Inspection on 20/02/07 for The Old Vicarage

This inspection was carried out on 20th February 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Old Vicarage 11/02/09

The Old Vicarage 12/02/08

The Old Vicarage 06/09/07

The Old Vicarage 05/06/06

The Old Vicarage 18/10/05

The Old Vicarage 26/10/04

The Old Vicarage 11/05/04

The Old Vicarage 25/11/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Warren Road Hopton On Sea Great Yarmouth Norfolk NR31 9BN Lead Inspector Linda Wells Unannounced Inspection 20th February 2007 9:30 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 Old Vicarage DS0000027487.V331226.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 Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address Warren Road Hopton On Sea Great Yarmouth Norfolk NR31 9BN 01502 731786 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) Estateband Limited Mrs Jill Chaplin Care Home 20 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (20) of places The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Twenty (20) older people of either sex may be accommodated. Two (2) older people who have dementia and are named in the Commissions records may be accommodated. The total number of people accommodated shall not exceed twenty (20). 5th June 2006 Date of last inspection Brief Description of the Service: The Old Vicarage is a two storey detached Georgian house that provides personal care and accommodation for up to twenty older people. The home stands in its own grounds of approximately two acres. There is parking to the front of the home and the gardens are mainly laid to lawn and are accessible by wheelchair. Service users at the home have the use of a passenger lift to the first floor and communal use of three lounges, a dining room, two bathrooms containing adapted bath, washbasin and toilet on each floor, two toilets on the ground floor and one toilet upstairs. There are nineteen single bedrooms and one double bedroom which all contain a washbasin and the majority of the windows have been replaced with double glazed fitments. The home is situated in the village of Hopton-on-sea, between the coastal towns of Great Yarmouth and Lowestoft and is surrounded by caravans and sited in the centre of a holiday caravan village that is densely populated at certain times of the year. There are local amenities and the beach is within walking distance of the home and a public transport service that provides a link to the main towns. The current fees for living at the home are from £338 - £360 per week. There is an additional fee for personal items such as toiletries, hairdresser, chiropodist, newspapers, dentist and outings. The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgments for each outcome group. A Pharmacy inspection was carried out at the same time as the key inspection and resulted in four requirements and a recommendation being made. The findings and outcomes are recorded in a separate inspection report that is available upon request. The overall judgement made by the Pharmacy Inspector, based on the evidence collected during the inspection stated that whilst the home had made some improvements, the outcome for residents in relation to medication practice is still poor because the home’s medicine management practices are placing the health and welfare of residents at risk. Enforcement action has taken place to ensure residents are protected. What the service does well: What has improved since the last inspection? Residents have benefited from the continued improvements to the environment and the provision of new bedroom furniture in three bedrooms, replacement of the beds in two bedrooms, redecoration and replacement of the carpet in two bedrooms, replacement of all towels and flannels and the provision of a new tumble dryer and dishwasher. To ensure staff members are able to be identified by residents and visitors and are trained to meet the needs of all residents new staff uniforms have been provided and the numbers of staff undertaking NVQ2 has increased. The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 6 What they could do better: Residents said that they are satisfied with the care they receive and liked living at the home. Most of the requirements from the last inspection have been complied with. However, four additional requirements and two recommendations were made to further improve the experience of living and working at the home for residents and staff. • • • A record of the daily activities offered and carried out must be maintained to aid in the monitoring of the variety of activities and to ensure they meet the interests of residents. All staff must hold a current food handling certificate to ensure residents are protected when staff members prepare, cook and serve food. The manager must complete the management component of the NVQ4 Registered Managers award to ensure she is fully trained to manage a residential care home. (Repeated requirement) (Planned for September 2007) The quality assurance audit produced must be further developed to include the views and opinions of staff members to ensure everyone is consulted on the standard of care and facilities provided. It is recommended that an alternative form of apron be offered to those residents who wish to use one to ensure their dignity is assured. It is recommended that an individual list of the training completed by each staff member is produced and maintained to aid in the planning of their training needs and the arranging of any updated training. • • • Plus four further requirements and one recommendation made by the Pharmacy Inspector and recorded in a separate inspection report. 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 Old Vicarage DS0000027487.V331226.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 Old Vicarage DS0000027487.V331226.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): 1,2,3,4,5, (6 N/A) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information available to people covers all aspects of the home, service provided and facilities and the assessments carried out ensure the needs of residents can be met. EVIDENCE: Those newly admitted to the home had been given information prior to admission in the form of the Service User Guide and Statement of Purpose; had visited the home and had their needs assessed by the manager. They said that they and their family were confident that the home could meet the their health and social care needs and that they had discussed with the manager how they would continue to attend community clubs and live their lives in the manner they always had. This was recorded in their plan of care. The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 9 Residents could not all remember signing a terms and conditions contract and most highlighted that their family dealt with their paperwork. However, the plans of care did contain a copy of the contract signed by the resident and/or their advocate. It contained the details of living at the home, staffing structure, staff training, aims and objectives of the home, facilities, routines, the costs of living at the home and how to make a complaint. Staff showed that they knew how to carry out the admission procedures, that they gained information from residents and their family members, recorded a life history, preferences and their routine in their plan of care, included residents in deciding their plan of care and assisted them in settling in at the home. This resulted in the needs of residents being known and met. The Old Vicarage DS0000027487.V331226.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): 7,8,9,10,11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Improvements have been made to the records held and residents have their personal and health care needs met. However, medication practice remains poor and residents are not fully protected. EVIDENCE: The Pharmacy Inspector carried out a random inspection on medication at the same time as the key inspection and has produced an additional inspection report on his findings and the 4 requirements and 1 recommendation made. This is the fourth pharmacy inspection conducted at the home in the most recent 9-month period. During each, failings in medicine management with poor outcomes for residents have been identified which place the health and welfare of residents at risk. Following the breach of Regulations, a Statutory Requirement Notice has been issued by the Commission to ensure residents are fully protected. The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 11 Records held in the plans of care were complete and up to date and evidence was seen of ongoing assessments and monthly reviews with residents. Risk assessments had been carried out on residents and included the monitoring of their moving and handling needs, nutritional and fluid intake and their weight. Records of visits of health professionals were held with details of outcomes and instructions to staff members. Monthly reviews carried out with residents demonstrated that they were consulted and their preferences and choices known and recorded. Residents said that they were well cared for and treated with dignity and respect by staff members. The gave examples of being able to choose when they got up, went to bed or had their bath and all said that the routine of the home was flexible and that staff did not hurry them. Three visitors said that they felt their relative received good care, that they were immediately informed of any changes, that staff treated residents well, with kindness and with respect and that staff and the manager were approachable and knowledgeable on the needs of each service user. Staff members showed that they were knowledgeable on the care needs of residents. They gave good examples of how they checked with residents how they wished to be cared for, their choice, preferences and routines. They showed that they knew how to monitor their health, adjust the care they received to suit their changing needs and how they made sure staff members coming onto shift were made aware of any changes or needs. This resulted in residents receiving the care they needed. The Old Vicarage DS0000027487.V331226.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): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The routine of the home is flexible, residents had access to some activities and the meals were varied. However, records are not up to date of the activities offered and carried out and the dignity of residents is not assured by the alternative to serviettes offered at meal times. EVIDENCE: Case tracking confirmed that residents had a relaxed style of life that included regular activities and outings to the shops, community events, shows and the local pub. No evidence was seen of daily activities, because the records held on the activities carried out with residents, were incomplete and no record had been made since August 2006. A requirement was made. Residents said that activities were carried out in the home and gave examples of occasionally playing bingo or board games, taking part in the ‘memory session’, listening to music and watching videos. The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 13 Three visitors commented that enjoyable, organised, activity evenings for residents and visitors had taken place, but for most of the time residents seemed to watch television or sleep. They said that staff and the manager always made them welcome at the home and that there was a friendly and inclusive atmosphere. Staff members said that due to the increase in staffing levels they were now able to carry out more daily activities with residents. They said that that the morning continued to be a time when they were busy, but they could fit in group or individual activities after lunch. They and the manager continued to say that motivating residents to take part in daily activities was difficult, but they made every effort to carry out more individual activities such as nail care, going shopping and for a short walk along the beach. This was confirmed by residents. The menus and main meal were seen to be varied and wholesome and residents had the use of a dining room that was arranged in tables of four that were attractively laid. Residents had access to drinks, serviettes, cutlery and condiments and meals were served to them, directly from the kitchen by the cook. He said that the menus were seasonally planned, that they could be flexible and were based on the likes and requests of residents. Records were held of the daily meal options and alternatives eaten by residents and showed that they had choice. However, some residents used an apron when eating their meals to help keep their clothes clean and had been provided with a blue, plastic, infection control apron. The manager said that ordinary serviettes were not large enough and tabards gapped at the neck but agreed that the aprons offered looked institutionalised and did not promote dignity for residents. A recommendation was made. The Old Vicarage DS0000027487.V331226.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): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: Case tracking confirmed that no complaints had been received by the home. A complete and detailed record of any areas of concern or complaints had been produced and signed and dated records gave a summary of the details, the action taken and the outcome. Visitors said that they had not had any reason to complain, but they were confident that if they did, that the manager would take the appropriate action. Residents said they felt safe living at the home, that they were listened to, any problems that arose were dealt with immediately and that the staff and the manager could be relied upon to resolve a concern or issue to the satisfaction of everyone concerned. Records showed that staff members had completed training in protecting service users from abuse. They were aware of the complaints procedure and The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 15 gave good examples of how they would deal with complaints or issues of protecting vulnerable adults. This helps make sure that residents are protected. The manager said that the rights of residents were promoted and that they were encouraged to vote by being taken to the polling station or by using a postal vote. This was confirmed through case tracking. The Old Vicarage DS0000027487.V331226.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): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely environment that is decorated and maintained to a good standard. EVIDENCE: The home continues to be redecorated and refurbished and is decorated and maintained to a good standard. The home’s plan to replace the worn furniture has begun and most of the carpets throughout the home have been replaced. Residents said that the home was comfortable, met their needs and was always clean and tidy. A tour of the home confirmed this and revealed that residents had personalised their bedrooms to suit their own individual tastes. The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 17 Staff said that they liked their new uniforms and were provided with protective clothing, that there was adequate moving and handling equipment and there were enough domestic staff to clean the home. This was seen at the home and found through case tracking. The manager said that the home had a rolling programme of routine maintenance, refurbishment and redecoration and that each time a bedroom became empty it was redecorated. Adequate sluicing and laundry facilities were provided and infection control measures were in place, resulting in the health and safety of residents being protected. The Old Vicarage DS0000027487.V331226.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are cared for by adequate numbers of competent staff. However, staff training and recording is not fully complete. EVIDENCE: Case tracking confirmed that three new members of staff have been recruited and that thorough and complete recruitment checks have been carried out. Records showed that all staff had completed an application form and held a current CRB, two references, proof of identity, a photograph and a POVA first check. Resulting in residents being protected, as far as possible, from the recruitment of unsuitable staff. Residents and visitors said that there were adequate numbers of staff to care for the sixteen residents living at the home. They said that staff were competent, aware of the needs of residents, well organised and treated them with respect. Staff gave good examples of the induction training they had received and of completing recent training in medication, nutrition and infection control. Certificates were seen to support this. The manager said that six staff The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 19 members were in the process of commencing the NVQ2 training and that she had booked staff onto updated moving and handling and adult abuse awareness courses in the near future. Letters were seen to confirm the training places and arrangements. However, not all staff had completed training in food hygiene and part of their duties included preparing, cooking and serving the tea meal and an individual list of the training each staff member had completed was not held. A requirement and a recommendation were made. The roster confirmed that adequate staffing levels were in place and residents and staff said that there were enough staff on duty if all posts were covered. Team Leaders have begun the role of assessing the competence of staff each month and records were seen to show that all aspects of care and their standard of work practice were recorded, resulting in poor work performance being identified and improved and residents being protected. The Old Vicarage DS0000027487.V331226.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): 31,32,33,34,35,36,37,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are safe, they are consulted and their well-being is promoted. However, the quality audit does not contain the views of staff members and the manager has not fully completed her NVQ4 training. EVIDENCE: Case tracking and looking at records confirmed that improvements had been made and that the home was run in a manner that promoted the rights and best interests of residents. The manager has completed the care component and is waiting to commence the management part of the NVQ4 Registered Managers Award and is booked to start in September 2007. Records were seen to support this and a requirement was repeated. Residents, visitors and The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 21 staff said that the home was well run and organised and that the manager was approachable. Staff said that they were supported by, the manager, handover, staff meetings, supervision and appraisal, and that the manager promoted high standards of care. They gave examples of the manager talking to them about residents, the attitude of staff towards their role and each other, the atmosphere in the home and team working. This was confirmed in the records held. The financial procedures and records held for residents had been reviewed and were individually held for each resident with an accurate and up to date record of the debits and credits and money held. Receipts were held on all expenditures, the records were checked each month by the manager and resulted in residents being protected. The quality assurance systems are effective and the views of residents, relatives and visiting professionals are sought on how the service can be improved, but the views of staff had not been sought. The manager said that she planned to seek the views of staff through appraisal, but agreed that staff members should be asked, at the same time as everyone, to complete the quality audit. A requirement was made. A summary of results and an action plan had been produced and demonstrated satisfaction from those whose opinions were sought and returned their questionnaire. Servicing and maintenance records were complete and up to date and showed that the health and safety of service users is being protected. The Old Vicarage DS0000027487.V331226.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 3 3 3 3 3 The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16.2 Requirement The registered person must ensure that a record is maintained of the daily activities offered and carried out with service users. The registered person must ensure that all staff hold, a current food hygiene certificate. The registered person must complete the NVQ4 Registered Manager training. (Previous timescales of 31/03/06, 30/9/06 and 31/03/07 not met) The registered person must further develop the quality assurance audit to include the views and opinions of staff members. Timescale for action 01/06/07 2. OP30 18.1 30/06/07 3. OP31 10.3 30/09/07 4. OP33 24.1 31/08/07 The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 24 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 OP15 OP30 Good Practice Recommendations It is recommended that an alternative form of apron be offered to those residents who wish to use one to ensure their dignity is assured. It is recommended that an individual list of the training completed by each staff member is produced and maintained to aid in the planning of their training needs and the arranging of any updated training. The Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Old Vicarage DS0000027487.V331226.R01.S.doc Version 5.2 Page 26 - 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. 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