CARE HOMES FOR OLDER PEOPLE
The Old Vicarage Leigh Sherborne Dorset DT9 6HL Lead Inspector
Anne Weston Unannounced 16 August 2005 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 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 Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Old Vicarage Address Leigh, Sherborne, Dorset, DT9 6HL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01935 873033 01935 874013 care@tovic.com Tovic Limited Ms Clare Buckland CRH PC - Care Home only 35 Category(ies) of OP - 35 registration, with number of places The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 09 February 2005 Brief Description of the Service: The Old Vicarage is a well established care home, situated in the village of Leigh, about six miles from Sherborne. The home is set in spacious and attractively landscaped gardens with ample communal seating, car parking is available. Services include 24 hour care, meals, laundry, domestic services and a range of social activities. The home is registered to accommodate a maximum of 35 older people (age 65 and over), both male and female. The main house is a Victorian building, originally a vicarage which has been extended. The accommodation is spread over two floors and contains 31 single rooms and 2 double rooms, most rooms are on the ground floor, 6 rooms are located on the first floor. A stair lift on the main staircase provides access to the first floor. Many of the ground floor rooms have direct access to the courtyard and gardens. Communal facilities include two dining rooms and a small lounge area. The home is registered under Tovic Limited, Annie Sinnott is the proprietor, she takes an active role in the operation of the home and is a well-respected ambassador for the social care industry. Clare Buckland is the registered manager responsible for the day-to-day running of the Old Vicarage. She is supported by a care manager and two deputy managers. An office manager maintains well organised administrative systems. The home are members of the Dorset Care Association (DCA) and achieved continuation of the Investors in People Award in April 2004. Annie Sinnott has been Chair of the DCA since 2000. The website address is www.theoldvicarage-leigh.co.uk.
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 16th August 2005, the inspection process, including the time spent in the home took a total of 7 hours. The inspector was made to feel welcome, Annie Sinnott and Clare Buckland made themselves readily available throughout the day. This was the first of the two statutory inspections required annually, the purpose of which was to ensure that the 33 people who were living there were safe and properly cared for. Key Standards 7, 8 and 9 were assessed during the previous inspection in February 2005 and have not been reviewed on this occasion. At that time Standards 7 and 8 were exceeded and Standard 9 was met. The premises were inspected and a variety of records and related documentation were examined. Time was spent talking with management and staff. Thirteen residents were observed or spoken with individually in the privacy of their own rooms, discussion was held with two visitors. Time spent in observation and talking with people gave a clear portrayal that the home promoted a holistic person centred approach with residents. What the service does well:
The Old Vicarage offered a homely, relaxed and comfortable well maintained environment, with a welcoming atmosphere. One resident said “It’s wonderful, it’s so welcoming”, a view endorsed by other people who were spoken with. Residents were enabled to make an informed choice about moving into the home through the availability of comprehensive information, opportunity to visit and effective assessment processes. Residents were treated with respect by staff who were sensitive of their rights to privacy and dignity, this was reflected by the comment of a resident who said “I get all the care and attention I need and the atmosphere is wonderful”. The staff approach was professional and caring. A strength of the home was the promotion of the individual lifestyles and preferences of residents. One resident commented “You are free to do what you like”, another said “I’m very pleasantly surprised, you can do what you like”, this was indicative of other comments received from residents. The activities programme offered a range of pursuits and events to enhance stimulation and socialisation. Daily life in the home promoted opportunities for residents to socialise together. Information was given at residents meetings about other activities that were available in the local area. Open visiting arrangements were in place, visitors were encouraged and welcomed into the home, in accordance with residents wishes. Good links were maintained with the local community. There was a good standard of nutritious meals with fresh
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 6 produce used, specialist diets were well catered for. Many positive comments were received from residents about the food. The home was well managed with an effective management structure, office administration systems were good. One resident said the Office Manager was “A gem”. An open climate had been created, this enabled residents to feel confident about voicing anything they were not happy with. The home has been accredited by Bournemouth University as a Practice Development Unit (PDU) since 2003. Recent research as a PDU has included work on a bereavement booklet, a pamphlet and training on urinary tract infections and a communication workshop. The home participated in an exchange work placement programme for Dutch students to gain new skills and share experiences. There was a strong learning culture with staff offered practical and academic learning opportunities for personal and professional development. This has enabled staff to feel valued and allows them to reach their full potential. Staff morale was generally high, resulting in an enthusiastic workforce that worked positively with residents to improve their whole quality of life. The Old Vicarage continues to be committed to the Care Ambassador scheme. The scheme involves care staff working with schools to inspire students to consider the career opportunities available in the care sector. The home had been short listed in the category of a small organisation for the South West region in the Edge Employer Awards. Subsequent to the inspection, the home have received a great result in winning in their category. This was a positive inspection with good outcomes experienced by residents who were safe and well cared for. What has improved since the last inspection? What they could do better:
The home was well staffed with a stable core group of staff. Work needs to be carried out to ensure staff members are deployed more effectively, in accordance with the assessed needs of all residents. This issue had already been recognised by the home and work was in progress to ensure increased
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 7 effectiveness in relation to the deployment of staff. For the most part, the home operates a thorough recruitment procedure. Examination of a staff file showed only one written reference had been received. Two written references must always be obtained for a potential member of staff to fully ensure they are suitable to work with vulnerable people. 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 Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 standard(s) 1, 3 and 5. Standard 6 is not applicable as the home does not offer intermediate care. Residents had their needs assessed before moving into the home and were assured that their needs would be met. Prospective residents and their representatives were provided with information about The Old Vicarage and were given an opportunity to visit the home. This meant that they were enabled to make an informed decision about whether to move into the home. EVIDENCE: Comprehensive information about the home in the form of a Service User Guide is readily available and is kept under regular review. The most recently updated information was examined. Written information about recreational activities, staff qualifications and achievements and progress on good practice development work was well presented throughout the home. The care records of two residents who had recently moved into the home were examined. One of these residents was spoken with. It was evident that people were encouraged to visit the home before they made the decision to move in. One resident had stayed at the home for two week’s respite before
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 10 making the decision to move in. Relevant assessments had been carried out with residents before they came into the home. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 standard(s) 10 Residents were treated with respect by staff who were sensitive to their rights of privacy and dignity. EVIDENCE: Staff were observed to be interacting with residents in a professional and caring manner and adopted a respectful approach. Staff were observed to routinely knock before entering bedrooms, residents confirmed this was usual practice. Most residents who were seen in their rooms had a private telephone. Comments received from residents included “Very caring staff” and “I couldn’t wish for nicer people, starting at the top”. These comments were reflective of the views expressed by most residents who were spoken with. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents had the opportunity to choose their own way of living in the home, this meant their individual preferences and routines were respected. The activities programme offered residents participation within a range of pursuits to meet their needs and interests. Open visiting arrangements were in place, residents were able to maintain contact with visitors and the local community, as they wished. Dietary needs of residents were well catered for with a balanced and varied selection of food that met residents tastes and choices. EVIDENCE: A strength of the home was the promotion of the individual lifestyles and preferences of residents. Residents expressed satisfaction over the choice and control in their daily lives. Notices were displayed within the home giving information on the range of activities and events that were on offer. Regular occurrences include Communion, a visiting library, scrabble evenings, availability of a private beautician, musical entertainment, celebration of specific calendar occasions such as Easter and a range of outings. One resident said how much they had enjoyed the war time tea party, time was spent with this resident who showed the photographs, clothing accessories and song sheets from this event. Outings the month before included Yetminster fair, Longleat trip and Cerne Abbas for cream teas. The annual garden party had been held the weekend before the inspection and was clearly a resounding success for everyone involved. Comments from residents included “It was
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 13 marvellous”; “An absolute triumph” and “They did it extraordinarily well”. One resident said they had used the home’s workshop to build bird boxes for sale at the garden party and that these had sold well. Contact with residents and visitors, observation and examination of documentation demonstrated that there were open visiting arrangements, visitors were encouraged and welcomed within the home. If desired and agreed by the resident, visitors were welcome to take part with the caring. One resident expressed satisfaction that they were able to invite visitors to dine privately in the smaller dining room. Good links were maintained with the local community, people from the village participate in the scrabble evenings and the annual garden party. Proceeds from the garden party were going to SCOPE and a church in the village. Many events are held in order to raise funds for designated charities. Regular outings around the locality enabled residents to maintain contact within the community. Discussion with catering staff and residents, observation and examination of menus demonstrated there was a good standard of catering. Residents said they were provided with their individual choices for breakfast and there was a choice of menu for lunch and supper. A kitchen assistant was observed asking the residents what their preference of menu was for the following day. Residents confirmed this was routine practice. Comments about the food included “Food is very good”; “Meals they provide are marvellous and balanced” and “Food is superb”. Residents had a jug of water or soft drink of their choice routinely supplied in their rooms, regular beverages and afternoon cake were served. Residents chose where they wished to eat, either in their own rooms or in the communal dining room. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) An open climate had been created, this enabled residents and their representatives to feel confident about voicing anything they were not happy with. Any concerns were dealt with promptly and effectively by the home. Policies and procedures and training for staff on the Protection of Vulnerable Adults promoted a safe environment which protected residents from abuse. EVIDENCE: A complaints policy and procedure was in place. Residents who were spoken with said they would feel able to complain and knew who to complain to. There have not been any formal complaints to the home or the Commission since the last inspection. Notes from the residents meeting gave evidence that residents felt able to bring any areas of dissatisfaction to the attention of management. Management took prompt action to resolve any issues that were brought to their attention. Policies and procedures were in place on Adult Protection and Prevention of Abuse in accordance with the Department of Health ‘No Secrets’ guidance. Discussion with management and examination of care records demonstrated that risk assessments were in place to ensure action was taken to safeguard vulnerable adults from abuse and harm. Not all risk assessments were dated, increased vigilance in recording is needed to ensure risk assessments are dated. Relevant advice from other health and social care professionals was sought, as necessary. Examination of in-house training material demonstrated an effective range of training methods were used, including a video and questionnaire. A member of care staff who had attended out sourced abuse training said it had raised their awareness and vigilance about abuse, particularly in relation to restraint issues. The manager initiated a discussion
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 15 on good practice around restraint and safety issues. It was agreed that that any decision to use safety equipment, including any equipment that restrains a persons ability to move freely, should only be made following a risk assessment and in conjunction with the resident, giving consideration to their capacity to consent. Wider consultation, including relatives where relevant, would take place if the resident’s capacity to consent is diminished. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 standard(s) 19, 20 and 24 Residents live in a homely, comfortable, clean and safe environment with their own belongings around them. There is access to indoor and outdoor communal facilities. A re-organisation of the layout of indoor communal facilities will enable residents to have access to improved sitting room space. EVIDENCE: Inspection of the premises demonstrated that routine maintenance and refurbishment work was being implemented. Five rooms have had refurbishment work carried out since the last inspection. The maintenance man, regularly employed was observed maintaining the outside of the property in good order. The grounds include gardens to the front of the property with seating, a lawn area and a pond with a fountain. There is an inner courtyard with a patio area with ample seating, tables and sun umbrellas. The grounds were all tidy and attractive with well tended shrubs and flower tubs. One resident commented how much they enjoyed walking in the grounds. Sitting room facilities have been restricted by the organisation of communal space. One resident commented “It would be nice to have a comfortable sitting room with comfortable chairs”. Plans were in hand to improve
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 17 comfortable communal seating by changing the layout of the second smaller dining room so this can also be utilised as a comfortable sitting area. The standard of individual accommodation was good. Residents expressed satisfaction with their private rooms, which were individually personalised, in accordance with their preferences. All rooms that were visited were homely and comfortable, people had their personal belongings around them including items of furniture, plants, photographs and ornaments. All rooms which were visited had radiator guards installed to ensure there was no risk of residents scalding themselves on hot radiators. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 There were sufficient numbers of staff to provide care but improvements were needed in the deployment of care hours to more effectively meet the needs of some residents. Procedures for the recruitment of staff were generally robust. Improvements need to be made in consistently obtaining all required references to fully ensure protection of residents. There was a strong learning culture, staff were well trained enabling them to provide a high standard of care. EVIDENCE: Discussion with residents and staff, observation and examination of the staff rota demonstrated that the home was well staffed with a stable core group of staff. The home operated a key worker system so residents had a designated member of staff to promote their best interests. Comment was received from some staff that the quality of care at peak times could be improved. There was particular pressure on staff at the peak times of assisting residents to get up and go to bed. Staff felt generally that residents were well cared for which was reflected in one staff member’s comment “Residents are looked after really well”. Those residents who maintained a high degree of independence felt there were enough staff to fully meet their needs. Some residents who had more dependent care needs did not feel fully satisfied about the availability of staff, but did feel fully satisfied about the friendly and caring approach of staff. Comments from these residents about staff deployment included “Don’t do as much as they could as they haven’t got the time” and “If I ask them for anything it is not always there”. The shortfall in deployment of care hours had been recognised by the home, a staff meeting was being held
The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 19 on the day of the inspection in order to formulate an action plan for more effective deployment of staff. A staff file for a recently appointed member of staff was examined. For the most part there was evidence that the home operates a thorough recruitment procedure including use of an application form, interview and obtaining references and Criminal Record Bureau checks. Only one reference had been obtained for this employee. Management Trainee, Natalie Foy had produced and implemented an in-house induction programme tailored specifically to the home. This training material was examined, the content was comprehensive, linked to Skills for Care induction standards and was of a high calibre. The induction programme was adapted as needed to ensure that all people who work in the home participate in a thorough induction programme. This includes young people from school gaining work experience as General Assistants in the home. Natalie Foy was observed delivering the newly devised induction programme to a group of trainees. Staff felt supported through their training, the home ensured that any member of staff who had particular learning needs received the level of support required. A strong learning culture within the home was evidenced, the home continues to promote the Care Ambassador scheme and carry out research under their accreditation of a Practice Development Unit. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 33 The inclusive management style enables residents and staff members to contribute to the operation of the home which is run in the best interests of residents. EVIDENCE: Discussion with residents and staff, observation and examination of relevant documentation demonstrated that staff meetings and residents meetings were held. An open climate had been created within the home, this enabled residents, visitors and staff to feel confident about voicing anything they were not happy with. A comments book was available in the entrance hallway for anyone involved with the home to write their comments, encouragement was given for feedback at all times, good or bad. Staff said that management were approachable, comment was made that some management staff may find it difficult to empathise with the pressure on care staff as they no longer experienced day-to-day hands on care. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 21 There were quality standards in place, an annual customer survey and annual staff survey monitored service levels and staff satisfaction levels. A staff survey completed in May 2005 gave a breakdown of staff satisfaction. The results included information on high scoring areas and action to be taken on the lowest scoring areas. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 3
COMPLAINTS AND PROTECTION 3 3 x x x 3 x x STAFFING Standard No Score 27 2 28 x 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 4 x x x x x The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 23 NA Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 19 Requirement Recruitment procedures must include always obtaining two written references relating to the person potentially working in the home. Timescale for action 30/09/05 2. 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. Refer to Standard 20 27 Good Practice Recommendations The plans to utilise the smaller dining room as a comfortable seating area should be implemented. The home should implement their action plan so that members of care staff are more effectively deployed, in accordance with the assessed needs of all residents. The Old Vicarage D55 S26856 Old Vicarage V233529 160805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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