Inspection on 18/12/06 for Valmark House

This inspection was carried out on 18th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Valmark House 12/01/06

Valmark House 05/10/05

Valmark House 15/03/05

Valmark House 01/12/04

Valmark House 24/02/04

Valmark House 15/12/03

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

CARE HOME ADULTS 18-65 Valmark House 90 Mill Road Colchester Essex CO4 5LJ Lead Inspector Pauline Dean Key Unannounced Inspection 18th December 2006 09:30 Valmark House DS0000017990.V322875.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 Valmark House DS0000017990.V322875.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. Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Valmark House Address 90 Mill Road Colchester Essex CO4 5LJ 01206 853539 01206 843367 broadhzn@aol.com 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) Broad Horizons Limited Mrs Jean Brown Fleming Revelle Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: Valmark House is an established small care home, for three young adults with learning disabilities, first registered in November 1998. The registered provider is Broad Horizons Ltd. The responsible person is Mrs Jean Revelle. Mrs Revelle is also the registered manager of Valmark House. Valmark House is one of three small care homes located in Mill Road, Colchester and there is close cooperation between all three. Valmark House is found in a residential area of Colchester, located close to Colchester General Hospital. There are local shops and facilities nearby, with the main town centre offering shopping and leisure facilities a short bus ride away. Accommodation for the three service users is on the ground and first floors, each service user having a single room with a wash hand basin. There is a bathroom and toilet on the first floor. An office/staff bedroom is also found on the first floor. On the ground floor there is a lounge/dining room and kitchen. The property is semi-detached and has gardens to the front and rear. There is some off-road parking. The rear garden is enclosed with a patio area, flowerbeds and lawns. Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, covering the key National Minimum Standards, took into consideration all recent records relating to the service, including information sent to the Commission by the Providers. A record of inspection was collated prior and during the inspection process. It also included a site visit to the home on 18/12/06, which lasted approximately 8 hours over the three Broad Horizon Care Homes. At this visit, the inspector was able to speak with some all of service users as they went about the home, the registered manager, Mrs Jean Revelle and care staff on duty. A tour of premises was completed and there was observation of care practice and the sampling of records. Where possible, the site visits focussed on the experience of a sample of two service users, a process known as case tracking. Of the twenty-three National Minimum Standards inspected on this occasion, fifteen were met and eight nearly met. One of which was a repeat requirement. Whilst it is recognised that there has been an increase in requirements, from two to eight, it should be noted that more Standards were inspected at this inspection. At the time of this inspection there were three service users living at Valmark House. Current fees are £550 - £575 per week. Hairdressing, papers, magazines, clothing, personal activities and college fees are not covered by the fees and are charged at cost. What the service does well: Broad Horizons Limited continues to offers their service users a homely environment. Current building work has impinged on this, but on completion of the loft conversion and planned and identified decoration the premises will return to their former state. There continues to be a relaxed atmosphere within the home. Service users accessing communal areas as they wished and coming and going to and from their rooms. They were seen to have friendships within the home and within the other two homes of Broad Horizons Limited. One service user was able to tell the inspector of his friendships in the home and outside the home and they gave examples of activities inside and outside the home they enjoyed together. In addition, the relationships between staff and service users were seen to be relaxed and friendly with support and guidance offered to each individual as needed. Valmark House DS0000017990.V322875.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. Valmark House DS0000017990.V322875.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 Valmark House DS0000017990.V322875.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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Documentation ensures that service users move into the home knowing that their needs will be met. EVIDENCE: There have been no new admissions since the last inspection. Valmark House has full occupancy of three service users. Admission paperwork sampled and inspected in one of the three Broad Horizons Care Homes had a detailed admission assessment with supporting paperwork and assessments from the placing authority. This admission was completed September 2006. Within survey work completed by the Commission for Social Care Inspection (CSCI) one of the service user spoke of visiting the home prior to admission, having meals and staying overnight. They said “I am happy in my home.” Valmark House DS0000017990.V322875.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning documents detailed health, personal and social care needs and records evidenced all aspects of care required. Service users are enabled to a degree to make decisions through risk assessments and risk management. EVIDENCE: A plan of care had been developed for all three of the service users living at Valmark House. At the site visit one of the service user took me through their care plan. They were clearly able to understand and communicate what their care plan meant to them and they had been involved in reviews and record Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 10 keeping. They were able to tell me the outcome of these discussions and their thoughts on the development of their care plan. The same service user had been able to make decisions about their life, such as attending particular college courses, selecting meals and planning menus and participating in leisure activities. Whilst it is acknowledged that service users are supported to take risks, it was evident that there was a lack of risk assessments in place. Whilst care planning documents highlighted activities and recognised that there were risks involved e.g. road safety and cookery, risk assessments were either very brief or not available. This was discussed with Mrs Revelle, the registered manager, who acknowledged that further work is required on identifying and detailing risk assessments with care planning. Valmark House DS0000017990.V322875.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, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support and assist service users to participate in educational, training and community activities, as they are able. Staff support service users to maintain family links & friendships. Service users rights are respected and responsibilities are recognised. EVIDENCE: It was evident from sampling care plans and record keeping that none of the current service user group are able to gain employment. One service user attends a Community Education College and they spoke positively regarding Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 12 their college, the course they were on and further courses they were hoping to attend in the new year. Service users within the home completed surveys produced by the Commission for Social Care Inspection (CSCI). All three service users had responded. Two had completed these surveys with assistance from their parents and one had been completed by the service user. All spoke of being able to make choices in what they could do and one parent spoke of picture communication methods being used in the home to help their relative make a choice. All three service users are encouraged and supported to access community facilities. Two of the service users attend an evening club, whilst a third goes to a Saturday morning club, which they attend with their parents. In addition visits to Aqua Springs, meals at a local pub and walks in the local park are popular with all three service users. Furthermore visits to the cinema, and bowling are enjoyed by one of the service users who goes with the residents of McKechnie House. All three service users maintain links with their families. The home liaises and arranges visits to their family as they wish. This was detailed within care planning records and confirmed by one of the service users. Small notebooks are used to ensure that there is good communication between the home and families and one service user was clearly aware of this form of communication. At this site visit, all three service users were seen coming and going from their bedrooms. They were encouraged to listen to music of their own choice in their rooms and could be alone or with company. Service users are able to plan and choose what they wish to eat. During the site visit, the inspector observed a service user making a choice and being involved in the preparation of their lunch. Adjustments where made to the meal to ensure that it was to the liking of all of the service users. Valmark House DS0000017990.V322875.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s arrangements for supporting the healthcare of service users was satisfactory, with the record keeping and medication administration well managed. EVIDENCE: Throughout the site visit, the inspector noticed that service users were able to come and go to their rooms as they pleased. This was confirmed by one service user who spoke of being able to make choices with regard to clothing, getting up and going to bed, mealtimes and leisure activities. On the day of the site visit, service users in this home and the other two homes were able to meet up socially as they wished. All service users are registered at a local GP surgery. There is access to local healthcare facilities such as the dentist, which has moved from the centre of Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 14 Colchester to the immediate locality. Links with a consultant psychiatrist and the outreach team are encouraged and service users are supported by the home and their relatives to attend regular review appointments. On this occasion medication records and medication were sampled inspected at Valmark House. Medication was held and securely stored wall cupboard in the first floor office. This was found to be in good order administration records accurately detailing medication administered and in the home. and in a with held The inspector was told that all care staff in the home have attended a Boots medication course in 2006. Valmark House DS0000017990.V322875.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): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, service users were well treated and listened to, with complaints and adult protection procedures in place. EVIDENCE: Valmark House has a complaints procedure, which has been devised using a care home consultancy company. This was found on a service user’s file. This procedure made reference to raising complaints with the Commission and states that complaints should be raised with “registered director of our Inspectorate.” Mrs Revelle, the registered manager was advised of the need to review this procedure for there are inaccuracies. In addition, clarification is required as to the role of Commission for Social Care Inspection (CSCI). It should be noted that the Commission is not a ‘complaints agency’ and does not have statutory powers to investigate complaints. The Commission will use their powers of inspection to undertake enquiry so that we can make a judgement as to whether the provider is complying with the regulations. Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 16 Whilst staff were aware that the home had an adult protection procedure, they were not able to locate it at the time of the inspection. However, from reviewing the adult protection procedure found in the other two Broad Horizons homes it was evident that these policies and procedures need to be reviewed and updated for reference to the previous Commission – National Care Standards Commission (NCSC) were found within the adult protection documents held in the homes. Mrs Revelle was advised of the need to review these documents making the changes as required. The inspector was informed that the home has the Essex CD training package on abuse and Mrs Revelle said that she plans to use this as a training tool. Valmark House DS0000017990.V322875.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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, the home provides a safe, well-maintained environment that is accessible to service users, homely and meets individual needs. EVIDENCE: Overall, Valmark House continues to offer a bright, clean and a homely environment. The premises are of a domestic type and are in keeping with the local community in a residential area. This home as with the other two homes managed by Broad Horizons Limited are to have a loft extension offering additional bedroom accommodation. Mrs Revelle said that this is planned for the new year. Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 18 Within the lounge/dining room furnishings and fittings are of good quality and appropriate to the needs of the service users at Valmark House. Whilst new kitchen units have been fitted, decoration is planned in the new year. In contrast one of the service user’s bedrooms was found to be stark and sparse. Care staff spoke of recent behavioural problems, which had resulted in broken windows. Opaque Perspex has been fitted to the window to ensure privacy and strengthen the glazing. This was seen as a short-term measure by both management and staff, for the inspector was told that this bedroom window and another bedroom window are to be double glazed when the loft conversion is completed. Management and care staff are advised of the need to continuing monitor and review these arrangements within the care planning paperwork, updating behavioural management strategies as required. Laundry facilities comprise of a washer and dryer, which are domestic in character. The washer is sited in the kitchen, with the dryer in the garden shed. Consideration is given to the management of laundry to ensure that soiled items do not come in contact with food preparation and eating. Valmark House DS0000017990.V322875.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): 33, 24, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Valmark House’s recruitment policy did not meet requirements and therefore does not support and protect service users. There was not sufficient evidence to demonstrate that staff were adequately supervised, trained or supported in their roles. EVIDENCE: Staffing levels and staff rotas were sampled and inspected on the site visit. A total of four care staff including the registered manager cover both the day and night shifts. Normally there are two carers on duty during the daytime, with one asleep carer at night. Staff spoke of flexibility within the staffing levels to ensure that service users needs are met as they access college courses, activities and appointments in the community. This was evidenced within the staff rota and care planning records. Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 20 Staff files were sampled and inspected. Two files of two carers were considered. Omissions were noted in the paperwork – there was no application form on one file and each had only one reference. Both staff members had job descriptions in place; one however needed updating to reflect changes in their role and responsibilities. Both staff members were on duty at the time of the site visit and they were able to assist with going through the paperwork. Later in the day when these matters were discussed with the registered manager, the need for improved staff recruitment practices was acknowledged as being required. Within the staff files inspected there was some evidence of Induction and Learning Disability Award Framework (LDAF) training. Care staff on duty confirmed that they had attended and are awaiting certification for a Health & Hygiene training course. One care staff member spoke of completing both level 2 and level 3 – National Vocational Qualification (NVQ) in Promoting Independence. Whilst the inspector was able to ascertain some detail of current staff training, they were not able to inspect individual training and development assessments and profiles. These were not evident and from speaking with the registered manager, this still needs to be developed. Within the two staff files sampled and inspected, there was little evidence of staff supervision. One carer had not received supervision since commencing employment and the second carer was only able to find a supervision record from 2004. This is disappointing for this was raised at the last inspection. It was evident that there is still a need to review and plan regular supervision sessions within the home. Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 21 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a competent and experienced manager to run the home. The home has to review and develop a quality assurance and quality monitoring system to help ensure that the home is run in the best interests of the service users. Safe working practices are promoted through ongoing training. Health and safety certification promotes a safe working environment. EVIDENCE: Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 22 Mrs Revelle said that she has completed the National Vocational Qualification (NVQ) level 4 in Management and is looking to complete the Health and Social Care section in 2007. She said that she is also planning to complete a NVQ level 5 in Care in that year. Since the last inspection service users, relatives and staff have completed quality assurance survey work. An analysis of the outcome of the survey work has been completed and these have been circulated and used to improve practice within the home. Copies of completed survey forms were found on service user’s files. Safe working practices are ensured through basic training courses and some evidence of this was seen on staff files and from discussion with staff and management. Mrs Revelle said that basic training courses in food hygiene and health and safety are planned in 2007. Safety certification and health and safety policies and procedures were not sampled and inspected at this site visit. Valmark House DS0000017990.V322875.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 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 X 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA9 Regulation 13 (4)(b)(c) 14(2) Requirement Timescale for action 20/02/07 2. YA22 22 3. YA23 13(6) 21 4. YA24 23 The registered person must ensure that staff enable service users to take responsible risks, ensuring that they have good information on which to base decisions within the individual service users’ care plan, risk assessment and risk management strategies. The registered person must 20/02/07 ensure that there is a clear and effective complaints procedure, which includes the stages of, and time scales, for the process, and that service users know how to complain. The registered person must 20/02/07 ensure that service users are protected from abuse, neglect and self-harm. This is with regard to the adult protection policy and procedure. The registered person must 20/02/07 ensure that the home has a planned maintenance and renewal programme for the fabric and decoration of the premises with records kept. This is with regard to maintenance and decoration following DS0000017990.V322875.R01.S.doc Version 5.2 Valmark House Page 25 5. YA34 19, Schedule 2 completion of the loft conversion. The registered person must 20/02/07 ensure that there is a thorough recruitment procedure in place to support and protect service users. The registered person must ensure that there is a staff training and development programme, which meets Sector Skills Council workforce training targets. The registered person must ensure that staff receive support and supervision to carry out the job as detailed in the National Minimum Standards for Care Homes for Adults (18 - 65). (This is a repeat requirement. Previous timescale of 05/03/06 was not met.) 20/02/07 6. YA35 18(1)(c) 7. YA36 12 (5), 18 (2) 20/02/07 8. YA37 9 The registered manager must ensure that they have the required level 4 qualifications in care by 2007. 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Valmark House DS0000017990.V322875.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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