Inspection on 13/12/05 for Swan Lodge

This inspection was carried out on 13th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Swan Lodge 01/08/07

Swan Lodge 10/08/06

Swan Lodge 05/05/05

Swan Lodge 11/10/04

Swan Lodge 29/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Swan Lodge Kent Avenue Wallsend Tyne & Wear NE28 0JE Lead Inspector Mrs Irene Bowater Unannounced Inspection 13th December 2005 13:40p 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 Swan Lodge DS0000028821.V258464.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. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Swan Lodge Address Kent Avenue Wallsend Tyne & Wear NE28 0JE 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) 0191 263 9434 0191 2621413 swanlodge@fshc.co.uk Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual is below pensionable age. Should this resident leave the home CSCI must be notified. 5th May 2005 Date of last inspection Brief Description of the Service: Swan Lodge is a purpose built care home situated on the same site as another care home owned by the same company. The home provides nursing and social care for up to 46 older persons. There is also a contract with the NHS to provide 6 beds’ for the local GPs. The home has lounges dining rooms and separate smoking rooms on each floor. All of the bedrooms are single and have en-suite facilities. There is a range of specialist bathrooms, showers and toilet facilities throughout the home. The first floor is accessible by stairs and a passenger lift and the grounds are readily accessible. There is ample car parking to the front of the home. The home shares the kitchen and laundry services with the adjacent home. Swan Lodge is well positioned for local transport and all local amenities. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted four and a half hours over the course of an afternoon and early evening. Since the last inspection two additional unannounced visits and site visits have been made, as there was a flash flood at the end of August, which caused serious damage to the ground floor. The water damage also disrupted the daily lives of all the residents over a six-week period. The company and the home’s responses to all requirements during this time were met. The company are working with the relevant outside agencies to address concerns regarding the initial responses to the crisis. Letters sent to the home during this time can be obtained from the CSCI office on request. The ground floor of the home has been refurbished and residents returned to their own rooms. None of the residents suffered any ill effects during this period. The inspection focused on the requirements from the last inspection, improvements following the refurbishment and spending time with the residents, visitors and staff. Nine staff, three relatives and thirteen residents were spoken to throughout the inspection. What the service does well: What has improved since the last inspection? Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 6 The recent flash flood and subsequent necessary refurbishment has meant that many of the outstanding requirements regarding the environment have now been met. The result is a nicely decorated refurbished ground floor. Residents who were relocated to the first floor are now back in their own rooms and are delighted with the improvements. A manager has now been recruited to the home. She is experienced, enthusiastic and keen to develop the care and services within the home. The staff are positive and happy now they have a clear direction and are kept informed about issues in the home. The manager is working hard with the staff to ensure the training and all other records are available and up to date .The residents now have a statement of terms and conditions of residency when purchasing their care privately. There has been a vast improvement in the care planning and health care of residents. Following a complaint detailed risk assessments are in place in care plans and relatives are involved as necessary. The employment of an activities organiser has improved the social life of residents. The issues about lack of hot water, heating and broken washing machines have been resolved. What they could do better: The homes record keeping has been disorganised for some time and the flood in August has resulted in many of the required records to be destroyed or “lost”. The manager is aware of the issues and is working hard with the rest of the staff to improve the situation. She should progress with the Registered Managers Award training and complete application to become registered with the Commission. Systems for assessing the quality of care and taking residents views in to account need to be developed and results made available. Although training is taking place this needs to progress with records available. The refurbishment of the shower room and minor repairs to bathrooms and the environment needs to continue to ensure residents safety. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 7 The home needs to provide a safe waste management system for medicines, which are to be disposed of. The systems regarding residents’ personal allowances need to improve to ensure they receive interest on their own money. There are several outstanding requirements from the last inspection reports that now need to be actioned within the given timescales. 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. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,5 The rights and obligations of residents and providers are clearly set out in the terms and conditions of residency. The comprehensive assessments ensure that residents care needs will be met. Preadmission visits enables residents and their representatives to test the home to ensure it will meet their needs. EVIDENCE: Since the last inspection the home have produced a statement of terms and conditions (or contract) for residents who are privately funded. It sets out the rights and obligations of both the resident and the provider. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 10 There are comprehensive admission policies and procedures. The care plans are based on the care managers and the homes own assessment. The care plans inspected showed that the preadmission and admission records were completed in detail and were dated and signed. The home encourages residents to visit for half or a full day, stay for a meal and meet staff and other residents before moving in to the home. There is a “trial period” of six weeks followed by a review before any decisions are made to live in the home on a permanent basis. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 11 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 There are clear care planning systems in place, which provide staff with the information they need to satisfactorily meet residents needs. The health needs of residents are well met with evidence of multidisciplinary working taking place on a regular basis. The systems for safe administration of medicines are comprehensive although the waste management of medicines is not clear. The staff have a good understanding of the residents needs. This is evident from the positive relationships, which have been formed between residents and staff. This support protects residents’ right to privacy, dignity and independence. EVIDENCE: There has been an improvement in the care plan recording since the last inspection. A sample of care plans from both floors were inspected and found to be up to date, clearly written and detailed regarding all aspects of the residents care. Risk assessments for dependency levels, moving and handling, wound care, nutrition, use of bed rails and use of lap straps for wheelchairs were available, up to date and signed by the resident or their representative. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 12 All residents have access to NHS facilities. There was evidence that other professionals advice is sought and acted upon regarding pressure sores, nutrition and continence care. The GP visits on a regular basis and the home provides six designated GP beds. One resident who had been recently admitted said she was very happy with the care she was receiving from the staff. There are policies and procedures for staff to follow to ensure the safe administration of medication. The treatment room and the systems were well organised by the qualified nursing staff. A random audit of the Controlled Drugs and a check of the Medicine Administration Records found no discrepancies. The home does not have a waste management contract for medicines, which are to be disposed of. All of the residents spoke highly of the staff and said that they are well looked after. Comments included “they can’t do enough”, “everyone is lovely, they do anything I ask” and “I couldn’t ask for better”. All of the residents looked well looked after and were suitable dressed. The residents who were unwell and remained in bed were comfortably positioned, had access to call bells and their bedding was clean and fresh. The staff have formed good relationships with the residents. They were observed to carry out all care with sensitivity, respecting residents’ rights to privacy. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 13 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): 12,13,14,15 The home provides a social and recreational lifestyle, which matches the current residents needs. The home supports and enables the residents to maintain links with the local community and with their families. The residents are supported to maintain their independence and control over all aspects of their lives. Dietary needs of the residents are catered for with balanced and varied selection of food that meets residents taste and choices. EVIDENCE: The recruitment of an activities organiser has improved the social life for residents. There is a reminiscence lounge available for use and a range of events and activities have been organised. These include entertainment for Christmas, a recent 100th birthday party and make over days. The residents said they were enjoying making Christmas cards. The home has an open visiting policy and relatives confirmed that they are always made welcome and are able to visit at any time. There are links with the local community including church and schools. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 14 Details about advocacy services are displayed in the home and the residents are able to handle their own affairs for as long as they wish and are able to. The residents have brought small items with them making their own rooms highly personalised. The home offers a four-week menu with choices available for all meals. There are three cooked meals a day with the main meal served in the evening. The evening meal was hot and of ample portion size. Residents were offered choices and hot and cold drinks were available. Jugs of fruit juices were readily available throughout the communal areas and hot drinks and biscuits were served mid afternoon. All of the residents spoken to were complimentary about the meals. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The complaints system is satisfactory, however without accurate records there is no assurance that residents’ views are listened to and acted upon. The arrangements for protecting residents are satisfactory. EVIDENCE: The home has policies and procedures available which set out how and to whom complaints may be made. There was a “flash flood” at the home at the end of August 2005 and the complaints records appear to have been damaged and lost. The manager is aware that detailed accounts of all concerns need to be documented and she is in the process of rectifying the problem. Residents and relatives said they would be able to use the procedure should they need to do so. Since the last inspection there has been one complaint, which has been investigated by the Company, and the investigation and outcomes have been shared with the Commission. There are policies in place for the Protection of Vulnerable Adults. The new manager has recently commenced in house training for staff with records kept. The staff were able to discuss the steps that they would take should there be any suspicion of abuse. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 16 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): 19,20,21,24,25,26 Recent refurbishment has improved the appearance of the home creating a comfortable pleasant environment for those living there. There are some infection control and maintenance issues, which have the potential to place residents at risk. EVIDENCE: The location and layout of the home is suitable for the residents who live there. There was a flash flood at the home at the end of August resulting severe water damage to all of the ground floor. An action plan regarding the full refurbishment was received and all of the ground floor has been refurbished to a good standard. This means many of the requirements from the last inspection regarding the environment have now been addressed. There are communal lounges and dining rooms on each floor that are comfortable, welcoming and nicely furnished. New dining room furniture has been ordered and delivery is expected at the end of the week. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 17 All of the bedrooms have an en-suite toilet and hand washbasin. There are suitably adapted bathing and shower facilities close to all resident bedrooms. There are some minor areas that still need attention: The bath panel on the Apollo Jacuzzi bath is loose. The shower room upstairs is out of use with tiles missing off the walls. The flooring in the second Apollo Jacuzzi bathroom is grimy. Many of the lights in bathrooms and toilets did not have light shades and the lighting in some areas was dim. The water temperatures were checked and found to be satisfactory. All of the bedrooms are for single occupancy and the residents have brought many of their own possessions with them making the rooms highly individualised and homely. Several of the residents who receive nursing care are nursed in nursing profiling beds. On the day of inspection the home was clean and organised. There are sluices on both floors that were smelly as used incontinence pads not being double bagged. There were no hand towels in the sluices or en suites to enable to staff to effectively dry their hands. Many of the light and emergency call cords were dirty, knotted and tied out of reach. The laundry is shared with the adjoining home and this was found to be clean and generally organised. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 18 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): 27,28,29,30 The staffing levels in the home are currently satisfactory to meet the residents’ needs. There is limited evidence to show that all staff have received appropriate training to ensure all residents needs are met. The recruitment procedures offer safeguards to protect the residents living in the home. EVIDENCE: A qualified first level nurse manager has now been recruited to the home. The staff team are now settled and the home benefits from a core staff team who have worked together for some considerable time. On the day of the inspection the staff were quietly organised and had a good knowledge of residents needs. The current staffing levels for the number of residents living in the home is: 2 1 4 3 qualified general nurses 8am to 8pm qualified general nurse 8pm to 8am care staff 8am to 8pm care staff 8pm to 8am. There is adequate administrative, domestic maintenance and activities staff employed in the home. The laundry and kitchen staff are shared with the adjoining home. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 19 The NVQ training is still on hold although the manager said that it is to recommence shortly. The home has comprehensive policies and procedures for the recruitment and selection of staff. Evidence from a selection of files showed that two references, Criminal Record Bureau checks, proof of identity and medical questionnaires are completed. There is evidence that the staff are receiving mandatory training with records available. Some of the records have been destroyed or “lost” during the flood, however records show that historically there were good training systems in place. The new manager is aware of the problems and is working hard to bring of the training records up to date. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38 The home now has a manager who has a clear development plan and a good understanding of the areas in which the home needs to improve. This has been effectively communicated to the residents’ staff and relatives. Changes to the financial procedures will ensure the residents financial interests are safeguarded. The current systems for record keeping do not safeguard or protect the residents’ best interests. There are some maintenance issues that have the potential to place residents at risk. The home endeavours to maintain the health, safety and welfare of residents as so far as is practicable. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 21 EVIDENCE: After a year, the home now has a manager. She is a 1st level registered nurse with previous experience in the care of older people. She is to complete the Registered Managers Award and needs to progress with her application to become registered with the Commission. She is aware of all of the problems in the home and is working hard to address them. The staff said the new manager is very approachable and keen to develop the home. They said there is good communication and they are clear about what is expected of them. The views and opinions of the residents are sought on a daily basis. When the flood damage occurred they were offered choices of accommodation in other homes and kept up to date with all of the refurbishment in the home. As there has been no manager in the home for a year the quality assurance systems are not up to date. The home has a non-interest bearing account for residents’ personal allowances. The accounting system is to be changed to ensure any interest earned is put into individual accounts. The records are available and show that there are details of all transactions with receipts and the account is regularly audited and reconciled. Staff supervision is in place with records kept. This need to be continued to meet the six times a year target. Many of the records have been water damaged or “lost” in the recent flood. The filing systems are disorganised and records not readily available. The staff are receiving ongoing training in safe working practices. Accidents are appropriately recorded and monthly analysis is completed. Contract maintenance certificates are available and up to date. The fire risk assessment has been updated for the current year. Following the flood in August 2005 the company are reassessing their Crisis action plan in partnership with other agencies. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 22 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 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 3 2 X X 3 2 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X 2 2 2 3 Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13(2) Requirement The home must ensure there are waste management systems in place for the disposal of nursing medication. The home must record all complaints including all investigations and action taken. Outstanding 24/05/05 The home must ensure the bath panel is repaired and the shower rooms refurbished. The emergency call cords must reach skirting level. Outstanding 24/05/05 The home must ensure that the lighting meets standards of 150 lux and provide suitable light shades in bathrooms and toilets. Outstanding 24/05/05 All light cords and emergency call cords require sheathing to enable easy cleaning. Outstanding 24/05/05 The sluice rooms must be regularly cleaned and the clinical waste suitably bagged. Liquid soap and paper towels must be available in all areas to ensure effective hand washing. DS0000028821.V258464.R01.S.doc Timescale for action 31/03/06 2. OP16 17 22 31/03/06 3 4. 5. OP21 OP22 OP25 23 16,23 23 01/06/06 31/03/06 31/03/06 6. OP26 12,13,16, 23 12,13,16, 23 31/03/06 7. OP26 31/03/06 Swan Lodge Version 5.0 Page 24 8. 9. OP28 OP30 18 12,18 10. OP31 7,9 11. OP33 24 12. OP35 12,20 13. 14. OP36 OP37 18 15,17 Outstanding 24/05/05 The home must ensure that 50 of care staff is trained to NVQ level 2 or equivalent The home must ensure that staff receive specialist training to meet residents needs with individual training and assessment files. The manager must progress with Registered Managers Award and complete application to become registered. The home must implement formal systems based on seeking the views of residents and all other stakeholders to assess and develop the quality of care in the home. The home must ensure that any interest is awarded on an individual basis to residents who have money deposited The home must ensure that all staff receive formal supervision six times a year. The home must ensure that individual records and home records are secure, up to date and in good order, and are constructed, maintained and used in accordance with the Data Protection Act and other statutory requirements. Outstanding 25/05/05 01/06/06 01/06/06 03/03/06 01/06/06 01/06/06 31/03/06 31/03/06 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. Refer to Standard OP19 Good Practice Recommendations The home should consider providing suitable perimeter DS0000028821.V258464.R01.S.doc Version 5.0 Page 25 Swan Lodge fencing to reduce the problems of criminal damage. Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Swan Lodge DS0000028821.V258464.R01.S.doc Version 5.0 Page 27 - 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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