Inspection on 04/05/07 for Tremona Care Home

This inspection was carried out on 4th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tremona Care Home 14/07/09

Tremona Care Home 09/02/06

Tremona Care Home 11/11/05

Tremona Care Home 09/02/05

Tremona Care Home 19/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Tremona Care Home, 18 Parkers Cross Lane 18 Parkers Cross Lane Pinhoe Exeter Devon EX1 3TA Lead Inspector Ms Rachel Fleet Unannounced Inspection 4 May 2007 12.00 Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 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 Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.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 Adults 18-65. 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. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tremona Care Home, 18 Parkers Cross Lane Address 18 Parkers Cross Lane Pinhoe Exeter Devon EX1 3TA 01392 460945 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 Melanie Louise Brunsdon Mrs Melanie Louise Brunsdon Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: ‘Tremona’ is a care home registered to provide personal care, support and accommodation for two younger adults with learning disabilities. Mr & Mrs Brunsdon live at the premises. No other staff are employed. The home is a detached house in Pinhoe, a residential area on the outskirts of Exeter. There are 4 bedrooms, with an adjacent toilet and separate bathroom. A lounge, utility area and a shower room are accessed through the kitchen. A conservatory has been built onto the main living room, leading onto a patio with enclosed garden beyond. The home is close to a bus stop, shops, and Doctor’s surgery. Weekly fees at the time of the inspection were £427.21. Extra costs to these include personal toiletries, hairdressing, some activities outside the home, and use of public transport – all at cost price. People funded through the Local Authority have a financial assessment carried out in accordance with Fair Access to Care Services procedures. Local Authority or Primary Care Trust charges are then determined by individual need and circumstances. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at www.oft.gov.uk Inspection reports by the Commission for Social Care Inspection (CSCI) are available at the home, or can be accessed through the Commission’s website at www.csci.org.uk. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out in just under four hours. Mrs Brunsdon had completed a CSCI questionnaire before the visit, but she had not been told the inspection date. We also spoke with two social care professionals who support the residents, before the inspection. During the visit, we spoke with both people who lived at the home - sometimes with Mrs Brunsdon’s help – and they showed the inspector around the home. Some records were looked at, including care notes and maintenance checks. This report has information from these sources and from communication with the home since the last inspection. We have not received any complaints about the home since the last inspection. What the service does well: What has improved since the last inspection? What they could do better: If money belonging to people who live at the home is in a bank account, this should be a bank account that is especially for them and not an account for the home. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 6 People are supported to take their own medicines if they want to, but more advice is needed from a pharmacist to ensure this support is being given as safely as possible. The home is generally a safe place to live, but they need to make sure certain things at the home are okay and do this regularly, so that the home will remain a safe place. 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. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to get to know, inform and support each individual thinking about moving in, to ensure the home is a suitable choice for each person. EVIDENCE: There have been no admissions since the last inspection, with the intention that the current residents will be at the home long-term. But Mrs Brunsdon described an appropriate, gradual introduction to the home for prospective residents - visiting the home for lengthening periods of time, etc. She uses a comprehensive assessment form to get as much information about people as possible, so as to be clear about their capabilities, needs and the support they would need. Information about the home has been updated since the last inspection, some of it being in ‘easy read’ form. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good knowledge of each person’s needs, capabilities and preferences ensures they receive support they need to make choices and to take risks that enhance the quality of their lives. EVIDENCE: Care plans seen had been updated regularly and were individualised, with evidence that the people who live at the home had been involved in reviewing their care. They included enabling peoples’ privacy and any limitations on that, such as when help was needed with personal care. People talked about recorded preferences, reflecting the accuracy of the care plans. Care diaries were used to record significant events that involve them – health matters, diet intake and outings, for example – to inform reviews of care. Mrs Brunsdon is appointee for both people, in the absence of another suitable person. Personal monies records were checked. These were kept individually for each person, with receipts for purchases numbered so as to make it easier Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 10 to check them against the records. Cash held was found to be the same as balances recorded, showing money is kept well by the home. Mrs Brunsdon said there was a residents’ monies bank account, but money she received as appointee was first paid into a business account. She agreed to address this since regulations require that peoples’ own money is not paid into business accounts, so access to their money is not affected by any change in business circumstances. Risks had been assessed – relating to the home environment, going out, vulnerability, and health needs, for example – and reviewed regularly as well as when circumstances changed. Action to minimise risks did not restrict people unreasonably, if at all – support being given so they could still enjoy going out, preferred activities such as cooking, etc. See also the following sections on ‘Lifestyle’ and ‘Personal & Healthcare support’ for other evidence of how people are supported to make decisions about their lives. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 - 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people who live at the home get excellent individualised support that enables them to have fulfilling lives with positive relationships and enriching experiences within and outside the home. They enjoy a good varied, balanced diet that takes into account their preferences and other needs. EVIDENCE: During the inspection, the people spent time with the Brunsdons - including whilst with us, and going out with their colouring books in the garden - or on their own in their bedroom. They said they had made chutney from vegetables grown in the garden with Mrs Brunsdon. They also spoke about preferred TV programmes, trips out (such as shopping, to Powderham Castle, and to an evening disco), and their recent holiday abroad with their previous carers. Enablers from their day centre had taken them to a Christmas carol service. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 12 Their care diaries showed the different places they went out to, including for meals, and when they helped around the home – tidying their room and emptying the dishwasher, for example. One laid the table for lunch, during the inspection. Mrs Brunsdon said she had been trying to get them a job at a local community café, but not succeeded yet. They said they also had writing books (which Mrs Brunsdon said she bought them), to practice copying letters in them. Community-based professionals felt the people had not been adversely affected at all by the move to their current home (which had taken place just before the last inspection), or by more recent changes in the Brunsdon household. They were clearly at ease in their home, but showed they still enjoyed and benefited from the ongoing relationship with their previous carers. They also said their current neighbours were friendly towards them. Diaries showed they had a varied and healthy diet; one spoke about the different packed lunches they took out with them, and different drinks they made when at the home. They eat with the Brunsdons, discussing during the inspection what they would all be having for their meals that day, and helping in meal preparation. See also other sections for more evidence of how people are able to have a fulfilling life. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People benefit from having a carer who has excellent knowledge and understanding of their individual needs and preferences, ensuring they are supported as they need and wish. This includes enabling medication practices and procedures, although one aspect should be reviewed. EVIDENCE: People said they liked living at the home, and they seemed relaxed and happy. Mrs Brunsdon showed in conversations with them and with us that she clearly knew their preferences (foods, activities, etc.), what they might worry about (changes in their usual routine, etc.), and so forth. Care plans are very individualised, including individual needs and preferences as to how needs should be met. One talked about various friends and what they did with their enablers at the day services they attended. Their conversation showing clearly these were positive, beneficial relationships. Care records included health checks by community services (such as eye tests, a visit to the dentist, and at hospital appointments), and general observation of residents’ health by Mrs Brunsdon Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 14 on a regular basis, including recording their weight. They enjoyed their swimming sessions, and trips to the park or riverside, which provided a balanced level of exercise needed in view of health needs (- reflected in care records). A risk assessment was seen regarding a sensory impairment one person had. It was seen in care notes that one person had requested a change to their medication, with a letter showing that this had been organised by Mrs Brunsdon through the GP. Only one person had medication at the home, with some given to both residents at the GP’s surgery as needed. One person’s wish to be self-medicating was recorded, and they were enabled to help themselves as much as possible - partly through use of a weekly dosage box, which the Brunsdons prepared from medication prescribed by the GP. It is good practice, however, to avoid such ‘secondary dispensing’ and advice should be sought from a pharmacist about this, to ensure systems are as safe as possible. Medication records included full information about each person’s health needs and health risks, a photo of the person, pictures of any tablets they take, and contact numbers for their pharmacist, doctor, etc. Both medication received into the home and then taken by the person were recorded by Mrs Brunsdon, with a running total kept of stock held - which tallied with stock that was checked. We also saw a record of medicine returned to the pharmacist. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Excellent attention to and support for people living at the home ensures they speak about their views and concerns, and are taken seriously. Good knowledge of people living at the home ensures that they are given protection from harm. EVIDENCE: The people living at the home seemed very happy and relaxed. They did not raise any concerns during the inspection, other than regarding someone they knew that was not well. Mrs Brunsdon tried to reassure them, in an appropriate way, whenever they talked about this. We saw an ‘easy read’ complaints procedure in a lounge, which encouraged them to speak about any worries. Mrs Brunsdon said that one person was clearer about what they liked or wanted than the other, so she tried to get the views of the other, quieter person first – to be sure of getting their true view before they simply agreed with other people. She was clear that she would contact Social Services, the police or the residents’ GP, if she had any concerns about peoples’ wellbeing or welfare, or thought they were being abused or harmed. Care notes and risk assessments for people included situations when they might be more vulnerable to harm and so need extra support to prevent this. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 16 Two social care professionals had no concerns about the service provided to people living at the home. One said there was very open communication with the home, so any problems were quickly shared, and were dealt with. Mrs Brunsdon had current public liability insurance as a self-employed carer, and personal accident insurance; we saw the policy requires her to abide by a specified, nationally recognised code of conduct for social care workers. She said her house insurance covered peoples’ property. These measures safeguard their rights as individuals, and their property. Since no other staff are employed, there is a written emergency procedure to be followed should the Brunsdons suddenly be unable to care for people living at the home. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good, well-kept accommodation provides people with a pleasant, homely and clean place to live. EVIDENCE: The home was very clean and orderly when we arrived. The two people living at the home showed us around, seeming very happy with their bedroom; they said they liked living at the home, going on to talk about using the televisions in the lounges and their bedroom. Environmental risk assessments had been updated in the last year when a potential tripping hazard was identified; no such hazard was noted during the inspection. When asked if repairs were carried out quickly when needed, one person said that they were - by Mr Brunsdon – giving examples of a broken bed and a door handle. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 18 Mrs Brunsdon had guidance from the Health Protection Agency (August 2006) on infection control in care homes. She said there have not been any issues other than occasional colds – reflected by residents and records seen. There are domestic laundry arrangements; Mrs Brunsdon confirmed laundry is not handled during food preparation. See also the final section regarding regular maintenance to maintain the safety of the home. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area was not judged since no staff are employed. EVIDENCE: Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home benefit from good management, with their views used to improve the care service provided, although aspects of regular maintenance should be addressed so as to ensure the safety of everyone at the home. EVIDENCE: We saw Mrs Brunsdon’s certificates for nationally recognised management and care qualifications, obtained in August 2006. She has current food hygiene and first aid certificates, intending to renew these in 2008 and 2007 respectively, to remain up-to-date on such matters. A recommendation made at the last inspection, about records relating to peoples’ personal monies, has been addressed. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 21 A professional in contact with the home said there was good two-way communication between them and Mrs Brunsdon, which benefited the people living at the home. During the inspection we saw that there were good, respectful relationships between them and the Brunsdons, people being consulted regularly. Mrs Brunsdon checked her understanding of their comments, and checked their response to information she gave them. She said she would be using the home’s survey soon, to record their views and views of others such as their enablers about the support they received more formally, as she had done in the past. People said they hadn’t had any accidents recently, and none were recorded in the accident book. We saw the most recent electrical safety certificate, dated April 2006, which had been obtained following a recommendation made at the last inspection. Mrs Brunsdon said she has been trying to arrange the annual check now due, and similarly will obtain a safety check for gas appliances (the most recent certificate being dated August 2005). An ‘easy read’ fire procedure was seen in one lounge. Fire safety checks had been recorded regularly, a different fire alarm being tested each time. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 2 X 3 X 3 X 3 2 X Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 YA7 Regulation 20 Requirement You must not pay money belonging to any people who live at the home into a bank account, unless a) the account is in the name of the person, or any of the people, to which the money belongs; b) and the account is not used in connection with the carrying on or management of the care home. This does not apply to money paid for charges payable for accommodation or other services provided by the home. Timescale for action 31/08/07 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 YA20 Good Practice Recommendations Medicines at the home should be handled according to the requirements of the Medicines Act 1968 – thus advice should be sought from a pharmacist about ‘Secondary dispensing’ and the use of the dosage box, so that residents can be enabled as safely as possible to selfDS0000039928.V332066.R01.S.doc Version 5.2 Page 24 Tremona Care Home, 18 Parkers Cross Lane 2. YA42 medicate. You should evidence that electrical hard wiring, portable electrical appliances and gas appliances are safe, to promote the health, safety and welfare of everyone at the home. Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Tremona Care Home, 18 Parkers Cross Lane DS0000039928.V332066.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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