CARE HOMES FOR OLDER PEOPLE
The Priory The Chipping Tetbury Gloucestershire GL8 8ET Lead Inspector
Ruth Wilcox Announced 31 October 2005, 09.00 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 Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Priory Address The Chipping Tetbury Gloucestershire GL8 8ET 01666 502332 01666 502332 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) Somerset Care Limited To be appointed Care Home with Nursing 30 Category(ies) of OP Old Age (30) registration, with number of places The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 3/5/05 Brief Description of the Service: The Priory Nursing Home is situated close to the centre of Tetbury, with many amenities within walking distance. The property is owned by the National Benevolent Institution (NBI) and is under the management of Somerset Care. The home accommodates 30 older people for nursing care. A registered general nurse is on duty twenty-four hours each day, and there are waking night staff. All health care services are available, and residents are able to choose their General Practitioner from within the locality. The accommodation offered is spacious, tastefully furnished and decorated to a high standard. The communal areas are all on the ground floor and include a large hall with comfortable seating areas, two large lounges, a library, a spacious dining room and a conservatory overlooking an attractive walled garden with raised beds and a water feature. The accommodation is set on three floors accessed by stairs, a shaft lift and a stair lift, and currently has twenty-eight single rooms, two of which can be used to provide shared accommodation if particularly requested by a couple. Assisted bathing and toilet facilities are also available on each floor. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. One inspector undertook this announced inspection over 7 hours on one day in October. The newly appointed acting manager, the outgoing temporary acting manager and the Somerset Care Quality Assurance Manager were on hand providing assistance where required. The home was calm, organised and very welcoming throughout the entire visit. The availability of information about the home to assist prospective residents and their families in making their choice was looked at, as were the contractual arrangements once admitted. Care records and the systems for managing residents’ medications were inspected, and there was direct contact with ten residents, with the care of three in particular being closely looked at. There was also direct contact with two visitors during the visit. In particular, their views regarding the standards of care and staff were sought. The arrangements for residents to make and pursue personal choices in respect of their daily lives were looked at, which also included their options for participation in social activities, and the safeguards for those choosing to place money or valuables with the home for safekeeping. The management arrangements for the home were looked at, as were the systems for monitoring and ensuring quality of the service, and the policy for dealing with complaints. The provision of staff and the way in which they are recruited and trained was inspected. A tour of the premises took place, with particular attention to the standard of maintenance, health and safety and cleanliness. Staff were observed at various times throughout the day, whilst going about their duties and interacting with the residents. Three staff were spoken to directly. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 6 What the service does well:
The Priory provides a very pleasant home for its residents. It has a welcoming atmosphere, is warm, clean and comfortable. Somerset Care has taken over the management responsibility of the home, and has been sensitive to the needs and choices of the residents during the transition and with regards to any refurbishment. The health and safety of all living, visiting and working at the home is promoted. Interested parties are provided with detailed information about the home, to help them make up their mind about it before deciding on admission. Once in the home, residents can be assured that staff work very closely with external health care professionals, in order that residents can have access to all community health care services to meet their needs. The staff at the home deliver care to residents in a sensitive manner, and with due regard to individual’s privacy, dignity and choices. Residents and visitors spoke very well of the staff, confirming that they were kind and caring. Despite recent changes to staffing and management, the home has done well to ensure a degree of consistency and retain a good standard of service to residents. Staff are assured of good training opportunities, in order that the home can equip them with the skills necessary for their work. There are good systems for dealing with complaints, not that many have been received, and there are also very good systems for monitoring and evaluating the quality of the service being delivered on an ongoing basis; these systems welcome and incorporate the views of the residents themselves, and their relatives or friends. Confidence levels amongst residents and visitors that staff take concerns seriously and would address them effectively were high. There are very good management arrangements at The Priory, despite them having been interim ones in the past month. These arrangements can now be resolved more permanently, with the appointment of an experienced new manager, who has yet to submit a formal application to the CSCI, only having just started at the home. Residents are able to place personal money or valuables with the home for safekeeping, safe in the knowledge that transparent recording is carried out in cases where this is applicable, to which residents can have access whenever they wish. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 7 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.
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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 Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.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 & 2. The home provides written information for prospective residents, in order that they can be clear about the services the home provides to meet their needs. Contract information given to funded residents on admission will be improved with a statement regarding contributions for nursing clients, and the introduction of separate terms and conditions specific to the home for funded clients. EVIDENCE: The home’s Statement of Purpose is contained in a folder, which is easily accessible for anyone choosing to read it. A Service User Guide is a brochure about the home, which is issued to all interested parties. This brochure does not contain all that it must at the initial point of issue, in respect of the home’s terms and conditions in a copy of a contract; however the inspector was assured that a copy is issued when the person shows further interest. Both of these documents have been revised under the management of Somerset Care since the last inspection, and it was agreed that the Quality
The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 10 Assurance Manager would forward updated copies of each to the CSCI for inspection by the end of November 2005. Each resident receives a contract for their stay at The Priory, whether they be privately paying, or in receipt of funding from Social Services. For those who have an Individual Service Contract from Social Services, the home has historically issued a copy of the terms and conditions, which are specific to The Priory to accompany it. However, the home was not able to provide evidence on this occasion, of similar good practice under the management of Somerset Care. Furthermore, the requirement to issue a breakdown of fees for those residents in receipt of the RNCC contribution has not been adopted and observed appropriately under the new management of Somerset Care; it was reported that the company has already taken initial steps to address this shortfall. Intermediate care is not provided at The Priory. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.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) 7, 8, 9 & 10. The care planning system provides staff with the majority of the information they need to satisfactorily meet residents’ health and personal needs; fuller recording in some cases would further improve this. The systems for the management and administration of medications are good, with clear and comprehensive arrangements in place to ensure that residents’ medication needs are met. Personal support in this home is offered in such a way as to promote the residents’ privacy and dignity. EVIDENCE: Each resident has an individual plan of care, which is based on an assessment of all their needs; three were selected as part of the case tracking exercise. Care plans are generally well written, and are subject to regular review. Each plan that formed the case tracking exercise contained clear instructions as to how the majority of each individual’s health needs are to be met. However, one particular care plan was far more reflective of the person’s circumstances in respect of their nutritional risks, whist the risk assessment was not.
The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 12 Continence care plans would be improved with the addition of the number and type of continence aids prescribed, and nutritional care plans with the addition of the use of prescribed dietary supplements. In one case, the resident had some particular mental health needs identified on assessment, for which the psychiatric services had been involved; there was no documented plan of care to meet this need. In another case, the care plan for managing a catheter did not incorporate the essential infection control procedures being undertaken in practice in this case. Care plans contained clear evidence of good multidisciplinary working between the home and external health care professionals in the community, with residents having access to all health care services as required. The system for handling residents’ medications is generally safe and well managed. The home has recently changed its pharmacy supplier, and meets the new requirements for the disposal of unwanted medications. All medications are stored appropriately, with good stock rotation, and with clearly printed Medication Administration Records from the supplying pharmacist. These records are thoroughly recorded by the staff, and are well maintained. Although the medication administration charts do not include the precise administration instructions regarding the use of prescribed external medications, acute care plans do record such information; there were also isolated instances of ‘as directed’ instructions on charts. The Controlled Drug cupboard has been re-sited in order to meet the fixing requirements under The Misuse of Drugs (Safe Custody) Regulations 1973; however, despite good, solid fixings, an additional rag-rawl bolt should be inserted through the back of the CD storage section into the wall, as at present there is only one. Residents are supported to self-medicate if they wish and are able to, though there is currently no-one choosing to do this. Staff were observed as being very attentive to residents during the inspection. Residents, without exception, said that the staff were kind and caring. Some said that they were happy with the care they receive, and the way in which it was given. One person said that she got ‘more than she needed’. Another person said that staff were very kind and respectful, with a few being ‘unbelievably good’. Visitors spoke of their satisfaction with the care their relative was receiving, indicating that staff were ‘lovely’ and ‘very helpful’. The home has ceased using the shared rooms as such, to ensure the privacy of individuals, by utilising them as single rooms. At least two of these rooms remain large enough to provide shared accommodation in the event it be particularly required by a couple.
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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 & 14. An activities and entertainments programme is offered, in order that residents are provided with regular and varied opportunities for social activity. Respect is shown to residents’ personal choices, in order that they are enabled to maintain some control over their lives wherever possible. EVIDENCE: The home provides a range of social opportunities for residents; the home administrator is the designated activities coordinator to plan social events. Opportunities vary from social gatherings, to entertainments and observations of calendar festival dates, to small group activity and interest sessions, to something more individual. The coordinator and the home manager are to attend training for this particular area, and will be reviewing social opportunities for residents, with a view to increasing the options on a smaller, more intimate and frequent basis. Staff have also focussed on the social needs of more disabled residents, such as those with partial sight and a degree of dementia. Residents were seen in a number of locations around the home, with respect shown by staff to how and where they were choosing to spend their time. Individual assessments in the care records demonstrated consideration to their personal choices and preferences.
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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) 16. The home has a satisfactory complaints system, with evidence that residents feel that any concerns they may have are listened to and acted upon. EVIDENCE: A copy of the complaints procedure was clearly displayed for anyone wishing to read or use it. Residents confirmed that the manager and staff were attentive to them, with some saying that staff will do what they can to help them. Two visitors also confirmed their satisfaction with the manner in which staff responded to any concerns that they might raise, with prompt and effective action to address them. The home maintains a record of complaints and concerns received. The record currently contains evidence of just one complaint received earlier this year, which was not upheld. The home has a complaints monitoring form, which monitors the progress of the complaint from start to finish. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.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 & 26. The standard of the environment at The Priory is good, and provides the residents with a pleasant, comfortable and safe place to live. The home is very clean, with appropriate and full observations regarding the control of infection. EVIDENCE: The NBI owns The Priory, and as such has responsibility for the upkeep and maintenance of the actual building. Since taking over the management responsibility for the home, Somerset Care has commenced an ambitious refurbishment and improvement programme, in terms of maintenance and decoration. Many areas have been redecorated, and there has been either a cleaning programme or a replacement of some fabrics and carpets. Bigger work is planned to improve some communal bathrooms, and to enhance the accommodation in two of the larger bedrooms. Improvements have been made to the resident call bell system, with the provision of staff pagers, and twelve new hospital style nursing beds have been purchased.
The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 17 All works to date have been carried out to a good standard, and the environment is very pleasant, safe and comfortable for the residents living there. The home is cleaned to a good standard, and all areas were fresh and odour free. There is very good provision of appropriate and easily accessible equipment to ensure that staff can adhere to good infection control procedures. Clinical waste is managed appropriately and safely. The laundry room washing machines are able to sluice and disinfect any foul or infected laundry. Foul items are transported to the laundry room in designated and easily recognisable bags that go into the machine, thus avoiding the need to handle this type of laundry directly. Although the laundry room was reasonably orderly, it was clear that certain aspects, such as the sink and areas around the machines, have been well used over time, resulting in a jaded appearance. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.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, 28, 29 & 30. Staffing provision is adequate to meet the needs of the residents currently living in the home. The home must be sure it consistently adheres to the robust recruitment procedures, in order to ensure that suitable staff are employed for the protection of residents. The arrangements for the induction and training of staff are good, with the staff able to demonstrate a clear understanding of their roles. EVIDENCE: A staff rota is maintained, which allows for one registered nurse to be on duty at all times, with six care staff in the morning, four in the afternoon and evening, and two overnight. Cleaning, laundry, gardening and maintenance, and an administrator provide ancillary support to the care team. The home manager works in a supernumerary capacity. Although there has been an increased amount of agency staff usage recently, a stable core group of carers has remained constant. Recruitment has been or is due to take place, to compliment the existing staff team. Residents and visitors spoke very positively about the staff, saying that they were very kind, helpful, attentive and caring. A random selection of staff files was chosen, but was selected on the basis of recent recruitment to the home.
The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 19 Each record contained application forms, including a full employment history; one of these did not contain a written explanation of reasons for employment gaps. Records of interviews were seen. Full and complete evidence of the required pre-employment checks was seen in each file, with the exception of photographs of each staff member. New staff receive a structured induction training within the first six weeks of employment with additional in-house training, and a nominated supervisor with whom they must work during this period. The home has access to Somerset Care’s own training centre, and there are regular opportunities for staff to have a range of mandatory and optional training, in order that they have the necessary skills for their work. The home is working towards achieving as many carers qualified to NVQ level 2 standard as possible, and is making progress in this regard, with seven already qualified, and a further one currently working towards it, and three registered to commence. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.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) 31, 33, 35 & 38. There are very good management systems in place to ensure that the interests, health and safety of the residents are safeguarded. The home reviews aspects of its performance through a good programme of self-review and consultations, which includes seeking the views of residents and their relatives. EVIDENCE: Since the departure of the previously registered manager, Somerset Care has ensured robust temporary interim management arrangements, the details of which have been approved by the CSCI. However, the home now has a newly appointed permanent manager, who was present on the day of this inspection. An application to register the new manager is to be submitted to the CSCI for processing as soon as possible. The home receives regular, strong support from the Quality Assurance Manager. Since taking over the management of the home, a residents’
The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 21 relative’s survey has been undertaken, the results of which are to be evaluated, with any corrective actions deemed necessary taken in response. A survey for the residents is planned in the next few weeks. There have been recent changes to the menus, which residents and their relatives were able to contribute to. There are regular resident meetings, to which relatives are invited, which provide an open forum for exchange of views and ideas. Managers within the Somerset Care group, to include The Priory, have devolved responsibility for a variety of areas and issues important in care homes, in order that up to date developments and good practice can be cascaded within the group. The Quality Assurance Manager will undertake a full quality audit annually, as well as regular visits under regulation 26 as required, and other miscellaneous quality monitoring visits. A raft of new policies and procedures has been introduced into the home, and the Quality Assurance Manager agreed to submit copies of these to the CSCI to inspect. Some residents have placed personal money and valuables with the home for safekeeping. Thorough records for each person, which include transaction details, running totals, and receipts, are kept. Although it was reported that residents or their representative could sign to acknowledge transactions, there was no direct evidence seen of this on this occasion. In the majority of cases two staff members sign the record to witness on behalf of the resident, but it was noted that there were some gaps in this practice; the new manager had already identified this since her arrival, and she and the administrator were taking steps to ensure that this did not continue. There was evidence that health and safety issues are addressed satisfactorily in this home, with written policies, procedures and risk assessments, provision of necessary equipment and staff training. Staff receive emergency first aid training, though at least two staff have received a fuller and more comprehensive four day training course. All necessary safety checks and maintenance of equipment is undertaken in a timely fashion. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.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 2 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 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 Standard No 16 17 18 Score 3 x x 2 x 3 x 3 x x 3 The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 23 NO 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 2 Regulation 5(A) Requirement Timescale for action 31/12/05 2. 7 15(1) 3. 9 13(2) Where a Nursing contribution is paid in respect of Nursing provision at the home to a resident, the home must issue a statement specifying: a) The date of payment and the amount of the Nursing contribution; and b) either i) the date (if any) on which the Registered Person is to pay the amount of the Nursing contribution to the resident or deduct that amount from the fees; or ii) if the Nursing contribution is not to be so paid or deducted, whether and if so how it is to be taken into account for the purpose of calculating those fees. Staff must prepare written care 31/12/05 plans, which will demonstrate how residents complete needs in respect of their health and welfare are to be met. (This is with particular reference to mental health, continence and nutritional needs on this occasion). The home must ensure that 31/12/05
Version 1.40 The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Page 24 4. 29 19, Schedule 2. there are clear instructions regarding the use of each medication on the medication charts. The home must obtain the following for future recruitment: A full employment history, which includes a satisfactory written explanation of reasons for gaps in employment, and A recent photograph of the worker. 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 2 Good Practice Recommendations The home should issue a copy of the terms and conditions specific to it, in order to enhance the information in an Individual Service Contract for funded residents. The Priory D51_D03_S64595_The Priory_V247054_AI_311005_Stage4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit 1210 Lansdown Court Gloucester Business Park Brockworth Gloucester GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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