Inspection on 08/11/05 for Wordsworth House Care Centre

This inspection was carried out on 8th November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Wordsworth House Care Centre 26/04/05

Wordsworth House Care Centre 14/12/04

Wordsworth House Care Centre 02/09/04

Wordsworth House Care Centre 17/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Wordsworth House Care Centre Wordsworth Street Hapton Burnley Lancashire BB12 7JX Lead Inspector Unannounced Inspection 8th November 2005 10:30 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 Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 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. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Wordsworth House Care Centre Address Wordsworth Street Hapton Burnley Lancashire BB12 7JX 01282 778940 01282 770311 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) Ashbourne Holdings Ltd Mrs Linda Heyes Care Home 40 Category(ies) of Dementia - over 65 years of age (17), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (22) Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This service should, at all times, employ a suitably qualified manager who is registered with the CSCI Within the overall registration of 40, a maximum of 17 service users who fall into the category Dementia Elderly, 1 named service user who falls into the category of mental disorder, 22 service users who fall into the category of Older People. Staffing levels are to be in accordance with the Notice issued 17 October 2002 Should any of the service users referred to in 1 above be no longer resident in the home, registration must be altered to reflect this. 26th April 2005 3. 4. Date of last inspection Brief Description of the Service: Wordsworth House is registered with the Commission for Social Care Inspection to provide personal care and accommodation for forty older people. The home is a purpose built establishment situated in the village of Hapton, Burnley. There are shops and public houses close by and it is near to public transport, rail and bus. Accommodation is in single en suite bedrooms on two floors with access to the upper floors via a passenger lift. There is a residential and dementia care unit in the home. Ashbourne Holdings Limited owns Wordsworth House. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the second inspection at Wordsworth House. It was unannounced. The process involved checking if the right action to improve in areas that were seen as falling short of meeting standards during the previous inspection had been taken. Written information and records relating to residents and staff employed was looked at. Time was spent talking to the people who live at the home, visitors and staff on duty. Observations were made of the care provided in line with Minimum Standards and the residents gave some account of their personal experiences of life for them in the home. What the service does well: Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 6 Staff knew the needs of residents and worked as key workers to a number of residents. This helped to personalise care. Residents were happy with the carers and felt more secure with the number of long serving staff who they ‘trusted’. The visiting district nurse had confidence staff would follow instructions she left for residents healthcare. Residents generally felt their health care was catered for. Activities in the home were varied and residents in the dementia unit benefited from this. The scope of family involvement in the care of residents with dementia was very good. The home has shown initiative in providing opportunities for relatives of people with dementia to be involved in learning about the illness and effect dementia has on those who suffer from this. Relatives were made welcome and the staff made themselves available to speak to them. Care and attention was given to the provision of meals to people with dementia. Good practice in how proper choices is offered and dietary monitoring was seen. People were encouraged to express any issue or concern they had at meetings and could directly speak to the housekeeper with basic household issues such as laundry. The standard of accommodation was very good. Residents were happy with their bedrooms and how they were kept. The overall standard of hygiene in the home remains satisfactory. Residents ‘liked’ the staff, describing them, as ‘the girls are very good’. One man appreciated having a male carer. . Staff were professional when caring. They were trained in basic care and had other specialist training. Training provided for staff included topics such as specialist care for people with dementia. This was having a noticeable impact on the approach in meeting resident’s needs. Staff showed they had a good knowledge in understanding the needs of older people. The senior staff on duty and unit leader also demonstrated clear leadership skills. Teamwork was evident and staff said they enjoyed their work. What has improved since the last inspection? Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 7 Since the last inspection activities has improved. There is a better scope of meaningful activities and staff awareness of their responsibility to make sure these are provided. There has been an improvement in the meals served and residents have influenced new menus to be introduced. All residents’ benefit fresh fruit being readily available and residents in the dementia unit are given fruit as routine. Laundry has improved. Residents can speak directly to the housekeeper over any issue they may have with this. This invitation is displayed on the notice board. The constant flow of staff working in the home has stabilised and residents’ had noticed an improvement. There had been no further difficulties in management being aware of any problem with routine. An additional member of staff works on an early shift to benefit residents receiving help when they most need it. What they could do better: As identified in the previous inspection, assessments carried out by the home should be better detailed. The current form used should be reviewed to help staff complete this task properly. It is important that information needed to keep residents and staff safe is detailed in risk assessments, particularly managing aggression. To protect residents’ privacy, and maintain their dignity, recording of personal care such as bathing in a record of activity kept in the home must cease. There is concern that staff recruitment practice can place residents at risk. Appropriate checks must be carried out for new staff before they are allowed to work in the home. Senior representatives from Ashbourne should monitor this better. Documents that relate to ‘nursing provision’ at Wordsworth House should be taken out of circulation, as they are misleading. Please contact the provider for advice of actions taken in response to this Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 8 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 9 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 Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 The admission process followed was satisfactory. Assessments were carried out prior to admission; however better recording of important information is required. The assessment forms used by the home could be reviewed to make them simpler to follow. EVIDENCE: Information was available for people looking about the home. Show rooms were prepared for people to look at. Since the last inspection several people had been admitted. Records showed these people had been given a needs assessment prior to this. Social work assessments were detailed. However better recording of information needs to be made when people are admitted without a social work assessment. The assessment forms used for private care, whilst giving guidance to staff was not very easy to use. This could be developed further to make sure important information needed to give the right care is recorded. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 11 People admitted had been given a contract of residence. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 Residents care plans provided sufficient detail to show staff how residents care needs would be met. They were reviewed regularly by staff with residents and where needed relatives. Information to keep residents and staff safe needs to be better detailed, particularly in the dementia unit when staff occasionally have to deal with aggression. Professional working arrangements with health and social personnel remains good. EVIDENCE: Residents had care plans. Daily entries in care records showed how personal care practice was monitored. The care plans showed how information recorded on resident’s assessment gave each person personalised care. A brief outline of their past history helped staff to understand resident’s present and past circumstances. Significant care needs had been included and there was evidence to show the residents or their families had been involved with the care planning process. Staff were familiar with the content of the residents care plans. They worked to a key worker system. This is when a carer takes extra responsibility for named residents to make sure their needs are met. Some residents confirmed staff Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 13 talked to them about their care. They liked their ‘special’ carer and were happy with how they were helped. The visiting district nurse said that care staff ‘followed instructions’ she made when caring for residents health needs. Health care checks were recorded. Other health professionals made regular visits. Risk assessments had been completed for residents. Information recorded dealt with risk of falls. However on the dementia unit managing aggression needed to be risk assessed with guidance recorded for staff to follow. This was seen as essential for one resident in the unit. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Since the last inspection the variety of activities provided had improved, and involved more people. However recording personal care as an activity in the record of provision of activities was not good practice, and as such does not maintain privacy of information. Maintaining good contact with family and friends was encouraged, and the home worked well towards involving relatives in awareness training of people with dementia and their care needs. Catering arrangements had improved and offered residents a better choice of menu. EVIDENCE: The residents’ care plans included details of their social and recreational needs and interests. During the previous inspection, one resident had enjoyed gardening. This had continued. Other residents benefited from an increased variety of leisure pursuits. Residents were pleased with the improvement in activities. They said staff spent time with them. During the inspection, an organist visited. Worsdworth House has an activities coordinator employed for this purpose. Activities in the dementia care unit also had improved. The luncheon club for relatives/friends, which was very popular, had continued. In both units the recording of residents having a bath in the activities book was not good practice. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 15 Some residents said they followed a religious faith and were visited by clergy. The homes visiting arrangements were outlined in the service user guide. Visitors in the home said they could visit whenever they wished and staff made them welcome. Staff were described as ‘having time for residents’ and ‘friendly’. Visitors were invited to events in the home and informed of any changes in the care of their relative. Relatives had been invited to attend a training event for staff on dementia care. It was combined with a social evening where they could meet with staff and other relatives. This had been popular, and gave those relatives who attended a better understanding of the experience of people living with dementia and the care needed to improve people’s quality of life experience. Comments about the meals served in the home also showed an improvement since the last inspection. Residents said they were happy with the quality, variety and choice of meals provided. Three full meals were being offered daily. Choice menus were available, the options being discussed with residents each day. Diets such as diabetic were being catered for and one resident had a liquidised meal. Drinks and snacks were also provided. The provision of fresh fruit had improved and residents had the benefit of fruit left in bowls they could help themselves to. As recommended in the previous inspection, residents in the dementia unit were encouraged to eat fresh fruit. This was by sometimes cutting the fruit into manageable pieces for them. The cook said the menus were changing and had sent the proposed menus to be approved at a senior level. Good practice continues in the dementia unit in the method of offering alternative meals they liked. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 16 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The complaints procedure was managed properly. Residents and visitors were consulted and given written information on the homes complaints procedure. Policies and procedures to protect people were in place. Staff were trained to use them to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: There had been no complaints received at the Commission. Records showed complaints made had been investigated and outcomes recorded. To help residents with expressing concerns meetings were held regularly and residents also could approach the ‘housekeeper’ with any domestic problems. This notice was displayed on the notice board. All staff employed in the home had as part of their training instruction on abuse procedures. However recruitment of staff showed residents were placed at risk because staff were allowed to work prior to proper police checks being received. This is referred to under ‘staffing’. Staff were given contracts that precluded them from financial reward or assisting in or benefiting from residents’ wills. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. The home was maintained to a high standard, and residents lived in a comfortable and homely environment. Resident’s bedrooms were furnished and decorated to their liking. All bedrooms had en suite facilities (toilet and washbasin). A good standard of hygiene was achieved. Bathing facilities included assisted baths. All rooms had radiator protection and emergency call points. EVIDENCE: Routine maintenance in the home and grounds remains very good. All the rooms in the home were pleasantly decorated and furnished to a relatively good standard. There were no restricted areas and access to the upper floor was via a passenger lift or staircase. Seating arrangements in the dining room on the dementia unit seemed sufficient with all residents who wished eating their meal together. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 18 All residents’ bedrooms were en suite. There were adequate additional toilet facilities situated around the home. There was a call system in every room that people could reach. Resident’s bedrooms were of a high standard in terms of provision of furniture and decoration. Residents who were able had their own bedroom door keys and staff kept other residents rooms private for them. All radiators throughout the home had been covered with protective guards. Since the last inspection the housekeeper had made herself available for any query about laundry. This information was displayed on the notice board for residents. The home was clean and odour free throughout. Wordsworth House has shown all staff have continued to keep these standards found in the past two inspections. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The deployment of staff to cover a busy period in the morning benefited both residents and staff. Regular long serving staff continued to be valued by the residents. The number of staff leaving and new staff recruited had fallen. Recruitment and selection procedures remain unsatisfactory and do not provide the safeguards to offer protection to people living in the home. Training provided and attended by staff was very good, and offered a wide range of topics. EVIDENCE: Residents spoken with, made positive comments about the staff team, they said they were kind, caring and hard working. Both residents and staff appeared to have a good relationship. Staff were confident in their work and expressed an understanding of their roles. Records indicated proper staffing levels were being maintained, residents and staff confirmed this. Additional staff had been introduced very early in the morning. This helped to provide care and support for residents during this busy period, as staff were available. Staff records checked found them to have some discrepancies. Records were not kept of discussions about specific matters arising from the recruitment process with full employment histories not being requested and considered. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 20 There also remains a concern that staff had started work prior to Criminal Record Bureaux check or POVA (Protection of Vulnerable Adults) register. Whilst there was only a relatively short time in these instances before the proper records were received in the home, this kind of practice places residents at risk. The high turnover of staff that was discussed during the last inspection does appear to have settled with three new staff appointed during this period. Residents were more settled about this. One resident said the new staff were ‘very nice and hoped they would stay’. Staff training was given priority in the home. The percentage of staff having completed a national vocational qualification in care level 2 was near 60 . Staff said they enjoyed training and were supported by the manager to develop their career in care. Arrangements for staff training were very good with a variety of topics covered to help staff work with skill and knowledge. Staff confirmed they received supervision regularly, for which records were kept. On appointment members of staff were issued with a contract of terms and conditions of employment. Staff were given a copy of the General Social Care Council’s code of practice and conduct. All members of staff had a job description. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,36,37,38 Residents, staff and management meetings were held regularly. Staff were trained in safe working practices and a record of staff training was kept. Staff, residents and visitors benefited from being able to influence care provision. Staff had necessary guidance and support to help them give care to an acceptable recognised standard. Senior management of Ashbourne need to monitor staff recruitment as part of their monthly inspection to the home. Maintenance management was very good and housekeeping was managed well. Record keeping required improvement. EVIDENCE: Copies of resident’s, staff and management meetings were available and relatives were invited to resident/relative meetings. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 22 A record of staff training was kept with individual one to one staff supervision sessions being held. Staff training in safe working practices including First Aid, Basic Food Hygiene and Moving and Handling was ongoing. Monthly inspections are carried out by a senior representative of Ashbourne who submit a report of the visit to the Commission every month. There is concern that despite concerns highlighted in previous inspections regarding unsafe practice in recruitment of staff, this is not monitored, and continues to be a problem. To make sure records are accurate it is advisable that all documents referring to ‘nursing’ be taken out of circulation such as the care staff job description. It is also recommended records are kept better organised for reference. Maintenance was managed very well, and residents and staff safety considered. Proper records were kept of safety checks. Housekeeping remains well organised. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 2 X X 3 2 3 Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1) Requirement Timescale for action 26/04/05 2. OP29 3 OP33 The Registered person must ensure a full assessment of need is carried out before a place is offered to that person. 19(4)(3)( The registered person must b)(i) sch 2 make sure satisfactory checks are obtained prior to offering employment as identified in the previous inspection. 10-(1) The registered provider must make sure the home is managed properly. 26/04/05 08/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP8 OP12 Good Practice Recommendations It is recommended that the current assessment forms used be reviewed to help staff carry out better assessments. It is recommended that risk assessments be carried out for managing aggression. It is recommended that recording residents’ personal care DS0000009590.V265568.R01.S.doc Version 5.0 Page 25 Wordsworth House Care Centre 4. 5. OP37 OP37 in the activities book stops. It is recommended there is an improvement in record keeping It is recommended all documents referring to ‘nursing’, be taken out of circulation. Wordsworth House Care Centre DS0000009590.V265568.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 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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