Inspection on 18/07/07 for The Royal Elms

This inspection was carried out on 18th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 Royal Elms 23/10/07

The Royal Elms 10/04/07

The Royal Elms 01/12/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Royal Elms The Royal Elms 23 Windsor Road Newton Heath Manchester M40 1QQ Lead Inspector Sue Jennings Unannounced Inspection 18th July 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Royal Elms DS0000067697.V345403.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 Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Royal Elms Address The Royal Elms 23 Windsor Road Newton Heath Manchester M40 1QQ 0161 681 9173 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) Rajanikanth Selvanandan Michelle Lawton Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home will only provide a service to a maximum of 26 people whose primary need for care arises from old age. The matters detailed in the attached schedule of requirements must be completed within the stated timescales. 10th April 2007 Date of last inspection Brief Description of the Service: The Royal Elms Care Home is a care home offering personal care for 26 older people. The home does not offer nursing care. The accommodation is provided on two floors in a Victorian style building, which is serviced by a passenger lift to all levels. The home has a modern extension that provides accommodation for five of the 26 residents accommodated at the home. The entrance to the home is at ground level and the garden area is accessible to all residents. The home benefited from the provision of a large garden to the rear of the property. It is set among similar sized well-established residential properties. There are three lounges; one of the lounges is the smoking area. There are two double rooms and twenty two single rooms; six of the single rooms provide ensuite facilities. There is an enclosed parking area to the front of the property offering off road parking for approximately eight vehicles. The home is situated in the Newton Heath area of Manchester close to good public transport links to Manchester City Centre and Oldham. Fees for the home are £373.54 per week with additional charges for hairdressing, chiropody and continence aids. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by the Commission for Social Care Inspection in relation to this home prior to the site visit. The visit was unannounced and took place over the course of 6.5 hours on Wednesday 18th and Friday the 20th July 2007. During the course of the site visit time was spent talking to the deputy manager, staff and the owner, 4 of the residents and a visitor to find out their views of the home. The Pharmacist inspector was asked to visit the home to audit the medication systems. Time was spent examining records, documents, the resident’s and staff files. A tour of the building was also conducted. None of the requirements from the previous inspection had been addressed and there was little evidence that the home was working towards improving the service. What the service does well: What has improved since the last inspection? There has been some improvement in the way the staff files are managed. An area manager has been appointed to review management procedures and staff training. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Royal Elms DS0000067697.V345403.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 Royal Elms DS0000067697.V345403.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to make sure that people’s needs are assessed before admission. EVIDENCE: Prospective residents were able to visit the home before making a decision to move in. Where this was not possible families were invited to visit on their behalf. This was confirmed in conversations with residents. The home had a Statement of Purpose and Service User Guide, which gave prospective residents and their families information about the home. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 9 Residents placed by the local authority had a care manager’s assessment of needs. The manager stated that she or the deputy manager visited prospective residents in his or her own home or in hospital before admission. The home does not provide intermediate care. The Royal Elms DS0000067697.V345403.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 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans were not sufficiently detailed and poor medication practices had the potential to place residents at risk of harm. EVIDENCE: There were a number of gaps in recording on the medication administration records (MAR). The MAR sheets were not correctly dated resulting in confusion as to when a course of medication began. A number of MAR sheets did not have a photograph. The photograph is a method of identification to avoid administration errors. It is good practice that any hand written additions to MAR sheets be double signed by staff. The staff were not doing this. The dates printed on the MAR sheets by the Pharmacy did not match with the dates on the MAR sheets. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 11 Residents MAR sheets were mixed up and one resident’s medication details were in with those of another residents. Due to the poor record keeping the medicines, which were given on the 18th July 2007 were signed as if they were administered on 25 June. There was no evidence to show that medication was being administered as directed by the GP. An example of this was that one medication did not advise staff of the quantity to be taken. One resident’s MAR sheet showed that they often refused to take their medication but the tablets had been removed from the blister packs. There was no evidence that they were stored waiting to be returned to the pharmacy. In some cases the records indicated that sixteen tablets had been taken when only fourteen had been prescribed. Some medication that did not require cold storage was being stored in the fridge. This has the potential to alter the effectiveness of the medication. Only those medications requiring cold storage should be stored in the fridge. Some eye drops were not dated on opening so it was not possible to know when they should be discarded. Some medication was being given in the morning and on checking with the GP this medication should have been given at night. The practice of giving medicines incorrectly poses a potential risk to resident’s health. Some medication had ‘take as directed by your GP’ on the label. This has the potential to place residents at risk of not receiving the correct doses and did not take into account any recent alterations. One resident was prescribed a seven-day course of medication on discharge from hospital with the instruction to contact the GP for more supplies. The medication should have been given twice a day however on the day of the site visit a week after the residents discharge from hospital only 4 doses of medication had been given. The records did not indicate what dates these 4 were given or why only 4 had been used. It was also noted that care staff were performing a clinical task usually carried out by a district nurse. This was poor practice as care staff are not qualified to carry out invasive treatments. A sample of care plans were examined and it was found that the standard had deteriorated since the last inspection. Three residents did not have a care plan at all. Where care plans were in place they were basic and did not fully detail The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 12 resident’s needs or what staff had to do to meet needs. An immediate requirement was issued that a care plan must be developed for all residents. One resident was assessed as at risk of developing pressure areas. The care plan gave no information about how to reduce the risks. The daily records did not mention what action staff had taken each day in relation to pressure area care. There was mention of one resident needing to use a hoist for all transfers but no information about the type of hoist or sling to be used. No risk assessments were in place for the use of a hoist. The daily records contained comments like “fine today” these records are kept to reflect the care given to residents and should be more detailed. Daily report sheets were kept for each resident, however where a resident was taking a special diet or at risk of developing pressure areas the daily record did not fully reflect the action staff had taken to meet these needs. Information relating to residents was also recorded in the diary. All information relating to the care of residents should be written on their individual care plans so that staff are made aware of any changes to the residents care needs. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provided a varied diet, and residents were supported to exercise choice and control over their lives. EVIDENCE: Residents spoken to said that they were able to have visitors when they wanted. The menus had been developed on a 4-week rota in accordance with individual resident’s likes and dislikes. The residents made positive comments about the quality and quantity of meals. Residents spoken to said that the meals were “very good”. One resident said, “the food is always nice”. Another resident said, “We always have a good choice of meals and if we don’t like what’s on offer they make a sandwich or eggs”. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 14 The main meal on the first day of the site visit was mincemeat, vegetables and potatoes. There were fresh vegetables in stock and a stock of frozen meats and pies. On the second day the meal was poached salmon steak or battered fish, chips and peas. Residents spoken to said that there were “no set rules about when we get up or go to bed”. One resident said “I smoke so I spend a lot of time in my bedroom or I sometimes go for a read after lunch”. There was no evidence of any activities taking place on the days of the site visits. One resident said, “It is boring there is not much to do”. It was reported at the last inspection that one of the care staff had taken on the role of activity organiser. However, there was little evidence on care plans where residents had taken part in any organised activities. Activities designed for people who have dementia should be researched so that all residents can be involved. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There were systems in place for recording complaints but staff were not fully aware of local adult protection procedures which has the potential to place residents at risk of harm. EVIDENCE: Residents were aware of the complaint procedure and one resident said, “ I have a complaint notice in my bedroom”. There was no evidence that staff had attended Adult Protection training and staff spoken to during the site visit were unable to describe the action to be taken in the event of an allegation of abuse, stating that they would start to investigate the allegation. All new and existing staff must be made aware of what constitutes abuse and the appropriate action that needs to be taken in the event of an allegation of abuse. The home had policies and procedures relating to the protection of vulnerable adults. However, there was no evidence that the home had a copy of the Manchester Multi Agency Policy and procedure for the Protection of Vulnerable Adults. The owner was advised to obtain a copy. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 16 The Department of Health ‘No Secrets’ Guidance clearly identifies that social service departments take the lead in all adult protection cases and no action must be taken prior to a strategy meeting being held. This lack of knowledge has the potential to put residents at risk. A requirement is made that staff training relating to adult protection is provided. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The premises are safe and the homes environment was generally well maintained both internally and externally. EVIDENCE: There had been no redecoration since the last site visit. The owner stated that a grant had been secured to improve the environment and that he was going to carry out an audit of the building to prioritise work. Since the last site visit the lounge previously used for smoking had become a no smoking area. Residents smoked in their bedrooms and were risk assessed. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 18 At previous visits to the home as part of the inspection process it had been noted that the bold stripe design of the carpeting raised some concerns as it was felt that the carpet design could present as a hazard for those residents with limited vision or those with dementia who could confuse the stripes for steps. This issue was raised again with the owner who gave a commitment to replace the carpet as part of the redecoration programme. There was a maintenance person who was responsible for undertaking routine maintenance who with the manager carried out a general tour of the building each week. There was a book where anything requiring repair was recorded by staff. A brief tour of the building was carried out. There were stocks of disposable aprons, gloves and paper towels to manage infection control effectively. The home also had a clinical waste contract in place. The cellar door did not fully close and lock posing a potential risk to the health and wellbeing of residents. The manager said that this damage was done when the washing machine was brought up from the cellar. Advised to make sure the door was locked at all times and repaired as soon as possible. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The numbers of staff were sufficient to meet the needs of the residents accommodated. However the recruitment and selection process was not sufficiently robust and did not fully protect residents from harm. EVIDENCE: A sample of staff files were examined and there was no evidence of staff training or any reference to the training and career development needs of staff. However the manager stated that 9 staff had NVQ level II, 9 were working towards NVQ level II and 5 had just started NVQ level II. There must be an up to date training record that identifies that staff have received appropriate training and are informed about the different health conditions that effect older people and about practices of care, to promote the well-being of residents. The manager stated that she was in the process of auditing staff files and has listed all outstanding mandatory training. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 20 Staff said they had received Adult Protection Training. The manager did not fully understand what action needed to be taken in the event of an allegation. There were a number of gaps on application forms and there was no evidence that these had been explored at interview. A number of staff files did not contain a CRB disclosure. Failure to obtain appropriate security checks prior to employing staff has the potential to place residents at risk of harm. It was noted that the care staff were responsible for preparing the evening meal although it was not clear if they had received training in basic food hygiene. All staff responsible for preparing or cooking food must receive basic food hygiene training. On the day of the site visit a student on work experience was helping out with collecting lunch choices and chatting to residents. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Improvements were needed to the management and overall running of the home. There was no quality assurance systems in place that fully involves people in the process of reviewing and developing the service. There were systems in place that safeguarded and protected residents financial interests. EVIDENCE: There were serious concerns raised regarding the management and overall running of the home. Particularly in relation to the management of the medication systems as detailed under standard 9 of this report. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 22 An improvement plan issued following the inspection on the 10th April 2007 had not been responded to. This and the failure to return the Annual Quality Assurance Assessment that had been sent to the owner raised concerns about the overall management and running of the home. Certificates regarding the servicing of health and safety equipment were seen and found to be in order. The inspection of the fixed gas and electrical appliances was under contract. The home had a recording procedure for ensuring that residents’ financial interests are safeguarded. Transactions made on behalf of resident’s were logged and receipts were held on file. The registered manager was working towards the registered manager’s award. There was an accident book that met the requirements of the DATA protection Act. There was evidence that accidents are recorded however completed reports were retained in the book. Completed accident reports should be filed within the residents’/staff individual files in accordance with data protection. It was concerning to note that some official records had been completed in pencil. This is poor practice as the pencil could be errased removing all or part of the record. There was some evidence that supervision had been started and manager said that she was in the process of arranging for all staff to receive formal supervision. There was no evidence to show that staff had received training in basic food hygiene. This was a requirement at the last inspection and is reiterated in this report. There was no quality monitoring system in place to seek the views of residents or their families. The owner said that an area manager had been appointed to oversee the management of the home. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 23 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 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 X X 3 The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 12(1)(a) Requirement There must be a care plan in place for each resident to inform staff of their needs and the action required to meet needs. An immediate requirement was issued with regard to the three residents who did not have a care plan. 2. OP9 13(2) The home must improve the medication systems; • to ensure that resident “A’s” medication is reviewed urgently to ensure that “A’s” health is protected, within 24 hours of the conclusion of this visit. This requirement has been met. • All record keeping must be clear, accurate and up to date to evidence that medication is being administered properly. • All medication must be accounted for by means of an audit trail to make sure that residents are given the correct doses of their medicines. • All medicines must be DS0000067697.V345403.R01.S.doc Timescale for action 18/07/07 18/07/07 The Royal Elms Version 5.2 Page 25 administered as directed by the prescriber to make sure the residents’ health is maintained. An immediate requirement was issued. Original timescale for improvements to the medication systems of the 28/05/07 not met and still applies. 3. OP29 19 (4)(a) Schedule (2) 18 There must be a robust recruitment process and each member of staff must have an enhanced CRB disclosure. The provider must produce staff training and development plan that is kept up to date and reviewed on a regular basis in order to be able to evidence the staff have the skills to meet residents needs. Original timescale of the 28/05/07 not met and still applies. 5. OP33 24 There must be an effective quality assurance monitoring system in place based on seeking feedback from residents and other interested parties. 18/08/07 18/08/07 4. OP30 18/07/07 6. OP38 18 All staff responsible for preparing 18/07/07 or cooking food must receive training in basic food hygiene to ensure that they have the necessary skills to undertake their role. Original timescale of the 28/05/07 not met and still applies. The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 26 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 OP7 OP7 Good Practice Recommendations Daily records attached to care plans should be more detailed and fully reflect the care delivered to residents. It is strongly recommended that any information relating to the health and wellbeing of residents be recorded in the daily records attached to the care plan so that all staff are aware of any changes to a residents care needs. It is recommended that the home research activities designed for people with dementia so that all residents can be involved in the programme of activities. It is recommended that minutes be kept of meetings held between the cook and residents when planning menus etc. It is recommended that a programme of routine maintenance and renewal of the fabric and decoration of the premises is produced and implemented with records kept. It is strongly recommended that the consideration be given to replacing the carpet in the dining room and lounge. The registered person should further develop a process of quality assurance/monitoring, based on seeking feedback from residents and other interested parties, in order to produce a report of the outcomes. Accident reports should be stored in accordance with the DATA Protection Act 2001. All official records should be completed in ink. 3. OP14 4. 5. OP15 OP19 6. OP20 7. OP33 8. 9. OP38 OP38 The Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Royal Elms DS0000067697.V345403.R01.S.doc Version 5.2 Page 28 - 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. 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