Care Home: 48 Holland Road

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What the care home does well The home offers people a thorough assessment prior to admission and ensures that they have ample opportunity to test the home before they move in. The house is homely and people who live there participate in everyday household tasks. People are supported to take risks and to make decisions about their lives and have a range of activities both inside and out of the home in the local community. The home provides a good varied diet and offers people the choice of a range of healthy meals. The Staff are well trained and supervised and the home has a good quality assurance system in place that asks for people`s views on a regular basis. What has improved since the last inspection? The care plans have been further developed and are reviewed on a monthly basis. Health records are now maintained in a way that makes them more readily accessible and easy to track and each person now has a health action plan. The complaints log has been developed and is stored with the complaints policy. What the care home could do better: To ensure the safety of residents the home must be more robust in its recruitment practice and ensure that all staff has a POVA 1st check before starting work at the home and then do not work unsupervised until a satisfactory criminal records bureau check has been obtained. The medication audit should include a tablet counting procedure to ensure that the amount of any medication held is correct. The registered manager should undertake the registered managers award. CARE HOME ADULTS 18-65 48 Holland Road Clacton on Sea Essex CO15 6EL Lead Inspector Pauline Marshall Unannounced Inspection 14th January 2008 08:25 48 Holland Road DS0000067256.V353941.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 48 Holland Road DS0000067256.V353941.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. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 48 Holland Road Address Clacton on Sea Essex CO15 6EL 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) 01255 474934 admin@csacltd.com Creative Support and Consultancy Limited Melanie Purcell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 4 persons) 13th February 2007 Date of last inspection Brief Description of the Service: 48 Holland Road is a large detached house situated in a residential area of Holland-On-Sea, a short distance from Clacton town centre, and the many amenities that the town has to offer. The house has two good-sized lounges, as well as two separate dinning areas, the house also benefits from a small conservatory area. The house has four bedrooms, two of which have en-suite facilities, with the remaining two having washing facilities, in addition there is a separate Jacuzzi bathroom with an adjoining shower room. The outside consists of an established, enclosed garden, which is unoverlooked, and includes an outdoor storage area and patio area; there is a small driveway, which can allow parking for a small number of cars. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with up to date information on the home. Fees are £1956.00 per week and there are additional charges for hairdressing, newspapers, confectionery and toiletries. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection that took place over a four and a half hour period. The process included discussions with the owner, the manager, staff and people who live at the home. A random sample of policies, procedures, safety records, staff and residents’ files were examined and a tour of the premises took place. The owner completed and returned the homes annual quality assurance assessment (AQAA) and this has been used throughout the report. Surveys were sent to people living in the home, their relatives, health and social care professionals associated with the home and staff that work there to obtain their views on the service the home provides. The response was very positive and comments from these surveys have been used throughout the report. All of the key standards were inspected. What the service does well: The home offers people a thorough assessment prior to admission and ensures that they have ample opportunity to test the home before they move in. The house is homely and people who live there participate in everyday household tasks. People are supported to take risks and to make decisions about their lives and have a range of activities both inside and out of the home in the local community. The home provides a good varied diet and offers people the choice of a range of healthy meals. The Staff are well trained and supervised and the home has a good quality assurance system in place that asks for people’s views on a regular basis. 48 Holland Road DS0000067256.V353941.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. 48 Holland Road DS0000067256.V353941.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 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to receive a thorough pre-admission assessment and up to date information on the home prior to their admission. EVIDENCE: The homes Statement of Purpose was reviewed by the manager in September 2007 and includes summaries of the service that the home provides, the admission procedure and the quality assurance process. The Service User guide comes in different formats and includes an easy read version; the two care files examined contained copies of both documents. The two residents’ care files examined contained thorough pre-admission assessments that included a functional analysis of complex behaviours to ensure that the home can meet their needs. The owner states in her annual quality assurance assessment (AQAA) that assessments are carried out by both herself and the manager. Both the manager and the owner said that assessments consist of some thirty hours of observations due to the complex needs of prospective residents. Residents spoken with confirmed that both managers had visited them to carry out assessments on many occasions prior to their admission. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can expect to have a support plan that meets their needs and personal goals. People can expect to be supported to take risks and to make decisions about their lives. EVIDENCE: The management strategy and risk management strategy together form the individual support plan. The owner said that there is a checklist for new staff that contains information on each resident and is used as a supplement to the support plan to ensure that all new staff are aware of the complex needs of the residents and the actions they must take to minimise any risks of incidents occurring. Two care files were examined and each contained an individual support plan that together with the information for new staff checklist, provided staff with sufficient information on the level of care required. Staff spoken with confirmed that they used the checklist for all new staff and that they had fully 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 10 read each residents support plan during their induction period. Health and social care professionals’ surveys stated that “the home is excellent in recognising a need and staff have the skills to put programmes into practice” and “the home uses an individual approach to improve residents quality of life”. Each of the care files examined contained a communication passport; the owner said that staff are in the process of preparing communication passports for other residents. The owner states in her annual quality assurance assessment that inclusive communication training is being planned for all residents and staff and confirmed that she had written to the Local Authority requesting this training and is awaiting their response. Residents spoken with said how they were able to choose what they wanted to do, where they wanted to go and when to get up and go to bed. One health and social care professionals’ survey states “each person in the home lives their lives individually and make choices where they are able to and are supported by staff to be involved fully”. The risk management strategies clearly identified any risks and included detailed plans on how to minimise them. Health and social care professionals and staff surveys evidenced that residents are provided with person centred support and that the home continually strives to expand community integration encouraging as independent a lifestyle as possible. Staff spoken with and surveyed were aware of the individual support plans and management strategies and how to use them. One resident spoken with described their training in the use of a bike and showed me their training folder, which contained evidence of their competence to ride the bike. 48 Holland Road DS0000067256.V353941.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, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to participate in appropriate activities both in the home and out in the local community and they can expect their rights to be respected in all aspects of their daily lives. People living in the home can expect to be provided with a healthy and nutritious diet. EVIDENCE: Two care files were examined and they contained evidence that residents regularly participate in various activities including college, pubs, walks, local clubs and meals out. Residents spoken with and surveyed said how much they enjoyed the range of activities and felt that they had plenty to do. The owner states in the annual quality assurance assessment that referrals have been made to employment agencies and one resident told me how they worked at an agency in the office and how much they enjoyed it. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 12 Residents spoken with said that they had regular visits from their family and friends and that the staff encourages them to maintain their friendships with others. There was evidence that regular residents meetings take place and that residents are fully involved in all aspects of running the home. Health and social care professionals’ surveys state “each person in the home live their lives individually and make choices and everything is centred on the resident”. Residents spoken with said that they had meetings with the staff and talked about what they wanted to do and eat. The manager said that although the home operates a three weekly rotational menu, which is in a pictorial format, residents often choose to vary this. Residents confirmed that they were able to choose what they wanted to eat from the varied and nutritious menu. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect that their physical, emotional, health and personal care needs will be met in a way that they prefer. People can be sure that medication is managed effectively. EVIDENCE: Two care files were examined and the daily notes included evidence that residents receive their personal support in a way that they prefer. Residents spoken with said that staff helps them to do what they want to do and health and social care surveys state “residents needs are complex and this service has worked to protect the dignity of all concerned and all of my dealings with Holland Road have been extremely positive”. Each of the care files examined contained full details of healthcare appointments and their outcomes and a health action plan. Health and social care professionals’ surveys state “the home is proactive in seeking reviews with consultants to ensure medication is appropriate for residents needs”. The owner states in her annual quality assurance assessment that the home identified two different residents health care needs that were not identified in 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 14 the patient hospital settings. As a result of this the two residents are now receiving treatment, which has improved their quality of, live. Staff spoken with and surveyed said that training is arranged in specific subjects to meet residents’ health care needs. The manager uses a monitored dosage system for most of the medication, however some cannot be packed in this way so it is stored in its original boxes or containers and kept in a locked cupboard off of the dining room. Two medication administration sheets (MARS) and the corresponding medication were checked and there was two occasions where it appeared that medication had been administered but not signed for. The manager said that she intended to investigate this with the staff concerned. Two of the boxed medications were counted and checked against the records, there was more medication than stated on either the medication administration record or the boxes. The owner states in her annual quality assurance assessment that a monthly medication audit is carried out; the manager said that the monthly audit does not include a tablet count but will do so in future. All staff has had medication training and staff spoken with was aware of the homes procedure. The risk management plans include details of the signs that staff should look out for when residents may need as and when required (PRN) medication. The owner and manager said that all staff is aware of this and that they know when PRN medication is needed. Staff spoken with confirmed that they are fully conversant with the risk assessment and the manager said that a copy of the protocols would be kept in with the medication administration record sheets to ensure that staff had the information to hand whilst administering. 48 Holland Road DS0000067256.V353941.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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to have their complaints acted upon and to be protected from harm and abuse. EVIDENCE: The complaints policy was reviewed in December 2007 and includes clear information on how to complain. The manager keeps a log of all complaints and compliments in the homes policy and procedure folder. All of the residents care files examined contained a copy of the complaints procedure in a pictorial and written format. Residents and staff spoken with were fully aware of the complaints procedure and how to use it. The manager reviewed the home’s abuse policy in December 2007 and it contains full details of the categories of abuse and includes a flowchart and staff guidance. The procedure also includes a copy of the Local Authority referral form. Staff spoken with had a good knowledge of the procedure and all staff has received training. There has been one adult safeguarding referral since the last inspection and discussions with the manager and owner and an examination of the records indicate that it has been dealt with appropriately. The owner states in her annual quality assurance assessment that the home promotes its whistle-blowing policy; discussions with the staff and the manager confirmed that the policy is highlighted through the induction process and then again in supervision meetings. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 16 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. People can expect to live in a homely, comfortable, safe and clean environment. EVIDENCE: The home has four bedrooms, two are en-suite and one has a bathroom adjacent to it, the other has washing facilities. There are two good-sized lounges, a conservatory and two dining areas. All of the furniture and fittings were of good quality and the home had a homely feel to it. The laundry room is sited upstairs and it is equipped appropriately with a domestic washing machine and tumble dryer and it has hand-washing facilities. The owner said that the call alarm system comprises of intercoms and monitors in rooms and that each have its own risk assessment and agreement from the individual resident. The owner states in her annual quality assurance assessment that several rooms have been redecorated and that the Occupational Therapist (OT) has approved any aids and adaptations. The 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 17 owner confirmed that there have been new carpets fitted to the hall, stairs and landing and that some new furniture has been purchased. Support staff is responsible with residents to keep the home clean and on the day of the inspection the home was nice, clean and hygienic and was a pleasant environment to be in. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. People living in the home can expect to be supported by well-trained and supervised staff. Shortfalls in the home’s recruitment practice can potentially affect outcomes for residents. EVIDENCE: The home’s owner and manager are both qualified 1st level nurses and between them have many years experience supporting people with learning disabilities, mental health needs and challenging behaviour. Ten support staff are employed three of which have achieved NVQ level 3; all other staff are currently working towards the award. Staff spoken with and surveyed said they felt that the training provided by the home equipped them with further knowledge and skills and that it helped them to feel more confident in their work. Three staff files were examined and shortfalls were found in two of them. Two staff files contained only one written reference and no evidence of induction having taken place. One of the staff files examined had no evidence of a criminal records bureau check and another had a criminal records bureau 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 19 check from a previous employer; neither of the files contained a completed POVA 1st check. The owner said that all staff have an induction period of at least two weeks where they do not work unsupervised. There is a new/bank staff checklist that all staff is given on their first day at the home and they are asked to sign and date it when read. The three staff files examined contained evidence of staff training and included certificates for epilepsy awareness, medication administration, moving and handling, health and safety, fire awareness, food hygiene and challenging behaviour. Staff spoken with and surveyed stated how good the training is at Holland Road and also that courses are set up quickly to enable them to prepare for any changes in residents care. Staff spoken with and surveyed said that although they have regular monthly supervision sessions with the manager they are also able to access both the owner and manager on a daily basis for guidance and support. The owner states in her annual quality assurance assessment that the management set the standard and role model as part of ongoing support for the staff team. The staff files examined contained evidence of regular supervision having taken place. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to live in a well run home where their health, safety and welfare is protected. The home has an effective quality assurance system in place. EVIDENCE: The owner and the registered manager have many years experience in supporting people with learning disabilities and between them provide on-call support to the home twenty-four hours a day. The owner states in her annual quality assurance assessment that the registered manager has twelve years experience in managing services and has a learning disability nursing qualification at master’s level. Both the owner and the registered manager intend to undertake the registered managers award after discussion with their NVQ provider to establish the relevant units that they will be required to do. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 21 The owner returned her annual quality assurance assessment by the due date and included all of the required information. The homes quality monitoring process includes a day-to-day organisational audit, a sickness and attendance audit, a medication audit and a petty cash audit. Staff and residents are asked to complete questionnaires as part of the quality monitoring system and a report together with an outcome and action sheet is prepared detailing any necessary actions. The manager and owner have recently reviewed the homes policies and procedures. The owner and manager have carried out a fire risk assessment that was reviewed on 14/01/08 and all fire safety equipment is regularly checked. All staff has received fire awareness training. Staff and residents were aware of the homes fire procedures. The gas safety check was due to be carried out in June 2007; the owner arranged for this to be done immediately and the work was carried out the next day on 15/01/08; a copy of the certificate confirming this has been received. There was no evidence of small electrical items having been tested for safety. The manager said that all small appliances were new when the home opened so there were guarantees in force until recently. The owner confirmed that her electrical contractor tested all portable appliances for safety on 16/01/08. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 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 2 X 3 X 3 X X 3 X 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 23 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. 1. Standard YA34 Regulation 19 (a) (b) (i) Schedule 2 Requirement Robust recruitment practices need to be in place in order to protect residents. The manager must obtain a POVA 1st check before staff starts work. Any staff employed before the manager has received a satisfactory criminal records bureau check must not work unsupervised. Timescale for action 01/03/08 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. Refer to Standard YA20 YA37 Good Practice Recommendations It is recommended that a tablet counting procedure be incorporated into all medication audits. It is recommended the manager undertakes the registered managers award. 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region 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 48 Holland Road DS0000067256.V353941.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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