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Inspection on 02/01/07 for Thomas Colledge House Care Home

Also see our care home review for Thomas Colledge House Care Home for more information

This inspection was carried out on 2nd January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There continues to be a very stable staff group at the home. Staff know the residents well and are very aware of their needs and wishes. Staff members said they worked as a team and always put the residents needs first. Staff spoken to were knowledgeable and enthusiastic, and made good use of training opportunities. Both the staff team and the management team worked well together in a open and positive environment. Residents care plans continue to be clear, up to date and regularly reviewed. The staff and managers work hard to try to ensure that residents` independence is promoted and they are offered a choice in many aspects of their lives. The environment is a good standard; clean, well decorated and maintained. Residents spoken with expressed satisfaction with the levels of care provided; `the staff look after all my needs and are always happy and cheerful`, `it`s lovely here`. All residents seen were well-dressed, clean and seemed settled. Staff were observed treating residents with kindness and sensitivity. There is a well established `key worker` system. There are regular residents meetings. Residents said the food was `very good` and that meals were `nicely presented`. The menu showed variety, and there was evidence on residents care plans and in the residents meeting minutes that they are consulted regularly about the standard of catering. The home follow Derbyshire County Council`s safe guarding adults and recruitment and selection procedures, and there is a corporate complaints procedure.

What has improved since the last inspection?

Requirements made at the last inspection have been met. The controlled drugs book was checked and found to be correct. There is a lockable fridge specifically for storing medication. The home are working hard to improve the variety and availability of activities; and the importance of activities, entertainment and continuing contact with family and friends is recognised by staff. Care staff have undertaken training in safeguarding adults. Formal supervision is taking place on a regular basis for care staff.

CARE HOMES FOR OLDER PEOPLE Thomas Colledge House Care Home Oxcroft Lane Bolsover Chesterfield Derbyshire DE45 1TB Lead Inspector Denise Bate Key Unannounced Inspection 2nd January 2007 09:15 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 Thomas Colledge House Care Home DS0000035728.V324357.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. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thomas Colledge House Care Home Address Oxcroft Lane Bolsover Chesterfield Derbyshire DE45 1TB 01246 348515 01246 348514 thomascolledgehouse@derbyshire.gov.uk www.derbyshire.gov.uk Derbyshire County Council Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Marlene Rhodes Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: Thomas Colledge House care home is a purpose-built residential home providing personal care for service users over 65 years. The home offers a good standard of accommodation. The care home is situated near to the town centre of Bolsover. There are two wings to the care home. There are no stairs, making the building fully accessible. All bedrooms are equipped with en-suite facilities, including showers. The 16 single rooms all have patio doors opening onto the attractive garden areas. Three of the rooms are used for respite care. There are two lounge/dining room areas, and two bathrooms with assisted bathing facilities. Fees are £364 per week for permanent service users, but a range of prices for short term care service users. Extra charges are made for hairdressing, chiropody, magazines and newspapers. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over six hours. During the inspection four residents, two relatives, and four staff members were spoken with. The manager and a deputy manager were present during the inspection and provided assistance and information. Written information was provided by the manager prior to the inspection. Ten surveys were received prior to the inspection providing feedback on the service. An assessment was made of the progress by the registered persons to address the requirements made at previous inspections. A number of records were examined, including care planning documentation, minutes of meetings, regulation 26 visit records, staff files and medication records. Four residents were case tracked. A tour of the building took place. What the service does well: There continues to be a very stable staff group at the home. Staff know the residents well and are very aware of their needs and wishes. Staff members said they worked as a team and always put the residents needs first. Staff spoken to were knowledgeable and enthusiastic, and made good use of training opportunities. Both the staff team and the management team worked well together in a open and positive environment. Residents care plans continue to be clear, up to date and regularly reviewed. The staff and managers work hard to try to ensure that residents’ independence is promoted and they are offered a choice in many aspects of their lives. The environment is a good standard; clean, well decorated and maintained. Residents spoken with expressed satisfaction with the levels of care provided; ‘the staff look after all my needs and are always happy and cheerful’, ‘it’s lovely here’. All residents seen were well-dressed, clean and seemed settled. Staff were observed treating residents with kindness and sensitivity. There is a well established ‘key worker’ system. There are regular residents meetings. Residents said the food was ‘very good’ and that meals were ‘nicely presented’. The menu showed variety, and there was evidence on residents care plans and in the residents meeting minutes that they are consulted regularly about the standard of catering. The home follow Derbyshire County Council’s safe guarding adults and recruitment and selection procedures, and there is a corporate complaints procedure. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Thomas Colledge House Care Home DS0000035728.V324357.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 Thomas Colledge House Care Home DS0000035728.V324357.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, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to ensure residents can make an informed choice about where they live. EVIDENCE: A copy of the Statement of Purpose, Service User Guide, and other information is made available to current and potential residents. In practice quite a few residents become long term after attending the home for short term care, so they are already familiar with the service provided by the home. The information will have to be updated in due course to take account of the extra beds provided by the extension and any changes in service provision. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 9 Copies of assessments carried out by social services staff were seen on care planning documentation of all case tracked residents. Potential residents have a visit to the home and an assessment completed after that visit. Some discussion took place regarding assessments and registration categories. The home does not provide intermediate care. Thomas Colledge House Care Home DS0000035728.V324357.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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans are suitably completed to demonstrate that residents’ health, personal and social care needs are being fully met. EVIDENCE: The four case tracked residents had good care planning documentation covering all aspects of care and including risk assessments. Items in files included the photo of the resident, care plans, needs assessment, copies of reviews, personal service plans, risk assessments (moving and handling, falls prevention, outings, nutrition), weight monitoring, health care professional visits, monthly report, night check agreement, preferred form of address and how individual rights and choices were to be promoted including individual routines, last wishes details, and day to day logs. Reviews were excellent, Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 11 being clearly written and resident focussed. Care plans and personal service plans had been signed by residents. The feedback from residents and relatives indicates that they feel the home provide good quality care and liaison with health professionals is good. Comments included ‘ my mother is quite happy here’, ‘the staff are friendly and approachable’. Positive feedback regarding levels of care had been provided by the home’s own quality assurance study in summer 2006, with all residents and relatives rating the home as excellent or good. The medication is stored in a cupboard on the main corridor. There is not much space and the cupboard frequently gets hot. The temperature should be monitored to establish whether the cupboard is safe to store medication. Requirements made at the last inspection in relation to handwritten records, controlled drugs recording, and a secure medication fridge had been met. Some residents who administer their own medication had not formally been risk assessed. The home should work through the new guidance from Derbyshire County Council to ensure they comply with current medication administration practice in every respect. The sample signatures were available, but some signatures on the MARS sheet were a little unclear. A system for recording the administration of creams is to be introduced. The supplying chemist visits regularly and has given a satisfactory report. The book listing medication and treatment, together with information on side effects, was dated 1999 and should be renewed to provide more up to date information. Serious consideration needs to be given to more suitable arrangements for storing medication as the cupboard is extremely small and there is not room for a medication trolley. Staff were observed treating residents with dignity and respecting their privacy. Staff spoken with gave examples of how they ensure that residents individuality is upheld, and showed sensitivity in how they deal with particular difficulties that can arise between residents with differing needs. As indicated elsewhere in this report, comments by relatives and residents were very positive about the staff. Thomas Colledge House Care Home DS0000035728.V324357.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 good. This judgement has been made using available evidence including a visit to this service. Activities are provided that generally suit the expressed preferences of residents. This assists in contributing to a pleasant atmosphere and the overall good level of satisfaction for service users. Dietary needs of residents are catered for with a balanced and varied selection of food available that meets service users’ tastes and choices. EVIDENCE: The home have identified activities as an area to be developed. Residents social interests were recorded on care plans. The residents meeting indicated that activities are discussed regularly and residents consulted. While residents were not keen on dominoes, they enjoyed playing bingo. There is an activities book where activities and entertainment are recorded. Entertainment was enjoyed, and the home had had a new years eve party. Opportunities were given for exercise, and residents were encouraged to walk around the home. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 13 Movement to music sessions were enjoyed by several residents. The home have joined the National Association for Providers of Activities for Older People, to get support and ideas. However, some residents still enjoy spending time in their room and said their privacy was respected. Several examples were given of where individual residents are enabled to have their spiritual needs met, and where their style of life reflects their individual choice of daily routine. There are regular contacts with a variety of local groups, and most residents have very regular visits from families and friends. Residents meetings are held regularly and the minutes were seen. These indicated that a variety of matters related to the running of the home were discussed on a regular basis and residents given an opportunity to air their views. Relatives spoken to indicated that they were made welcome to the home and were confident that the home would communicate any changes in their relative’s circumstances. There is a well established key worker system and staff are clear about their roles and responsibilities. All residents and relatives spoken to, and the feedback received from CSCI and internal questionnaires, indicates that the quality of food is extremely high, is well presented, and is enjoyed by residents. Residents were offered three meals a day as well as snacks and hot and cold drinks. The kitchen will be enlarged as part of the work being carried out on the home and arrangements will be put in place to provide meals as the kitchen will be out of action for several weeks. Thomas Colledge House Care Home DS0000035728.V324357.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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear and accessible complaints and safeguarding adults procedures are in place to ensure residents can be confident that any issues raised would be acted on effectively and promptly. EVIDENCE: There is a corporate complaints procedure in place. There have been no formal complaints reported to the Commission. The complaints book contained details of day to day issues raised and how they were resolved. All relatives and residents spoken to said they would talk to the staff, key worker or a manager if they were not happy. Derbyshire County Council has clear procedures for dealing with the safety of residents and safeguarding them from harm. Staff spoken to showed an awareness of safeguarding adults issues and would pass any concerns on to their line manager. Training in safeguarding adults has been provided for staff. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is purpose built and provides residents with an attractive and comfortable place to live. EVIDENCE: The home has two lounge areas for residents that are comfortable, nicely furnished and decorated, and homely. There are pleasant gardens outside. There are two bathrooms and toilets that are suitable for residents’ needs. However, on the day of inspection the hairdresser was at the home and the main living room and one of the bathrooms were being used. The home would benefit from a specific area that could be used by the hairdresser which would be more convenient, less intrusive, and more dignified for residents. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 16 All rooms are en suite, and the bedrooms seen had been personalised. Residents really appreciated having a private space to sit outside in fine weather, and liked having en suite facilities. The home was neat and tidy on the day of inspection, and there was a high degree of satisfaction with cleanliness expressed through the questionnaires. The home is generally well maintained and comfortable, but does not have sufficient storage or office space. There is a new extension being built at the moment that will provide accommodation for a further eight residents. A separate application for registration of the new facility with CSCI will take place in due course. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A trained and competent workforce are in place which meet the dependency needs of residents currently accommodated within the home. EVIDENCE: Four staff were spoken with and all were experienced and skilled, and aware of residents needs and wishes. Several staff provide relief cover undertaking a variety of tasks, e.g. cooking, domestic, as well as care. Staff felt this was an advantage as they understood each others jobs and were able to be flexible. There was a discussion about dementia and dependency levels, and staff showed good knowledge and appreciation of residents as individuals. There continued to be two staff on duty at all times, although in the afternoon there was only one care staff on duty with a manager who was expected to undertake care duties. At present care staffing levels meet residents needs, but dependency levels will need to be monitored to ensure that staffing levels remain appropriate. The manager informed the inspector that extra staffing hours are available if necessary. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 18 Staff training was discussed and the inspector informed that a great deal of training had taken place recently and all mandatory training was up to date. In addition supplementary training had taken place, e.g. on dementia. Staff had undertaken induction training prior to starting work. There were many very positive comments about the staff who were perceived as ‘like family’; ‘they always talk to you’, ‘I am very happy with the care I receive at the home’, ‘staff are always interested and polite’. Two staff files were checked. There is a thorough recruitment procedure in place, which included an application form, two written references, and a criminal record bureau check. The manager will soon be involved in recruitment to provide new staffing for the increased number of residents expected when the extension is finished. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager is suitably qualified and experienced and staff demonstrate an awareness of their roles and responsibilities, thus ensuring the home is run in the best interests of residents. EVIDENCE: The manager is suitably qualified and experienced to run the home. The management team is fully staffed and feel well supported by their service manager. Each deputy takes responsibility for some aspect of the home, e.g. hotel services, medication. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 20 The inspector was informed that the home is visited regularly by a representative of the registered person but copies of recent Regulation 26 visits were not available on a monthly basis. Both staff and managers feel there is good communication at the home with effective handover arrangements. There had been a quality assurance exercise which indicated that all residents and relatives feel the home provides an excellent/good overall service. The details of the results are displayed in the foyer at the home. The inspector was informed that at present residents’ personal finance records are kept manually which appears to work satisfactorily. Personal finances are sometimes included in reviews. Reviews are an opportunity where any difficulties residents have in accessing their personal finances can be raised. Supervision for care staff is up to date. Staff spoken to felt supported by managers whom they felt were approachable and supportive. Information on maintenance and health and safety records was provided by the manager in the pre-inspection questionnaire and indicates that matters relating to health and safety are satisfactory. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 3 3 X 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N0 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 Refer to Standard OP1 OP7 OP7 OP9 OP9 OP9 Good Practice Recommendations In due course a new Statement of Purpose should be prepared. Finances should be included at each review to ascertain where there are any problems for residents of getting access to personal monies. Consideration should be given to archiving copies of old documents e.g. out of date care plans, to make it easier to see which documents in the care planning files are current. Risk assessments should be carried out for residents who administer their own medication. The temperature in the medication storage cupboard should be monitored to ascertain whether medication is being stored at an acceptable temperature. The home should work through the new guidance from Derbyshire County Council to ensure they comply with DS0000035728.V324357.R01.S.doc Version 5.2 Page 23 Thomas Colledge House Care Home 7 8 9 10 11 OP9 OP9 OP19 OP19 OP33 current medication administration practice in every respect. Consideration should be given to replacing the location of medication and purchasing a proper trolley An up to date system of information regarding medication and possible side effects should be purchased. Consideration should be given to enlarging the office space available. Consideration should be given to the provision of a more suitable space for the hairdressing. A written record should be kept of Regulation 26 visits. Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Thomas Colledge House Care Home DS0000035728.V324357.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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