CARE HOMES FOR OLDER PEOPLE
Taymer Nursing Home (Dr Saraogi) Barton Road Silsoe Bedfordshire MK45 4QP Lead Inspector
Katrina Derbyshire Unannounced Inspection 13th October 2006 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.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 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. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Taymer Nursing Home (Dr Saraogi) Address Barton Road Silsoe Bedfordshire MK45 4QP 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) 01525 861833 01525 861889 Pressbeau Ltd Linda Jordan Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability over 65 years of age of places (33) Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. Up to 4 Adults 50 - 64 years Old age, not falling within any other category (OP) 33. Physical Disability over 65 years of age PD (E) 33. The home is permitted to accommodate one named service user in the category of DE(E) 27th October 2005 Date of last inspection Brief Description of the Service: Taymer is a purpose built Nursing Home situated in the Bedfordshire village of Silsoe, which lies off the A6 road between the towns of Bedford and Luton. The home is situated in rural grounds overlooking the Bedfordshire countryside. The home has been extended to accommodate 33 residents and is currently planning to again extend accommodation to increase the number of beds at the home. Information relating to this proposed extension can be gained by contacting the home directly. The home provides care for elderly people with physical disabilities and medical conditions. The home is staffed with qualified nurses and carers who provide a range of services to aid and improve the physical wellbeing of the residents. The home provides eight single bedrooms with en-suite facilities, 17 single bedrooms without en-suite facilities and five double bedrooms. Each room is fitted with an electronic nurse call system. The three main reception areas consist of a TV lounge, a quiet study room and a conservatory. The home has attractive surrounding gardens with parking facilities available. The fees for this home vary from £443.46 per week, to £710.00 per week, depending on the funding source. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of this visit was to undertake a key inspection. This unannounced visit took place on 13th October 2006. The manager Linda Jordon was present at the inspection. During the inspection all areas of the home were visited and the inspector spent time with many of the residents’ in the sitting areas of the home and individual rooms. The care of three residents’ was examined by looking at their records and interviewing the residents’ and staff who look after them. The views of residents and relatives were also received, and their feedback has been used alongside information from the home through a pre inspection questionnaire to assess the outcomes within each standard. Observations of care practice and communication between the residents’ and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well:
Almost all the residents at this home feel that the standard of food is excellent. One resident said, “everything is home cooked, l think the food is lovely”, another said, “the quiche l had last night was beautiful”, and two other residents described the food as “absolutely marvellous”. There is a menu that residents can choose from, the chef at the home goes around to ask what residents would like. He also asks the residents how they think the menu should change and if they have enjoyed their meals. Residents feel that their nutritional needs are met, and that they are provided with a nutritionally balanced diet that is of a very good standard. Residents also feel that they were given enough information about the home when they were thinking about moving there. There is written information about the services that the home offers and residents said that they had found this very useful. One resident commented “I was very impressed with the manager Linda when she came and visited me in hospital”, feeling that she had given her lots of information about the home. This means residents have enough information so that they can make an informed decision, about whether they want to move into this home. They are also very organised in the way they manage health and safety in the home. Fire safety is very good and checks are made to make sure equipment is working properly to protect the residents. Staff are also trained in lots of Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 6 areas including moving and handling, food hygiene and infection control; this all helps in making the home a safer place to live in for the resident’s. What has improved since the last inspection? What they could do better:
One of the areas that the home need to improve in is the way they make checks and record information about monies held on behalf of the residents. A small sum of money is kept for paying for certain things such as hairdressing. The home does keep individual records of resident’s balances, but all monies are kept in one account. What they need to change is when they look at reconciliations of these two figures so that a clear audit trail is in place. They must start to see if the balances that they are keeping at the home match those provided by the bank when a statement is given. They also need to make sure that they keep a clear record of the receipts that they have, so residents can have all the information they need about their money. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 7 Another area is that staff need to make sure that residents are aware of when they will be coming to help them with something. Several residents commented that they realised that at times staff could be busy, but felt that they would like to be informed of an approximate time that the staff would be able to give them the assistance that they needed. One example was the time that residents got up in the morning, residents felt that they would like to know that they would be assisted to get up in the morning by 9 o’clock for example. 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. The summary of this inspection report can be made available in other formats on request. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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 Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a good standard of pre admission information so that they can make an informed decision about moving into the home. EVIDENCE: The home has a statement of purpose and service user guide. The information was detailed in both documents and described the range of needs that the home intended to meet, the complaints procedure, the qualifications and experience of the Registered Provider and staff alongside all other information as detailed within schedule 1.Through discussions with staff on the day of inspection it was evident that the homes statement of purpose was both accessible and that the Registered Person had ensured that its content had been shared in the home. Comments from residents and relatives taken from Commission for Social Care Inspection survey forms stated that the home had
Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 10 supplied sufficient information for them to make a decision on whether they would move into the home. Resident care records contained evidence of pre admission/admission assessments. The manager, or a qualified nurse, prior to accepting the resident for admission, had carried out a pre admission assessment. Where residents had been admitted to the home from hospital, nurse assessments from the ward were also in place. Physical, social and emotional needs had been included. There was evidence that the home had then used the information to direct the development of the care planning so that a plan was in place for all the residents assessed needs. The home does not provide intermediate care. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning systems in the home are to a good standard and provide sufficient information and guidance to staff in how to meet residents assessed needs. EVIDENCE: Care plans for residents reflected the care that staff were seen to provide at this visit and gave sufficient guidance on the care that should be offered. Entries seen within the daily notes made reference to the actual plan of care and showed that staff had been following their guidance. There was also some evidence that residents had been involved in the drawing up of their plans and some were seen to contain the signature of the resident, however some did not and a previous recommendation will remain. Staff through discussion were able to describe the individual needs of the residents, the level of knowledge is this area was mixed however and this was discussed with the manager on the day of this visit.
Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 12 Care records showed that residents had access to medical services if required, appropriate aids were available and advice is sought from Healthcare specialists in the care of residents. There was evidence of nutritional screening prior to or after admission on each file seen, catering staff confirmed that they were informed if a resident needed a diabetic/specialist diet. The incidences of pressure sores and their treatment were appropriately maintained and documented. All residents are registered with a General Practitioner and access to dental, chiropody and community health services had been accessed on behalf of the residents by the home. Feedback from residents and relatives were that their medical needs were either usually or always met, one resident did comment that they would like the General Practitioner to visit more often. The manager advised that the homes policy normally provides for a staff escort if a resident needed to go to hospital in an emergency. However one resident had been assisted to get ready by staff on the morning of this visit. It was observed that they received a visitor after the lunchtime meal that was having difficulty conversing with them. Staff had forgotten to provide the resident with their hearing aid. This had prevented this resident from even being able to hear for most of the day and it was the visitor who went and got the hearing aid as staff had not noticed. Medication stocks and records were inspected. The system in place for the ordering of medicines was sufficient to provide a clear audit trail. Staff had received updates to their training in the safe administration of medication and the medication administration records were seen to be in order. A returns system was in place and this demonstrated that the home followed best practice guidance in this area. Controlled medication was seen to be stored in the correct manner and records maintained relating to this were also in good order. Staff confirmed that as part of their induction they had received training which made clear that at all times the privacy and dignity of the residents must be maintained when providing personal care. Throughout this visit staff were observed knocking on residents doors before entering. The interaction between staff and residents was also encouraging and supportive. Staff making sure that when speaking to any resident, that they lowered themselves so that they were at the same level as the resident. A notice on one bathroom door giving information on the name of some residents and the day they have a bath should be removed to ensure the privacy of residents is maintained. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meals at the home are of a very good standard and residents receive a varied diet, which meets their nutritional needs. EVIDENCE: Daily menus are in place and detailed that there were two options available from the lunchtime menu. Through discussions with residents and staff it was confirmed that the practice of offering more choices occurred daily, this is when a resident didn’t want what was on offer and the chef would make them something else. The kitchen is clean, tidy and well organised and in place are robust monitoring procedures for hygiene and food preparation standards. Cleaning schedules, temperature checks and storage are out in the correct manner. The inspector observed service users to be given sufficient time to eat their meal in an unhurried manner, and staff offered assistance in eating when necessary. This was carried out discreetly, sensitively and individually; tables contained the necessary condiments to enable residents to independently flavour their food. All residents spoken to felt that the standard of meals at the home were very good and the way in which they were presented, one resident said, “ they take the trouble to make sure it looks nice”.
Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 14 Information on display in the homes front reception and within the information files in resident’s rooms, showed that there had been an increase in the amount of activities offered in the home. There is a social activities coordinator and outside entertainers also visit. At the time of this visit a keep fit class was being held, this and other entertainment is displayed in the home for residents to see. The majority of residents spoken with felt that the home did provide enough entertainment; others did not wish to join in but preferred to remain in their own individual rooms. Residents are supported and encouraged to maintain and develop appropriate control over their own lives and with the involvement and help from their families if they so wish. Their financial affairs are managed by them for as long as they are able and wish to do so. Many had personal possessions that they were encouraged to bring with them at the time of their admission to the home. Day to day choices residents said that they could make included what clothes they could wear and what they would like to eat. . Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints system in this home is good, residents know how to complain and feel staff will listen and act upon their views. EVIDENCE: A requirement was made at the previous inspection that the home must ensure that any concerns raised are followed up by the homes policies and procedures and all action taken recorded. This related to standard 18 and the local protection of vulnerable adults scheme. No further incidents of this nature had taken place. The homes complaints policy is clear and gives residents timescales in which the home will respond to any concerns that they raise. All the Commission for Social Care Inspection survey forms received from residents and relatives that they knew how to complain and felt staff listened to them. One relative spoken to said, “at first we were not happy about a couple of things, we spoke with Linda and they changed things straight away”. Staff were also interviewed and were able to describe the action that they should take if they received a complaint, all knew that any concern or complaint had to be responded to. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of cleanliness and hygiene at this home is good providing a pleasant environment for the residents. EVIDENCE: The home is purpose built and to a good standard, a good amount of natural light is available in many areas of the home. The grounds are attractive and well maintained and are accessible to residents and their families, outside seating is available. It was noted that at this time the home met all fire and environmental health requirements. Individual rooms of residents contained items, which assisted in the personalising of the rooms with photographs ornaments and pictures in place. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 17 The décor and furnishings and fittings were of a good standard, domestic and well maintained and the home was seen to be clean and tidy throughout. The home is planning on extending the premises and had held meetings with residents and relatives about this. If this extension takes place the home is reminded of the need to inform the Commission for Social Care Inspection of any situation that may affect the residents at the home. The home manager also confirmed that the call bell system in the home was to be replaced this year as part of their maintenance and renewal programme. Contracts are in place for the removal of clinical waste. There were no odours in the home and all areas were clean. Staff were observed to wear protective clothing when required and wash hand facilities are available throughout the home. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. EVIDENCE: Information provided by the home show that the home at this time exceeds the number of staff hours recommended by the Residential Forum. Staff rotas examined show that Registered nurses are on duty alongside care staff 24hours a day. The majority of residents and relatives feel that there is sufficient staff to meet their needs as detailed in the Commission for Social Care Inspection survey forms. Training records were examined, these showed that staff had undertaken a variety of courses including protection of vulnerable adults training, end of life guidance and health and safety. In addition the manager and two senior staff had attended external training in the care of people with dementia. They in turn had provided training to the staff at the home and had purchased a video to assist them in this. 80 of care staff hold a National Vocational Qualification in Care at level 2 or above. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 19 The induction of staff follows the national guidance in this area for the induction and foundation standards. Staff confirmed that they had received a comprehensive induction into the home. A previous requirement was noted to now be met. On examination of a sample number of staff files evidence was in place to show that the home had secured two references, Criminal Records Bureau check and evidence of identification. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and Safety systems are good reducing the risk of injury and providing protection for the residents at the home. EVIDENCE: Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 21 The Home Manager has many years experience, which is directly relevant to the role of manager in the home and in addition is a Registered General Nurse. Interaction observed between her and the residents and staff was supportive and caring. Staff informed the inspector that the Home Manager was very supportive to them and provided sufficient and effective management and leadership. The home has a system for gaining the views of residents and relatives and in addition undertake a quality review in areas such as medication, maintenance and staff training. Information, analysis and action were seen following a survey of relatives undertaken in September 2006. The views of residents were again going to be sought in October 2006, this had been done previously. The home will need to make an analysis of these views and action any changes required following this The homes Health and Safety policy was noted to contain all required information. Staff confirmed that they had undertaken fire, manual handling, food hygiene and first aid training. Risk assessments had been undertaken and were seen on the service users care files that were tracked on this inspection. All major equipment is serviced regularly and the home maintains documentation to support this and when safety checks such as recording water temperatures have been undertaken. Examination of the records kept at the home about monies held on behalf of the residents was undertaken. A small sum of money is kept for paying for certain things such as hairdressing. The home kept individual records of resident’s balances, but all monies are kept in one account. The reconciliations of these two figures is not clear so a clear audit trail is not in place. The home must start to see if the balances that they are keeping at the home match those provided by the bank when a statement is given, therefore all reconciliations must take place from the bank statement date. They also need to make sure that they keep a clear record of the receipts that they have, so residents can have all the information they need about their money. This was discussed with manager at the inspection. Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 12 & 13 Requirement Timescale for action 30/11/06 2. OP35 12(1)(a), 17, 20. Residents must be supported by staff so that they have any aid or adaptation needed by them to hear. Reconciliation of residents 31/12/06 money must be carried out to ensure an audit can take place also receipts of all expenditure must be referenced in resident’s financial records. 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 OP7 Good Practice Recommendations The registered person should provide evidence that the service user or their representative have been fully involved in the care planning process. (Previous recommendation) Residents should be given a reasonable time frame for when to expect to receive help and support. The registered person should provide suitable storage
DS0000042234.V315971.R01.S.doc Version 5.2 Page 24 2. 3. OP10 OP22 Taymer Nursing Home (Dr Saraogi) space to accommodate the hoist. (Previous recommendation) Taymer Nursing Home (Dr Saraogi) DS0000042234.V315971.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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