Inspection on 10/07/07 for The Limes

This inspection was carried out on 10th July 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Limes 03/07/06

The Limes 20/09/05

The Limes 05/10/04

The Limes 14/04/04

The Limes 13/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Limes 12 Limes Avenue Mickleover Derby Derbyshire DE3 0DB Lead Inspector Claire Williams Key Unannounced Inspection 10 July 2007 10:00 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 The Limes DS0000001983.V340360.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. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Limes Address 12 Limes Avenue Mickleover Derby Derbyshire DE3 0DB 01332 516819 01332 521531 woodhousejulies@aol.com 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) Mrs Bexson & Mrs McGarrity Julie Serena Woodhouse Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2006 Brief Description of the Service: The Limes is a 34 bedded home for older people situated in Mickleover, in a residential area in the suburbs of Derby. The property was originally a private dwelling and has been converted into a care home. It is a grade 2 listed building with attractive grounds. Resident’s bedrooms are situated on the ground and first floors with the first floor being accessed by a passenger shaft lift and additional stairs by a stair lift. Five bedrooms have en suite facilities. Private telephone lines are available for those who wish to have them. Communal areas are bright and spacious and have view over the gardens. Information about the service is provided through the combined Statement of Purpose and Service User Guide, both of which are made available to residents and their families. The pervious inspection report is located in the reception area. Information included on the Annual Quality Assurance Assessment questionnaire received on 22/06/07 stated that the fees for the home were £305 to £380. Items not included in this fee are detailed in the Service user guide. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. Where possible, we include evidence from other sources, notably District Nurses and Social Workers. We also use information gathered throughout the year, to support our judgements. This may include notifications from the provider; complaints or concerns and information from the Annual Quality Assurance Assessment. The primary method of inspection used during the visit to this service was ‘case tracking’. This involved selecting three people and tracking the care they receive through the examination of their care plans and associated care records, inspection of their private and communal accommodation, and discussions with them or their representatives and the staff team. During this visit time was spent undertaking a brief tour of the service, looking at records and speaking to the people and staff about their experience of the home. Lunch was spent with the residents and medication was also examined. The Registered manager was on annual leave so the administrator assisted the inspector with the inspection, and all of the key standards were inspected on this occasion. Following discussions with the people who live at this service it was agreed that for the purpose of this report they would be referred to as ‘residents’. What the service does well: Residents have the opportunity to undertake visits to the home and have an assessment completed in order to decide if the home can meet their needs. Feedback from residents and their relatives indicated their satisfaction with the running of the home and the care and support they receive as many positive comments were made about home. Some comments included: “the staff are good and work very hard ”. “The food is good and choices are always offered”. “The routines are flexible and we have plenty to do if we want to”. Discussions with the staff team confirmed their commitment and knowledge of the resident’s specific needs and preferences and how these are to be met. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 6 Systems are in place in order to obtain feedback from the residents and their representatives about the running of the home. 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. The summary of this inspection report can be made available in other formats on request. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 3, and 4 (standard 6 not applicable in this service.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are fully assessed prior to moving into The Limes and the people are confident that the home is able to meet their needs. EVIDENCE: A copy of the combined Statement of purpose and Service user guide was available in the reception area and there was evidence to support that this document had been reviewed on the 09/07/07. The document continues to meet the required standard. The availability of this document ensures that the residents have all of the required information to be able to make an informed decision about moving into this home, and feedback from the residents consulted and the surveys confirmed this. The discussions with residents indicated that they generally think the service is meets their needs, and residents felt that they were kept well informed and had access to information, help and advice. Comments received about the staff team included: “ the staff are friendly, polite and helpful”; this was also supported by observations made throughout the inspection. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 9 The three files examined contained assessments that provided sufficient information to enable the staff team to find out what people needed, in order to delivery the required level of support. The service accepts emergency admissions and the inspector examined the file for a person who was admitted on an emergency. A care plan was completed within 2 days of the individual being in the home, which is good practice, and in accordance with the National Minimum Standards. The Registered manager does not routinely confirm in writing that the home is able to meet the resident’s needs following the preassessment. The staff spoken with demonstrated a good understanding of the needs of older people and all stated how they are committed to their role. They felt they received enough information, to deliver appropriate care, and received good support from the management team and positive training opportunities which assists them in meeting residents needs The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in decisions about their lives and have an active role in the planning of their care and the support they receive, which meets their personal, health and social needs. EVIDENCE: The residents spoken with confirmed that they are consulted about the development of their plan of care and there was evidence in the files to confirm this. The staff members also understand the importance of residents being involved in this process and to be supported to take control of their lives. The care plans for residents are now completed electronically using a prescribed system, and then a copy is printed for their files and for staff and residents to access. Each person’s file examined contained the required information to enable the staff team to delivery individual care and support to meet their needs. The files contained some information concerning the individual’s life or preferences, which is good practice as this means the service, provided is person centred. There was some information concerning individual daily routines but this could be developed further so that staff have access to this information. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 11 The files contained the required assessments to identity any risk’s and support requirements in relation to moving and handling, tissue viability, and falls. Residents confirmed that they have access to health care professionals when needed, and attended routine or specialist healthcare screening. Residents confirmed that they are consulted about the monthly review of their care plans and are involved in any changes made to their care plan. The medication practices and storage was examined and these were found to be generally satisfactory. The staff who administer the medication have received some training provided by the local pharmacy and some have completed an advanced medicines management course. There was evidence to support that individuals that wished to self medicate had an assessment undertaken to confirm that they are able to do this safely. Observations and feedback indicated that the staff deliver care in a manner that upholds individuals privacy and dignity, and residents confirmed this during the discussions held. Visitors spoken to also stated that they felt “the care was good” and that the staff team “did a really good job and worked very hard”. Residents stated that support is “always provided in a courteous and respectful manner”, and “we are able to exercise choice in the home such as clothes we wear, and how we occupy our time”. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to social, cultural and recreational activities that meet their expectations, and were satisfied wit the meals provided. EVIDENCE: Residents confirmed in their feedback that they felt the home was relaxed, the routines were flexible, and they indicated they “are always consulted and given choices on a daily basis”. Details of entertainments and social activities were posted on the resident’s notice boards which detailed a variety of in-house activities such as: bingo, board and card games, sing-along, arts, crafts, quizzes, and movement to music. Residents have access to a library, which provides books in large print and talking books. On the day of the visit residents were observed listening to music, and some played skittles in the lounge area; a quiz had been planned for the evening’s entertainment. Individuals spoken to confirmed access to religious services of their choice and some individuals continue to access hobbies and social clubs as they did when living in the community. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 13 There was many relatives, family and friends visiting throughout the day, and those spoken with stated how they are welcomed into the home; one comment made included: “the staff are always friendly and we can visit when we want”. Comments from residents and information within the surveys confirmed that residents were satisfied with the meals provided. The inspector joined the residents for their lunchtime meal. The tables were set with napkins and a variety of drinks depending on individual’s choice. The meal was relaxed and conducted at the residents pace. Residents confirmed that choices are available and stated that the menu detailing the food for that day is displayed outside the kitchen area. A recommendation was made following the last inspection report to display the menu in the communal areas and this has been implemented with the menu now displayed on the notice board outside the main lounge. The catering staff members had a good knowledge of individual’s dietary needs and have attended a course concerning good nutrition for older people. They are aware of individual’s preferences but this was based on experience and verbal information rather than detailed information based on individual preferences concerning likes and dislikes. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 14 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): Standard 16, and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to express their concerns and are safeguarded by the procedures in place. EVIDENCE: Residents stated that they felt able and confident to raise any concerns they had with the Registered manager, who they stated would listen and resolve any issues. Residents are aware of the procedures in place, and stated that they have no concerns at this time, and any issues they did have, they would usually raise in the residents meetings or directly to a staff member. The complaints records were examined and 2 complaints had been made since the last inspection, which had been investigated and responded to. Procedures are in place in relation to safeguarding adults from risk of abuse and around whistle blowing. The staff members spoken to confirmed access to this training and had a good awareness of the procedures to follow. The administrator confirmed that all care staff has undertaken training in safeguarding adults, but not all of the catering or domestic staff have. This was recommended, as it is important they are aware of their responsibilities in relation to an important issue. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 15 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): Standard 19, 25, and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well maintained, comfortable and safe environment, which they can enjoy. EVIDENCE: The feedback from resident’s indicated that the home is “always clean and never smells”. One resident stated; the home is usually kept to the same good standard on a daily basis. Residents felt that the environment was homely, safe and spacious as there are many communal areas that can be accessed. Residents spoke of the lovely views, which can be seen, from the dinning area and of the grounds, and comments included; “they are full of wildlife” and “are beautiful to, look out at”. The inspector viewed some bedrooms, which were personalised in accordance with individual’s preferences. Residents commented on how they liked their rooms, and they confirmed they had places to lock their valuables and are given the choice to have a key to their room if they wish. The administrator informed the inspector that a rolling programme was in place to provide The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 16 thermostatic temperature controls in each person’s room to enable them to adjust the temperature. This is in response to the previous inspection reports, and the inspector was informed that this work is near completion. During a tour of the building the inspector noted that the flooring near to the toilets located near to he communal lounge was discoloured and beginning to lift off the floor, and the laundry floor had several holes in it. The inspector was informed that the flooring by the toilet was due to be replaced due to the wear and tear. Residents have access to several outside areas, which have a variety of seating areas available. The outside areas were well maintained and colourful with various hanging baskets, and flowers. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 17 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): Standard 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The training and recruitment practices do not ensure that residents are appropriately safeguarded. EVIDENCE: The number of staff on duty on the day of the inspection was consistent with the numbers identified on the planned staffing rota. Feedback from residents indicated that they felt adequate staffing levels were on duty and that the staff did meet their needs. Some comments received indicated that at times staff shortages have resulted in reduced time spent with each individual when providing support, and comments on the surveys indicated that some people have “had to wait for support”. The inspector did observe on this visit that a call bell was left unanswered for a period of time, and this was raised with the administrator. From discussions with the residents it was clear that they felt the staff did their best and positive comments about them were made. Discussions with some of the staff members indicated that at times additional support would be beneficial especially during peak times of activities such as in the morning as they felt they were ‘rushing all the time’. Staff demonstrated a clear understanding of their roles and responsibilities and confirmed that they have access to training opportunities. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 18 The recruitment of the staff team was discussed and four files for the most recently employed staff members were examined. All of these files contained Criminal bureau checks (CRB) that had been undertaken at their previous work place. This practice is not in accordance with the regulations and could place residents at potential risk as staff have not been vetted appropriately. There was evidence to support that a CRB had been processed for one staff member, but this person had commenced employment before two references were obtained and an additional check on the vulnerable adults register had not been undertaken as an interim safeguard during the time waiting for the return of the CRB. A serious concerns letter was sent requesting the registered provider to take action to address this shortfall. A full employment history was not provided in three of the files examined, and an explanation of any gaps had not been explained. Evidence of training undertaken was available in the staff files examined, which included formal and informal training covering variety of subjects. Staff confirmed access to an induction, which included shadowing an experienced staff member for the period of two weeks. Staff are given an in-house induction book which they are supported to complete during the first few months of their employment. The information provided in the Annual Quality Assurance Assessment indicated that 7 care staff have achieved a National Vocational Qualification to level 2 or above, and 13 are currently undertaking this qualification. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 19 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): Standard 31, 33, 35, and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The shortfalls in the recruitment of staff, and access to training could potential place the residents at risk, although outcomes for residents were generally good and their needs met. EVIDENCE: Residents stated that they felt they were consulted about day-to-day issues, and found the Registered manager to be approachable and receptive to new ideas. Feedback from the residents indicated that generally the home was well managed and a good rapport between the residents and the staff was observed. Staff stated that they found the management team to be supportive and confirmed that they provide guidance and direction, and have access to regular supervision and team meetings. This is evidence to support that the Limes supports residents in accordance with their needs and that outcomes are good. However as improvements are required to some of the management The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 20 systems such as the recruitment of staff the service does not fully ensure that it is managed in the best interest of the residents. Systems were in place for the ongoing monitoring of standards and for the purpose of quality assurance, and these included; residents meetings, satisfaction questionnaires for residents, and relatives, in order to measure the success of the home in meeting its stated aims and objectives. The inspector examined the system in place for the management of resident’s finances, which is managed through a computer system. Residents have their own finance sheet detailing all of their transactions, and the systems in place were clear and easy to follow with an effective audit trail, therefore safeguarding individual’s from any risks. Staff files indicated that majority of the staff have undertaken training in the required mandatory health and safety subjects. However there was evidence to support that not all of the staff have undertaken practical training in moving and handling which is the use of techniques for moving or assisting to move people or objects avoiding injury to staff or residents. There was evidence to support that staff have read the policies and procedures and have been instruction on how to use equipment. The Annual Quality Assurance Assessment indicated that all of the records for the Health and Safety monitoring and the servicing of systems and appliances were up to date. The Limes DS0000001983.V340360.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 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 2 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 N/a DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 2 The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 22 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 OP4 Regulation 14 (d) Requirement Individuals must receive formal written confirmation if the home is able to meet their assessed needs, so that individuals know their needs can met. A programme must be developed to replace the flooring (located by the toilet and bathroom area) and in the laundry so that these areas are safe for residents and staff to access. The programme to provide suitable heating controls must be continued until all bedrooms have this facility in place. Staff must be employed following the receipt of all of the required checks to ensure that residents are safeguarded. (serious concerns letter sent) All staff must access the training that is deemed mandatory to ensure they support residents safely. Timescale for action 01/09/07 2. OP19 13 (4) (a) 01/09/07 3. OP25 23 (2) (p) 30/09/07 4. OP29 19 (1) (c) 20/07/07 5. OP38 13 01/09/07 The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6 Refer to Standard OP7 OP9 OP15 OP15 OP27 OP30 Good Practice Recommendations All individuals should have a formal review of their care package annually. Staff should record the actual dose given when the dose is variable at all times. Menus should be accessible to all individuals and should be displayed areas to enable all individuals to access them. Information in relation to individuals dietary preferences should be included in their plan of care and provided to the catering staff. The staffing levels should be under regular review to ensure they are in accordance with the dependency needs of the residents. The induction programme should be reviewed to ensure it meets the new common induction standards specifications. The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 © 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 The Limes DS0000001983.V340360.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!