Care Home: The Tulips II

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What the care home does well Good information is available to people about the home. The needs of people using the service are fully assessed to make sure that they can be met. People have care plans that give good information about their support needs. People are able to take part in activities and be part of the local community. People live in a clean, comfortable and homely environment. The staff team have good training opportunities. The homes recruitment process is good with systems to make sure that appropriate checks are made. Some people living at the home told us "I like living here it`s a nice home" and "I like the staff, they help me when I need it". A member of staff told us "I feel well supported", "I am listened to and able to exchange ideas with the registered provider and other staff" and "the home has a good team that works effectively with the residents". A care coordinator told us "staff are always welcoming and informative" and "that there is always a homely atmosphere". What has improved since the last inspection? N/A CARE HOME ADULTS 18-65 The Tulips II 375 Hither Green Lane Hither Green London SE13 6TR Lead Inspector James O`Hara Key Unannounced Inspection 19th May 2008 10:50 The Tulips II DS0000071112.V363341.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 The Tulips II DS0000071112.V363341.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. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Tulips II Address 375 Hither Green Lane Hither Green London SE13 6TR 020 3121 0005 020 3121 0005 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) Navlette Ommouy McFarlane Joyce Brako-Amoafo Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Female whose primary care needs on admission to the home are within the following category: 2. Mental Disorder, excluding Learning Disability or Dementia - Code MD The maximum number of service users who can be accommodated is: 4 N/A. Date of last inspection Brief Description of the Service: The home is registered to support women with mental health conditions. There are currently four women living at the home. The home is located in a residential street close to good public transport routes and shopping facilities. The home is decorated and furnished to a high standard. The current fee for staying at the home is £850 per week. The Tulips II DS0000071112.V363341.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 star. This means the people who use this service experience good quality outcomes. This key site visit was carried out between 10.50 am 1.40pm on a Monday morning/afternoon. This was the first key inspection carried out at the home. Documents examined during the inspection included the homes Statement of Purpose, care plans, staffing records, training records, health and safety records and the homes policy and procedures. Methods of inspection included interviews with a number of people living at the home, a member of staff, a visiting care coordinator and psychologist and the registered provider. What the service does well: What has improved since the last inspection? N/A The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 6 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. The Tulips II DS0000071112.V363341.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 The Tulips II DS0000071112.V363341.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 and 5. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available to people about the home. The needs of people using the service are fully assessed to make sure that they can be met. EVIDENCE: The registered provider produced the homes Statement of Purpose & Service Users Guide. The Statement of Purpose included most of the details as required in Schedule 1 of the Care Home Regulations however the registered provider told us that the document was currently under review. The registered provider was advised to complete each section in the Statement of Purpose in the order laid out in the Schedule. The Statement of Purpose included the homes admission procedure. The registered provider told us that four women moved into the home over a period between February and March 2008. The women moved in from a long stay hospital. There was evidence that the women visited the home before moving in and that care co-ordinators, health care professionals, relatives and friends were involved in the process. The home carried out is own comprehensive pre admissions procedures before people moved into the home. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 9 Residents have contracts detailing what they should expect from the home and how much they have agreed to pay. The registered provider told us that the current fee for staying at the home is £850 per week however the contract stated that people would pay between £600 and £1000 per week. Residents have signed and agreed the contract. It is recommended that the contracts be amended to the exact fee that people pay for their care and that people sign and agree the contract. The Tulips II DS0000071112.V363341.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 and 9. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have care plans that give good information about their support needs. Risk assessments are completed to help people live as independently as they can however risk assessments relating residents storing medication in their own bedrooms need to be reviewed. EVIDENCE: People have care plans and input from care managers. Two people’s personal files were examined. Both had comprehensive pre admissions assessments carried out before they moved into the home. The assessments included information on psychological, physical, lifestyle, dietary, personal care, social, activity, education, employment, diversity and daily living needs. The files examined also included feedback from health care professionals, the occupational therapist and the community opportunity service. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 11 Care plans had been drawn from the pre admission assessments and Care Programme Approach reports. The care plans included the individuals needs, goals, necessary steps to achieve the goals, time scales and review dates, both care plans had been kept under regular review. The registered provider produced weekly and six monthly progress reports, these indicated the progress made by individuals, concerns, recommendations and the steps needed to further progress. One person had a review on the 29/04/08; the individual, the care co-ordinator, the registered provider and a consultant attended this. The registered provider told us that the residents are settling in and that the home is learning more about their needs and preferences as time goes by. She told us that the home would like to move towards a more person centred approach so that people can have more say about what happens to them and what happens in the home. The registered provider told us that the home is trying to cater for the diverse needs of the residents. Staff and residents have had discussions in relation to diet, religion, spiritual needs and sexuality and the staff team plan to support the residents to meet these needs and preferences in the future. Files also included individual and general risk assessments. The risk assessments include the risk factor, triggers, measures to minimise the risk, level of risk and review dates however risk assessments relating to residents storing medication in their own bedrooms need to be reviewed. (See Standard 20) The Tulips II DS0000071112.V363341.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): 11, 12, 13, 14, 15, 16 and 17. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to take part in activities and be part of the local community. EVIDENCE: Residents are encouraged to access the community independently and it was observed that all had ventured out of the home to the local shops or to health care appointments during the time of the inspection. The registered provider told us that the home is working with individuals to develop social activities that they would like to do. Some people prefer to stay at home and take part in domestic activities and other prefer to go out. There is an in house film club when people choose films they like to watch and some people like to play scrabble. The registered provider told us that some people The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 13 like going to the theatre and pubs. Some people go out with their friends and family during the week and one person likes to go swimming with staff. Residents have close friends or relatives and either go out with them, visit or be visited by them or keep in contact by phone and letters. The registered provider told us that staff at the home is supporting one resident to build a firmer relationship with her family. Residents have a choice of meals; one person was observed supporting a member of staff to cook lunch. The registered provider told us that the home employs a four weekly rolling menu, if people do not wish to eat what is on the menu they can choose something else and a record is kept in the menu folder. One person is vegetarian and has her own menu. The Tulips II DS0000071112.V363341.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 and 20. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care needs of the residents are addressed and they have access to appropriate healthcare professional however risk assessments relating residents storing medication in their own bedrooms need to be reviewed. EVIDENCE: The home carried out is own pre admissions procedure before people moved into the home. The assessment included information on individual psychological, physical, dietary, personal care and daily living needs. There was evidence that care co-ordinators, and health care professionals were involved in the process. All of the residents have a health action plan that includes details of health care needs and how the home meets these needs. There were guidelines in place for how residents prefer to be supported by staff with personal care including bathing, showering and washing. The registered provider produced The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 15 an emergency plan for one resident, this was for signs of a relapse in mental health and included what to look for and who to contact in an emergency. The registered provider told us that all of the residents are registered with a local General Practitioner. There was evidence that all of the residents had visited General Practitioners, dentists, opticians and chiropodists were appropriate. On the day of the inspection one resident was supported by staff to attend an appointment at a clinic. A care coordinator and a psychologist were visiting one of the residents; the care coordinator told us that she visits the home every two weeks to see her client. She said that the home is meeting her client’s needs and there has been some improvement in her client’s mental health. She told us that the staff are always welcoming and informative and that there was a homely atmosphere. The care coordinator felt that the paperwork could be improved upon but that the service was still developing. Medication is stored in locked cabinets in resident’s bedrooms. None of the residents self medicate. The registered provider told us that this was an area were independence could be promoted and that further assessments would take place once they got to know the residents better and when the residents were more settled. Risk assessments are in place for individual residents mental health conditions, the risk assessments include suicidal tendencies. One residents risk assessment indicated there was a medium risk of suicide. A requirement is therefore set that medication is removed from residents bedrooms and placed in a secure location until full risk assessments are carried out. Risk assessments must be completed on individual residents storing their own medication in their bedrooms. It was noted that one of the cabinets was not locked during the inspection. The resident had gone out just after receiving her medication and staff had mistakenly left it unlocked. Medication administration records were examined for all of the residents. There was one occasion when medication had been administered but not signed for by staff. The registered provider told us that all members of staff were due to attend training on medication and administering on the 24th of May. It is recommended that during the medication training that the registered provider raise the issue of leaving medication cupboard doors unlocked and the importance of making sure that medication administration records are properly completed. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 16 The registered provider told us that advice was readily available from the supplying pharmacist and that the pharmacist had agreed to do periodic medication audits for the home. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has appropriate complaints and adult protection procedures however these need to be updated. EVIDENCE: The registered provider produced the homes complaints procedure. The procedure explained how to make a compliant but did not include the telephone number of the Commission for Social Care Inspection. It is recommended that the complaints procedure be amended to include the telephone number of the Commission for Social Care Inspection. The registered provider produced the homes policies and procedures on the Protection of Vulnerable Adults. She told us that the homes policies and procedures had been drawn from and run along side Lewisham Social Services policies and procedures for the Protection of Vulnerable Adults. The telephone number for the safeguarding adults team had not been included. It is recommended that the telephone number of Lewisham Social Services safeguarding adults team be included in the homes policies and procedures on the Protection of Vulnerable Adults. The registered provider produced evidence that all members of staff had recently attended training on adult protection. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 18 The Commission had received one compliant about the home however this was an employment issue and not related in any way about care practices at the home. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable and homely environment. People are encouraged to personalise their rooms. EVIDENCE: The home is located in a residential street close to good public transport routes and shopping facilities. The home is decorated and furnished to a high standard. Resident’s bedroom’s observed were spacious clean and reflected the individual’s own personalities. Bedroom 2 on the first floor measures just fewer than 10 square metres. The registered provider was informed when registering the home that this room should only be used for placements of less than 6 months. The registered The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 20 provider told us that there were plans for person currently living in this room to move on. There is a lounge with dining area. In addition there is also a small sitting room to the rear of the house, residents told us that they could use this as a smoking room during cold weather. The kitchen is well equipped and has a dining table that offers residents a choice of where they wish to eat. There are sufficient toilet and bathing facilities. There is a separate utility room, which is satisfactorily equipped. There is a well-maintained garden to the rear of the home with good quality furniture, residents were observed enjoying the garden on the day of the inspection. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 21 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 and 36. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team have good training opportunities. The recruitment process is good with systems to make sure that appropriate checks are made. Staff supervision sessions need to take place more often. EVIDENCE: There is currently six staff employed at the home. One member of staff holds an NVQ level 3 and another member of staff holds an NVQ level 2. The registered provider told us that two members of staff are completing NVQ level 2 and one member of staff is starting NVQ level 4. The deputy manager is a Registered Mental Nurse. Staff training records indicated that all staff had completed a comprehensive induction programme and most had received training on mental health, moving and handling, food hygiene, fire safety, health and safety, adult protection and were due to attend training on medication. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 22 Staff personnel files were examined, all members of staff had Criminal Record Checks, copies of passports, completed application forms, interview questions, job descriptions, two written references, confidentiality statements and contracts. It is recommended that all staff files include a recent photograph and a statement from staff as to their physical and mental health. The registered provider produced evidence that staff had formal supervision once since the home opened. It is recommended that all members of staff receive formal supervision at least six times per year. The registered provider told us that all staff would receive an annual appraisal once the home had settled down and new staff had been there for a year. One member of staff told us that she felt very well supported by the registered provider. She told us that she had formal supervision and lots of informal supervision with the registered provider, she felt that she was listened to and able to exchange ideas with the registered provider and other staff, she felt that the home had a good team that worked effectively with the residents. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall impression when visiting the home is that it is well organised and people are offered opportunities to take part in appropriate activities both in and out of the home. EVIDENCE: The previous registered manager is no longer employed at the home. The registered provider told us that the deputy manager is currently acting as the home manager until a new manager is appointed and registered with the Commission to run the home. It is recommended that the registered provider inform the Commission when a new manager is appointed to run the home. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 24 The registered provider produced the homes quality monitoring system, this consisted of six monthly reviews on issues such as customer satisfaction, person centred planning, risk taking, health and safety, medication, resident’s life styles and choices, promoting resident’s health and welfare, staff training and maintenance. The registered provider also produced satisfaction questionnaires completed by residents, staff and visitors to the home including relatives and health care professional and other interested parties. Some people living at the home told us “I like living here it’s a nice home” and “I like the staff, they help me when I need it”. The registered provider produced certificates confirming electrical wiring, portable appliance testing and gas safety checks had been carried out. The registered provider produced a copy of the homes fire risk assessment, she told us that had been seen and agreed with the fire officer. The registered provider told us that there was a fault with the homes fire alarm system and that an engineer was due to visit the home on the day of the inspection to fix it. The registered provider told us that she had contacted the local environmental health department to arrange a visit to the home and a date had yet to be arranged. It is recommended that the registered provider inform the Commission when the environmental health officer visits the home. The registered provider told us that she had yet to arrange for legionellas testing to be carried out at the home. It is recommended that the registered provider arrange for legionellas testing to be carried out at the home and informs the Commission when this has been done. The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 25 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 3 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 3 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 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 26 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 (4) c Requirement A requirement is set that medication is removed from resident’s bedrooms and placed in a secure location until full risk assessments are carried out. Timescale for action 31/05/08 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 YA5 YA20 Good Practice Recommendations It is recommended that resident’s contracts be amended to the exact fee that people pay for their care and that they sign and agree the contract. It is recommended that during the medication training that the registered provider raise the issue of leaving medication cupboard doors unlocked and the importance of making sure that medication administration records are properly completed. It is recommended that the complaints procedure be amended to include the telephone number of the Commission for Social Care Inspection. It is recommended that the telephone number of Lewisham Social Services safeguarding adults team be included in the homes policies and procedures on the DS0000071112.V363341.R01.S.doc Version 5.2 Page 27 3. 4. YA22 YA23 The Tulips II 5. 6. 7. 8. YA34 YA36 YA37 YA42 Protection of Vulnerable Adults. It is recommended that all staff files include a recent photograph and a statement from staff as to their physical and mental health. It is recommended that all members of staff receive formal supervision at least six times per year. It is recommended that the registered provider inform the Commission when a new manager is appointed to run the home. It is recommended that the registered provider inform the Commission when the environmental health officer visits the home. It is recommended that the registered provider arrange for legionellas testing to be carried out at the home and informs the Commission when this has been done. 9. YA42 The Tulips II DS0000071112.V363341.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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