Number). Of those files inspected not all had a record of induction. The majority of files evidenced that staff received mandatory training, however gaps were evident in relation to specialist training i.e. diabetes, catheter care, parkinsons disease etc. Of the eight files inspected, five did not evidence that staff had received resident welfare training. One member of staff who transferred from another Ashbourne Healthcare care home did not have a file readily available at Stambridge Meadows. No staff records were available for agency staff utilised at the care Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 17 home. In addition there was no written confirmation from the agency stating that all checks had been completed and these were satisfactory. Stambridge Meadows DS0000015554.V251143.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): 31 and 36 The registered manager is in day-to-day charge of Stambridge Meadows. Both the registered manager and registered provider need to take a more active role to ensure compliance with the Care Homes Regulations and to ensure that the home is run in the best interests of residents. Supervision records were not available for all members of staff. EVIDENCE: Since the last inspection the home has been registered with a new provider (Ashbourne Healthcare). The manager was formally registered with the Commission in July 2005. As stated within earlier sections of this report, much work is required to ensure that residents currently residing at Stambridge Meadows receive appropriate care and their interests are protected and safeguarded by the home’s record keeping, policies and procedures and care practices. On inspection of eight staff recruitment files, formal supervision records were unavailable for some. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 19 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 3 3 2 2 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X 3 3 3 3 3 X STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 2 X X Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 20 No 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 Standard OP4 Regulation 18 (1)a & 18 (1)c Requirement Timescale for action 01/03/06 2 OP7 15(1) 3 OP7 13(4) 4 OP8 17(1)(a), Sch 3 The registered person must ensure that all staff at the care home undertake appropriate training to the work they perform and have the necessary skills and expertise to meet the specialist needs of residents. The registered person must 01/02/06 ensure that comprehensive and detailed care plans are devised for all residents. Ensure that risks to residents are 01/02/06 identified and as far as possible eliminated. Risk assessments must be detailed and comprehensive, and reviewed regularly to reflect changes. Ensure that information relating 01/01/06 to pressure sores (treatment and outcome) are recorded within resident’s care plans. The registered person must ensure that appropriate and safe arrangements are made for the recording, safekeeping and administration of medicines received into the care home. 14/10/05 5 OP9 13(2) Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 21 6 OP10 12(1)a & 13(4)c 7 OP11 12(2) 8 OP19 13(4)(a) & (c) 9 OP19 16(2)(j) 10 OP19 16(2)(j) & (K) 11 OP27 18(1)(a) The registered person must ensure that proper provision is made for the health and welfare of residents and that unnecessary risks are identified and where possible eliminated. This refers specifically to call alarms not being answered promptly. Ensure that resident’s wishes and views are considered. This refers specifically to funeral arrangements and terminal care information being sought. The registered person must ensure that all parts of the home are free from hazards to resident’s safety and that unnecessary risks are identified and where possible eliminated. This refers specifically to unlocked cupboards/cleaning fluids being easily accessible. The registered person must ensure that suitable arrangements are made for maintaining satisfactory standards of hygiene in the home. This refers to hand washing facilities within the home’s sluice facilities. The registered person must ensure that suitable arrangements are made for maintaining satisfactory standards of hygiene in the home and ensure that suitable arrangements are made for the disposal of general/clinical waste. Ensure that at all times care staff are working in the care home in such numbers for the health and welfare of residents. This refers specifically to the deployment staff within the home’s lounge areas and the staff rosters evidencing staff not completing DS0000015554.V251143.R01.S.doc 14/10/05 01/02/06 14/10/05 14/10/05 14/10/05 14/10/05 Stambridge Meadows Version 5.0 Page 22 12 OP29 17 (2) & 19 (1) 18(2) 13 OP36 their scheduled hours. The registered person must ensure that all records as required by regulation are sought for all members of staff. The registered person must ensure that all staff receive supervision. 01/01/06 01/01/06 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 2 3 Refer to Standard OP15 OP7 OP30 Good Practice Recommendations Nutritional records should not be muddled and should be completed for all residents. Information relating to Oxygen should be detailed and comprehensive and documented within individuals care plans. All newly appointed members of staff should receive an induction according to their qualifications and previous experience. Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. Extracts may not be used or reproduced without the express permission of CSCI Stambridge Meadows DS0000015554.V251143.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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