Care Home: 25 Horsegate

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What the care home does well People are supported and have opportunities to be as independent as possible, both in the home and in the community. There is a large range of activities available for them to participate in, as they wish. Staffing levels are flexible toprovide the support that the residents need to fulfil their wishes and keep active. The residents are provided with as homely an environment as possible taking into account their individual needs. Staff displayed a good knowledge of the needs of the people living in the home. Staff were able to `converse` effectively in different ways according to the needs and communication abilities of the residents. The ongoing training programme ensures that the staffs` knowledge and skills are regularly updated to provide appropriate care for the residents at all times. There are good systems in place for the organisation to monitor the quality of the service, which includes the involvement of the residents where possible. What has improved since the last inspection? The care plans are now comprehensive documents with all the necessary risk assessments in place to keep the people safe, happy and comfortable. The manager is in the process of making them more person-centred and personalised. What the care home could do better: No requirements or recommendations were set at this inspection visit. The manager and staff are meeting and in some areas, exceeding, the National Minimum Standards. CARE HOME ADULTS 18-65 25 Horsegate Deeping St James Peterborough PE6 8EW Lead Inspector Vanessa Gent Unannounced Inspection 28th November 2008 11:55 25 Horsegate DS0000002655.V370824.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 25 Horsegate DS0000002655.V370824.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. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 25 Horsegate Address Deeping St James Peterborough PE6 8EW 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) 01778 347037 albert.pearce@sense.org.uk www.sense.org.uk Sense, The National Deafblind and Rubella Association Mr Albert Pearce Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 sensory impairment/learning disability Date of last inspection 5th September 2006 Brief Description of the Service: 25 Horsegate is a modern house, built around nine years ago. It was originally a family home and is domestic in appearance. It provides personal care and support for up to six people who have a sensory impairment and/or learning disabilities. The home is one of a number of care homes within the county operated by SENSE East. It is situated in the village of Deeping St James, approximately one mile from the centre of Market Deeping where there is a range of shops, pubs, churches and other amenities. The centres of Peterborough, Stamford and Bourne are within a short driving distance. The home is situated on the main road through the village, in a residential area. It is on a bus route to the nearest town centres. The bus stops outside the home. People are supported to live in six single bedrooms, one of which is ensuite. The ensuite bedroom is on the ground floor, the remainder on the first floor. There is no passenger or stair lift; all residents are able to climb the stairs to their rooms and bathrooms. Communally, the rooms are all spacious: a lounge, dining room, large kitchen, utility room and two bathrooms. One of the bathrooms has a separate shower cubicle; the other has a shower attachment in the bath. Downstairs, there is a toilet next to the utility room for general use. From the dining room, there are patio doors giving access directly into the garden. The large domestic-style two-door garage is used mostly for storage. The garden is situated to the rear of the property. It is enclosed and safe for people to enjoy. It has a brick-built barbecue for summer dining. Transport to venues and for outings is provided by the use of a minibus and staff cars. The overall philosophy of Sense East is “to enable the people we work for to participate or sample as wide a range of vocational, educational or recreational activities as possible and in doing so to interpret their wishes.” The aim of the home is to provide a safe and supportive environment, based on best care values and person-centred planning and care. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 5 The current range of fees is from £1479 to £2059 per week. There are no additional charges. Information about the day-to-day operation of the home, including a copy of the last inspection report, can be obtained from the manager’s office. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The staff and manager call the people who live at the home by the collective name of ‘residents’, which they, and the people who live there say, is the term they prefer and respond readily to. An unannounced visit to the home was made as part of a key inspection. It started at 11.55, as no one was at home before this time. It lasted until the evening so we could meet all the residents. The manager had completed a questionnaire called the Annual Quality Assurance Assessment (AQAA) giving important information about the service and this was used to contribute to the inspection process. Information from this as well as that which the Commission for Social Care Inspection (CSCI) holds about the service was used to plan the visit and produce this report. The main method of inspection used is called case-tracking. This involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. Residents were able to share their views with us in their unique way directly through the staff team, who were able to ‘translate’, for us so that we were able to understand about the care they received and the facilities provided. Our visit focused on whether key standards and requirements from previous inspections had been met and how the people feel about the service provided. Three residents health, safety and welfare assessments and care plans were checked to ensure they are supported with their dignity, autonomy and choice and that their needs are met. We toured the home and saw each person’s room, and looked at other records. We spoke with all the staff on duty and all five residents, including those being case-tracked. The manager was present for most of this inspection visit. What the service does well: People are supported and have opportunities to be as independent as possible, both in the home and in the community. There is a large range of activities available for them to participate in, as they wish. Staffing levels are flexible to 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 7 provide the support that the residents need to fulfil their wishes and keep active. The residents are provided with as homely an environment as possible taking into account their individual needs. Staff displayed a good knowledge of the needs of the people living in the home. Staff were able to ‘converse’ effectively in different ways according to the needs and communication abilities of the residents. The ongoing training programme ensures that the staffs’ knowledge and skills are regularly updated to provide appropriate care for the residents at all times. There are good systems in place for the organisation to monitor the quality of the service, which includes the involvement of the residents where possible. 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. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 8 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 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 9 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, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The comprehensive assessment process in operation ensures that people’s needs are fully identified prior to their admission and staff have sufficient information available for them to provide appropriate care. EVIDENCE: From the care plans of people we were case-tracking, we saw that they are comprehensive documents that are created from wide-ranging initial assessments. They fully inform the staff of how to care appropriately and sensitively for the people who live at the home. Each care plan is written, where possible, with the help and agreement of the resident or their representative, as confirmed by the care plans of the people we case-tracked. The connection between the risk assessments and the care plan issues and how these should be managed was in place for staff to follow. We discussed with the manager how they could be filed in a simpler form to make them quicker and easier to read and follow. The care plans showed what the residents like and do not like, how people make their own choices or decisions and how they do what they want in their daily lives. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 10 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 excellent. This judgement has been made using available evidence including a visit to this service. The care plans are sufficiently detailed to ensure that staff know how to meet the needs of the residents. They support people in an individualised and respectful way to develop their independence and make choices, whilst minimising the risks. EVIDENCE: The care plans are comprehensive documents that fully inform the staff of how to care appropriately and sensitively for the people who live at the home. Each care plan is written, where possible, with the help and agreement of the resident or their representative, as confirmed by the care plans of the people we case-tracked. Records showed that care plan issues and risk assessments are reviewed regularly and the whole file at six monthly or yearly intervals. Review records 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 11 show that the relevant people are consulted about, and agree to the care plans. The care plans covered all aspects of each resident’s changing personal health, emotional and social needs and behaviour and were specific to people with learning difficulties and/or visual or hearing disabilities. They informed what the person likes and dislikes and showed that they can choose what they want whenever possible. People told us there are enough staff on duty at any time to enable residents to live the life they want to live. The manager has incorporated into the care plans the relevant section of the Mental Capacity Act 2005, in relation to how much ability the residents have to make judgments about the care they wish to receive. This is to ensure that the limited communication and comprehension abilities of the people does not prevent them from ‘having a say’ and having control in their daily lives and activities. We saw, both at the daytime workshop the residents attend, in the community and at home, that people are encouraged to reach their full potential, within a risk-assessed environment. The Society owns its own stables and the residents told and showed us how they enjoy horse-riding. We also saw photographs of them pursuing the riding and other activities and how happy they were doing each activity. Risk assessments cover all their activities so they can be supported in the right way and can take risks within each person’s individual capability. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to be as independent as possible, with a good range of day centre and leisure activities available. They benefit from a wide range of social and communal opportunities. These activities and opportunities enable them to lead full, active and fulfilling lives. EVIDENCE: We saw individual and communal daily programmes, including evenings and weekends, that clearly show how much leisure, social and home management activity is available for and taken up by the residents. All of the people attend a day centre owned and run by the Sense Group. The workshop timetable for each individual is tailored exactly to their needs, abilities and tastes and contain mostly their vocational and social activities. We saw the ones for the people we were case-tracking. They are reviewed six monthly or more often. They are transported with the person each time they 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 13 attend the workshop so that there is good communication between the workshop and care home staff at all times. Records showed that all residents go out on social activities with friends and other people who live at the home. The transport owned by the home is used to assist in these activities. We were told by the manager and staff that family members and friends, where involved, are encouraged to visit the residents. Residents who have no family are made to feel that the staff are their family and are included in social activities with staff members so they do not ‘miss out’ on experiencing family inclusion. People were encouraged to maintain the home’s cleanliness and tidiness by helping with tasks appropriate to their capabilities. Staff assisted them sensitively and with fun. They responded to the residents in a respectful way, and offered gentle reassurances where necessary. We saw that menus are flexible, and are prepared around the people’s activities and preferences. During the visit, a staff member cooked a twocourse homemade dinner, with vegetables and fruit incorporated into the meal, for the residents after their day’s activities. Although most of the people are unable to state their preferences, staff said they know what they like or dislike using records, reviews and care plan information. During our visit people showed that they enjoyed their food by enthusiastically eating all their food. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. Residents receive the personal support they need from the staff and outside healthcare agencies to ensure their health needs are fully met. They are treated with dignity and respect by the staff team and the manager at all times. They are protected by the medication policies and procedures and staff training in place. EVIDENCE: We saw the staff being very supportive of the residents, who responded readily and with smiles on their faces. The rapport between the staff and people was clearly evident during our visit to the home. They provided personal support in a private and dignified way. Everyone has two allocated key workers. The manager and key workers showed how they had put together a health care plan for each person to ensure that their health needs are assessed, met and reviewed on a regular basis. Every visit by or to health care professionals such as their doctor, 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 15 hospital consultants, district nurses, dentists, opticians and chiropodists is recorded in the care plans. Staff demonstrated through discussions and practice that they know the residents’ health needs very well. The care plans are detailed and show staff how to support needs such as challenging behaviour, epilepsy and diabetes. They also include information about emotional needs such as anxiety and things like weight and seizures are monitored. None of the residents are able to handle or independently take their own medicines. We saw certificates and the training matrix, which told us that the staff are trained to handle and give medication safely and receive update training for medication administration regularly. We observed a medication round; the staff gave full instructions and patient assistance to the people who were taking the medicines. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 16 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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected by staff who are well-trained in the comprehensive policies and procedures the organisation has in place relating to raising concerns, complaints and the protection of people. EVIDENCE: Since the last inspection, neither the manager nor we has received any concerns or complaints. During our visit staff told us how they would take action, if needed to keep people safe from harm. They had a wide knowledge of what abuse is and how to protect people. Records showed that they have received training to safeguard the residents and themselves. Any decision to restrict choice or freedom is made by risk assessments undertaken with the full involvement of the person, where possible, and their representative, advocate and any health or social care person involved, and is recorded and explained in their care plans. 25 Horsegate DS0000002655.V370824.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. The people living at the home have a clean, homely, comfortable and safe environment in which to live and thrive. EVIDENCE: On the day of the visit, the home was very clean, tidy and well maintained. Each bedroom is very individualised, matching the person’s needs and unspoken wishes exactly to make them feel ‘at home’, comfortable and safe. In some instances, this has required extensive research and alteration to the rooms. The organisation’s maintenance staff visit whenever they are called by the manager to undertake repairs and to do regular maintenance tasks and decoration tasks. Clear records are kept to show that tests are done in all areas where and as required. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 18 The last Environmental Health Officer’s report stated that everything was in place to keep the environment clean and the residents safe. Since our last visit the manager had the single sink changed for a double sink in the kitchen to provide staff with a separate unit in which to wash their hands when preparing food. 25 Horsegate DS0000002655.V370824.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): 32, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient staff, who are well-trained, supported and supervised, are on duty at any time to ensure that the residents are cared for safely and according to their needs and wishes. EVIDENCE: Staff told us they are a stable workforce, many of whom have worked at the home since or shortly after it opened. They said they work as a close team, get on very well together and are well-supported in their duties. One staff member said, “I love working here – such a lot of satisfaction in my work.” Although they have not had any new staff start work recently, staff demonstrated that new employees would have a thorough induction to prepare them for the work they do and the people they work with. The duty rotas indicated that there was an ample number of staff on duty, taking into account the dependency levels of the residents. 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 20 We looked at the records for three staff members. The records were well organised and complete with all the records necessary. The recruitment records included all the information and details required such as criminal record bureau checks, an application form, two written references, identification and interview records. Staff said they felt well supported in their training programme to care safely for the residents at all times. Their records showed the certificates they have received and the manager maintains a training matrix to see easily when training needs to be updated. Staff also said the manager supports them both formally and in frequent, casual chats during their shifts. Their records confirmed that they have regular formal one-to-one sessions with the manager or a senior staff member. They said that supervision helps them to look at their personal development, and they are able to voice their views and opinions. Records showed that there were regular staff meetings, and minutes showed that they contained varied discussions and items of incidental training to support them in their work. 25 Horsegate DS0000002655.V370824.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, 41, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents and staff, by an enthusiastic provider and manager. Residents feel safe and enjoy living at the home whilst staff are happy with their jobs, are well supported and enjoy coming to work. EVIDENCE: The manager has worked at the home since shortly after its opening. He has achieved the registered manager’s award. He has many years experience of caring for people with learning difficulties. Staff told us that they felt well supported by both the manager and deputy manager and that one of them is always contactable. They told us that the manager has an ‘open door’ and they feel they can talk freely with him. The 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 22 manager said he works in a totally managerial role although he does some shifts to cover staff shortfalls. The organisation has a comprehensive internal quality audit system in place, which includes obtaining, by way of questionnaires, the views of the residents, where possible, relatives, staff and funding and other authorities. The responsible person visits monthly. They comment on the quality of the service and report back to the manager each time, keeping a copy for us to see when necessary. The residents have annual reviews and records indicated relatives and other professionals attend these whenever possible. Organisational policies and procedures are in place relating to health and safety issues and staff said they could refer to these as needed. There are also regular health and safety audits. Clear records are kept to show that electrical equipment is tested, showerheads are changed and that carbon monoxide monitors, fire alarms and water temperatures are checked regularly. 25 Horsegate DS0000002655.V370824.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 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 4 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 4 3 X X 3 X 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 25 Horsegate DS0000002655.V370824.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 25 Horsegate DS0000002655.V370824.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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