Inspection on 03/10/06 for Swallowfields Care Centre

This inspection was carried out on 3rd October 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Swallowfields Care Centre 02/12/08

Swallowfields Care Centre 03/12/07

Swallowfields Care Centre 09/01/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Swallowfields Care Centre Swallowfields Care Centre 45 Alexandra Road Epsom Surrey KT17 4DB Lead Inspector Mavis Clahar Key Unannounced Inspection 3rd October 2006 10:00 Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swallowfields Care Centre Address Swallowfields Care Centre 45 Alexandra Road Epsom Surrey KT17 4DB 01372 720908 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) Leighton House Limited To be confirmed Care Home 8 Category(ies) of Learning disability (8), Mental disorder, registration, with number excluding learning disability or dementia (8), of places Physical disability (3) Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be within the category of learning disability (LD) but may also have needs associated with the category mental disorder (MD) 9th January 2006 Date of last inspection Brief Description of the Service: Swallowfields Care Centre is a residential care home, based in a large detached house within easy access to Epsom Town Centre. The home has eight single bedrooms, three on the ground floor and five on the first floor; all with en-suite toilet and bath/shower facilities. The service is able to cater for three service users with a physical disability in the first floor bedrooms. There is no lift in this home so service users using the second floor bedrooms must be able to negotiate the stairs The home offers service users two spacious sitting rooms, dining room, kitchen, and conservatory for those service users who wish to smoke. Service users also benefit from the home’s specialist facilities, which include an occupational therapy room, which can be used for a wide range of therapies and life skills development, gymnasium and sensory room. Service users also have access to a good sized and secure garden to the rear of the property and there is ample off road parking to the front of the premises. Overall the home provides a good standard of accommodation for younger adults with needs in the learning and physical disabilities categories of registration. Fees at this home are in the range of £2650.00 to £3000.00. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit, which forms part of the home’s first key inspection to be undertaken by the Commission for Social Care Inspection, was undertaken by Mrs Mavis Clahar on the 3rd October 2006, and lasted for six and one half hours; commencing at 09:25 and concluding at 16:00 hours. The first part of the visit was spent speaking with those service users who were on their way out to attend their activities for the day, and observing care workers interacting respectfully with these service users. The inspector was mindful of the service users timetable including the traffic so this encounter was not prolonged. Time was spent updating the acting manger, the deputy manager and the provider on the improvements CSCI has made to improve the inspection processes under Inspecting for Better Lives. Two service users were still asleep so a tour of the home was not conducted until after they had risen, washed and had their breakfast and went out for their daily activities. The home was found to be clean and tidy, and free of unpleasant odours. The grounds were in good condition with the lawn neatly cut. The second part of the inspection was spent reviewing service users care notes, and sampling care workers records. These were all in order. Observation of the weeks’ duty roster indicated that there is adequate numbers of care workers on duty to meet the assessed needs of the service usersThe final part of the inspection was spent giving feed back to the manager about the findings of the visit. Service users’ opinion on the service contained in this report was obtained from two service users. One was able to fully discuss all issues relating to life at the home, within the community, likes and dislikes and dietary intake. The other service user was not so verbally able so communication was by observation of body language such as facial movements hand movements sitting position etc when the inspector asked direct questions to this service user. What the service does well: There are now seven service users living in the home and the staffing levels were observed to be four carers plus the Occupational Therapist (OT)in the morning, four carers plus the OT (until Mid-afternoon) in the pm. Two care workers were on night duty. Staff training has been given high priority with care workers encouraged and enabled to pursue qualification to enable them to meet the assessed needs of the service users. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Admissions to the home are not made until a full needs assessment has been undertaken to ensure the home can meet the needs of the service user. The assessment is conducted professionally and sensitively and involves the service user and their family or representative where appropriate, and the psychologist, and the occupational therapist. Where the assessment is undertaken by social services, the home obtains a copy and a copy of the care plans also. EVIDENCE: Review of service users files demonstrated that the home has established a good process of assessing service users needs. This has been enhanced by the joint development of service users care plans with service users. The assessment contains the documented evidence of the psychiatrist, psychologist and occupational therapist. In discussion with service users it was evident the service users are involved in the assessments of their needs and aspirations. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9. Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. Service users are involved in the review of their care, and agreed changes are documented in their care plans, thereby ensuring all care workers have access to this new information. The home encourages service users to make decisions about their daily lives, and to take risks as part of their independent lifestyles, with assistance from the key worker when necessary. EVIDENCE: Random review of service users files demonstrated that service users assessed needs are documented in the care plans and the evaluations demonstrated that changing needs are recorded. How much the service users are currently aware of this was hard to ascertain. It is obvious from the information contained in the care plan that the service users were involved, but since neither the care worker or the service users signed and dated the care plans it is hard to be certain of service users agreement. A requirement was issued on Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 10 this standard. Care workers spoken to say the assessment of needs is carried out over a period of time and that the service users and their families are very involved. It was apparent that service users made decisions about their lives. The inspector noted that one service user took a long time to get dressed this is because this service user need to be fully dressed up with make up and jewellery. The care workers allow her time to accomplish this. It was noted during random review of service users file that this information was documented in the assessment and also in the care plans. The inspector observed that this service user was well dressed for the day. Another service user told the inspector he is goes to church on a regular basis and he has a voluntary job at the church. When questioned about the job he told the inspector I like to see the church clean also the gardens so I try to do this two times per week with help from my key worker. In discussion with care workers the inspector was told service users are involved in the care of their home. They have a weekly menu-planning meeting followed by food shopping which involves the service users. Some service users are encouraged to do their own laundry with the support of their key worker. No service user is allowed to do any ironing at this home. The home has only recently been opened and the first intake of service users were involved in the decision on which service users to be admitted into the home. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 17 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service The service has a strong commitment to enabling service users to develop their skills, including social, emotional, communication and independent living skills. Service users are encouraged and supported to identify their goals, and aspirations and work to achieve them Service users are able to make choices in accordance with their abilities and are provided with balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The observed relationship between care workers and service users was relaxed and friendly creating a warm and friendly homely feeling. They are encouraged to live a full life and to partake in age related activities such as going to the pub, having meals out attending college of further education. Their religious beliefs are acknowledged and encouraged. One service user in Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 12 particular attends church on a regular basis, whilst another likes to use his computer and another likes his football and will watch every game his team plays. Review of service users records and in discussion with care workers it was documented that Service users are encouraged to make friends outside of the home and to keep in touch with their friends and families as they wish. One service user’s family is unable to visit the home at present so the home has made arrangements for this service user to visit her family on a two times weekly basis as agreed with the service user and his family. Service users are enabled to entertain their guest in the privacy of their bedroom if they so wish. The home documentation on service users choices is based on Respect, Independence, Community participation and Community presence. The care workers aided by the service users provide catering service for all at the home. The inspector did not sample the mid-day meal but the service users said it was delicious, and the amount was right. The inspector noted a good amount of dry, frozen and fresh food in the home. Service users are allowed to make drinks as they wish with assistance from their key worker. The manager informed the inspector that at their weekly menu-planning meeting they discuss the advantages of healthy diet. They discuss foods rich in carbohydrates, fats, proteins minerals etc and how these foods are necessary for body building and keeping the body healthy. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20. Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. Carers understand the principles of giving personal care and support and are responsive to varied and individual requirements of the service users. They recognise that the delivery of personal care is highly flexible, consistent and reliable ensuring that service users receive personal care and support in the way they prefer; and that their emotional and health needs are met. None of the service users at this home are assessed as capable to selfadminister their medication. Medication is administered by staff trained to do so, thereby being protected by the home’s policies and procedures on administration of medication. EVIDENCE: Discussions with service users, care workers and review of care plans indicated each service user received the agreed personal care and support as directed in the care plans. Physical and emotional needs identified in the care plans are also met. The care plans are reviewed on a regular basis, visits to the doctor dentist, and dietician are carried out on a regular basis. Daily care notes are Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 14 documented dated and signed by the key worker or other care worker as necessary. Review of randomly selected service user files revealed that no service user at the home is risk assessed as capable to self-administer their medication. A review of the medication records demonstrated that medication is not being administered within the home’s policy and guidelines of administration of medicines. One off prescriptions ordered by the GP are being hand written on to the MAR sheet by care workers, with no photocopy of the original prescription. A requirement was issued on this standard. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. The home operates in a manner that supports service users to air their views and concerns, which are acted upon before they can become complaints. Robust safeguarding policies are in place to protect the service users from abuse. EVIDENCE: CSCI Eashing office has not received any complaints about this home since the last inspection. The home did not have a complaint log for the inspector to review. Included in the service users information pack kept in their bedroom is the homes’ complaints policy and service users’ guide. However, the manager informed the inspector that issues raised by service users are dealt with instantly before they can become complaints. The home did not keep a compliments log either. A recommendation was made on this standard to start a complaints log immediately. This was done prior to the ending of the visit. Random sample of care workers files and in discussion with care workers it was evidenced that care workers are being trained to recognise and report any act or suspicion of abuse to service users. The manager supported this by the production of the staff training record. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. Service users are encouraged and supported to personalise their bedrooms, to make it a homely, comfortable clean and safe environment. The home is clean and tidy and free from odours. EVIDENCE: The home has a well-maintained environment, and provides aids and equipments to meet the assessed needs of the service users. The home presents as a safe place to live with bedrooms that meet the National Minimum Standards for Younger People. The home presents as comfortable with attractive gardens made safe by the wrought iron fencing around the garden to prevent service users slipping as the garden is on a slight slope. There is good access to the gardens via the steps and the ramp. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35. Quality in this outcome is adequate. This judgement has been made using the available evidence including a visit to this service. Service users are supported by adequate numbers of competent and qualified staff. The home operates from a good recruitment policy, which strives to protect the service users. Appropriately trained staff meets joint care needs of the service users. EVIDENCE: Review of service users care plans indicated their named key worker supports service users. Review of care workers training files indicated the carers have been trained to assist the service users achieve their agreed care and social needs. Review of the rota from July to the day of the visit indicated that four carers plus the OT are on duty in the am and four carers plus the OT on duty in the pm. Two carers cover night duty. In discussion with care workers it was verified that the home provided training and regular updates for them. The home has a good recruitment policy, which is adhered to. It was noted Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 18 that all members of staff were recorded as having had an application to the Criminal Record Bureau (CRB). The home is still awaiting the return of two applications. Review of staff files demonstrated Schedule 2 of the Care Homes Regulations 2001 (Amended) was being observed by the home. In discussion with care workers, supported by the acting manager and the Provider it was revealed that staff training is high on the agenda for the home. The home is working toward having 50 of its staff with NVQ. To date the home employs three carers with Level 3 NVQ; whilst four carers are currently undertaking the course; and two carers are undertaking the Level 4 qualification. In addition the home employs two Registered Nurses. Review of carers’ files and training records supported this discussion. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42. Quality in this outcome is good. This judgement has been made using the available evidence including a visit to this service. The acting manager continues to ensure that care workers follow the policies and procedures. Care workers have handbooks and easy access to all documents including the latest copy of the CSCI report. Regular staff and service users and staff meetings are held but these meetings are not recorded. There is evidence that the management of the home is open and that service users and care workers opinions are listened to and valued. EVIDENCE: Following the resignation of the registered manager, the provider has appointed the Head of Care as temporary manager until a replacement manager was appointed. The provider informed the inspector that in spite of national advertisements a suitable candidate has not been found so he has Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 20 decided to train two of his current care staff one as manager and the other as deputy manager. Both these members of staff are currently undertaking the Registered Managers Award (RMA) and NVQ L4 in care. On the day of the visit the Head of Care was not available. In discussion with service users the inspector was told there is good service users involvement in all aspects of the running of the home even though some service users might not like performing some task such as cooking. One service user said, “we are asked about having a new resident. They come and stay for a while and if we don’t like them we say no and we don’t see them again.” It was difficult to measure how confident service users were that their views underpin all self-monitoring, review and development by the home. Documented evidence from service users/care workers meetings was not available. However, the acting manager informed the inspector that service users and care workers opinions were listened to and acted upon. Service users are encouraged and supported to make choices even when these choices might involve some degree of risks, for which appropriate risk assessment is completed. Review of service users care plans and daily notes revealed that each service user is allocated a key worker and a supporter to the key worker. In discussion with service users it was apparent they knew who their main worker was and the support worker as well. Service users said their key worker accompanies them when they go out on social occasions. Each service user is registered with the local GP practice, which they access as required. Chiropody service and dental service is also accessed as required. Service users have access to the wider primary health care services and the acting manager is aware of whom to contact if the need arises. The acting manager ensures that at all times the health, welfare and safety of the service user and care staff are promoted and protected by having suitable numbers of trained care workers on duty at all times to meet the assessed needs of the service users. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 22 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 YA6 Regulation 15 Requirement Timescale for action 03/01/07 2. YA20 13 (2) The registered person must consult with the service user /relatives regarding matters included in the care plans. The care plans must be signed by the service user/relatives to indicate consultation has taken place. 04/10/06 The registered person shall make arrangements for the recording of medicines received into the care home. One off prescription written by GP and hand written on to the Medication Administration Record (MAR) Sheet by care workers MUST have a copy the original Prescription attached to the MAR sheet. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000064389.V314962.R01.S.doc Version 5.2 Page 23 Swallowfields Care Centre 1 2 Standard YA8 YA22 Residents and staff meetings must be recorded and kept for inspection purposes. The registered person should include a compliments folder in with the complaints folder. Swallowfields Care Centre DS0000064389.V314962.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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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