Inspection on 24/11/06 for 1 Wharf Close

This inspection was carried out on 24th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Wharf Close 23/09/08

1 Wharf Close 04/10/07

1 Wharf Close 02/03/06

1 Wharf Close 15/11/05

1 Wharf Close 16/02/05

1 Wharf Close 25/10/04

1 Wharf Close 26/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Wharf Close (1) 1 Wharf Close Goldingham Farm Estate Stanford Le Hope Essex SS17 0EJ Lead Inspector Sarah Buckle Unannounced Inspection 24 November 2006 10:00 Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wharf Close (1) Address 1 Wharf Close Goldingham Farm Estate Stanford Le Hope Essex SS17 0EJ 01375 360789 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) Mosaic Essex Manager post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd March 2006 Brief Description of the Service: Wharf Close provides personal care and accommodation for four adults with a learning disability. The homes’ facilities include one large living/dining area, four single bedrooms and one bathroom. The home is situated in a quiet cul-de-sac in a residential area close to the town centre of Stanford-le-Hope. There is a pleasant garden to the rear of the property and adequate car parking facilities. Public transport runs close by the home and all amenities are in close proximity. Service users within the home are encouraged to access leisure pursuits and community facilities. The home has its own vehicle available for use by the residents. Family Mosaic (formerly New Essex Housing Association and Mosaic Homes) manages the home. The current scale of weekly charges for residents is between £1050.00 and £1116.10. Additional charges are made for aromatherapy, chiropody, hairdressing, toiletries, personal clothing, activities and for the lease vehicle. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced key inspection. Information was the home in the form of a pre-inspection questionnaire, which was the Commission in June 2006. Surveys were sent to the residents home and one of these was completed and returned. Two relative cards were also completed. provided by received by within the comment Sarah Buckle undertook a site visit at the premises on 24th November 2006. Richard Bird, a legal adviser accompanied the inspector for the purposes of his own professional development. A tour of the premises was carried out; one staff member was spoken with, as was the newly appointed manager. Residents were observed within the home, a mealtime was also observed and relevant records, documents and certificates were examined. What the service does well: What has improved since the last inspection? A manager has been appointed at Wharf Close; however, this information has not been put in writing and forwarded to the Commission as required by regulation. The home has been refurbished in many areas. The lounge has been newly carpeted, two new sofas have been purchased and the walls have been decorated. This has improved the environment and given it a more homely atmosphere. A rotten window frame has been repaired and bedrooms have been painted, with new bed linen, furniture, carpets and curtains purchased. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 6 Staff recruitment files were available for 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. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Not inspected. EVIDENCE: No residents have been admitted to the home since the last inspection. A new ‘statement of purpose’ and ‘service user guide’ have been devised and this has been forwarded to the Commission. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The changing needs of residents are adequately reflected in their care plans. Residents are encouraged to make decisions about their lives. Residents are supported to take risks and risk assessments are in the main part, thorough. EVIDENCE: One care plan was sampled during the course of the inspection. This contained detailed information in relation to the specific abilities and support needs of the individual. For example in relation to their personal care needs, one plan regarding bathing stated, “(The resident) can add (their) own bubble bath. (The resident) likes to have two flannels”. Independence was clearly encouraged i.e. a support plan regarding hair washing stated “Staff to wet (the resident’s) hair. Staff to apply shampoo. Ask (the resident) to rub the shampoo in (their) hair. If (they) refuse… repeat request. Staff to assist if (they) continue to refuse”. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 10 A support plan in relation to challenging behaviour demonstrated clear awareness of triggers and interventions to be used. Within the occupations and leisure section of the plan there were areas that needed to be updated regarding attendance at day care facilities that have now closed. However, it was positive to note that health care needs were clearly documented and there was evidence of the resident’s involvement in tasks around the home. Residents within Wharf Close are encouraged to make decisions about their lives. Residents meetings are held on a regular basis and record decisions about choice of menus. One resident had images and makaton symbols on a board in his bedroom to facilitate communication. These included images of place they liked to visit and encouraged choices. During the course of the inspection one member of staff was observed asking each individual resident what they would like for lunch and offering a selection of food to choose from. Risk assessments were contained within the care plan sampled and in the main part these were thorough. However, one resident did not have window restrictors on an upstairs window. A staff member spoken with stated that this was because they like to have the window open wide and look out of it. There was no risk assessment in place in relation to the risk impact on the residents within the home. The care plan and risk assessments examined were reviewed regularly. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Residents within Wharf Close are able to take part in appropriate activities, however, since the closure of day services this must be developed further. Residents are able to access the local community, however, this is reliant on there being enough staff on duty to enable this. Family links are encouraged at Wharf Close. The rights and responsibilities of residents are adequately recognised and the menu offers a balanced diet. EVIDENCE: The residents at Wharf Close are no longer able to access day care facilities as these have all recently been closed. The acting manager within the home stated that all of the college courses that she looked at for the residents were full up, however, she did state that she would be trying to find people places on appropriate courses in the future. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 12 The residents within the home do have the opportunity to take part in activities within the home, these include house keeping tasks, weekly food shopping, putting away their laundry etc. The acting manager stated that the staff within the home do undertake activities with the residents such as painting, drawing and keep fit. She also said that other homes are invited to come and take part in these activities. The residents are able to access the local community, however, this is mainly as a group rather than one to one. The acting manager stated that residents visit the cinema, go to Southend by train, visit the library and go shopping for clothes. Community access was documented within the care plan examined during the inspection. One relative comment card received by the Commission stated that since the closure of services such as Benton’s Farm, residents tend to stay in the house most of the time, unless staff members are able to take them out. The relative expressed concern that there was not enough stimulation for the residents. Residents at Wharf Close are encouraged to have close family links and friendships. One resident was going to her family home for the weekend. All of the residents go to a Monday Club each week where they meet up with residents from other homes. Menus were examined during the inspection and one meal was observed. The residents were able to make choices about what to have for their lunch. The menus demonstrated that the diet was both balanced and varied. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive personal care in the way they prefer. The physical and emotional health care needs of residents are adequately met. Medication is in the main part well managed, however some areas require improvement. EVIDENCE: The care plan sampled demonstrated that residents received support in their preferred manner. There was evidence of comprehensive procedures in place to assess and address the physical and emotional healthcare needs of residents. A GP monitoring form was examined for one resident and this documented all GP visits and the reasons for the visits. There were monthly weight checks in place and records of other professional input, such as opticians and continence advisors. These had outcomes recorded. An antecedent behaviour chart was also contained within the care plan sampled, which detailed incidents of challenging behaviour, including what happened directly before the incident, what the behaviours were and what the consequence of this was. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 14 Medication was examined as part of the inspection. In the main part this was well managed, however there were a number of omissions i.e. Metornidazole 400mg was not signed as given on 19/11/06 at 21:00; on 21/11/06 at 17:00 and 21:00; on 22/11/06 at 17:00 and 21:00; on 23/11/06 at 17:00 and 21:00 and on 24/11/06 at 08:00. Handwritten medication profiles were not countersigned and the information provided on them was not always clear i.e. a homely remedy of evening primrose oil was recorded as “500mg 250 x 2” a second stated “520mg x 2” and a third stated “capsules x 2 500mg”. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s views are adequately listened to and acted upon. Residents are protected from potential harm and abuse. EVIDENCE: There have been no complaints since the last inspection, however there was one compliment. There were minutes available of regular residents meetings. One staff member spoken with had clear understanding of the procedure to be implemented if they suspected an incident of adult abuse. The accident and incident book was recorded appropriately and these were cross-referenced to the care plan for further information. The training file was examined and seven staff members had completed POVA training in 2005. Two staff recruitment files were examined and these had evidence of POVA training, however, one had completed the training in 2004 and is therefore due to undertake updated training in this area. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The environment is in the main part safe and comfortable for the residents, however, there are some outstanding maintenance issues. The home is, in the main part, clean and hygienic. EVIDENCE: A tour of the premises was undertaken and it was positive to note that there had been a lot of refurbishment within the home. A new carpet had been laid in the living room, which had also been redecorated and had two new sofas. All of the resident’s bedrooms were observed and these were personalised, with residents choosing their colour scheme and bedding. All of the rooms had been redecorated and had new carpet. New curtains, bedding and furniture had been selected and was either in place or had been ordered. However, there were still outstanding maintenance issues within the home. The kitchen is in need of modernisation, one drawer was broken and the cooker had a part missing. Radiators were not covered, and these had sharp edges. One resident has epilepsy and this is a serious health and safety issue. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 17 The bathroom was unappealing. The floor is worn, the rug was dirty and stained, the toilet was dirty and there was a mop in a bucket and an old blind rolled up in one corner. The staff sleep-in room does not have adequate facilities for washing. There is a sink basin within the room; however, there is nowhere for the staff on duty to shower. The home was clean and tidy on the day of the site visit, except the toilet/bathroom on the first floor. There were no apparent odours. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff recruitment procedures are not robust and there is no clear system in place for recording or storing recruitment information. Mandatory training is adequate, however, this needs to be updated. EVIDENCE: There are currently six staff members within the home including the acting manager. Staff recruitment files were examined. These were disorganised and there was no clear procedure in place for recording information. Two staff files were examined in depth and both of these contained most of the required information. However, neither contained proof of identity, a start date, a current photograph or a date for their CRB disclosure. Family Mosaic have an agreement with the Commission that they will keep CRB Disclosures, records of disciplinary action and references at their central HR office. Each employee will have a pro forma in their staff file at the home, completed by HR detailing all of this information along with all other records. However, although two pro forma’s were examined, neither of these had been completed appropriately. The person concerned had completed the employee information, but HR had completed none of the other information. CRB Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 19 disclosures and references were still contained within some staff files, however this was not consistent. Some staff files contained most of the required information and some contained no information at all. There was no recruitment information available at all for the most recently appointed employee. Two staff training files were examined and although it was positive to note that mandatory training had been completed one staff member had completed this in 2004 and therefore required updates. One staff member had completed medication training in 2006. This was Boots MDS training. All of the staff members that administer medication need to have appropriate medication training. The MDS (monitored dosage system) training is concerned with showing staff how to administer according to the specific system, it is not a safe handling of medication course. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Wharf Close is a well run home. Quality assurance is addressed at corporate level. Health and safety is well managed. EVIDENCE: A new manager has recently been appointed at Wharf Close. She stated that she has registered to undertake the NVQ4, which should start in January. The Commission have not yet received an application for registration as manager. The manager has been acting into the role for a number of months and it is positive to note that improvements have been made within the home during this period of time. Family Mosaic manages quality assurance within the home. This is completed at a corporate level. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 21 Health and safety is well managed within the home. Staff do receive mandatory training, however, this does need to be updated regularly. A number of records and certificates were examined during the inspection and these demonstrated that water temperatures are tested on a weekly basis, there are weekly fire drills, and the emergency lighting is tested, as are the means of escape. The gas safety certificate was seen, as was the Legionella risk assessment. These were both in date. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 X 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 2 13 2 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 Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA12 Regulation 16(2)(n) Requirement The registered person must ensure that arrangements are made for the provision of facilities for recreation, including training. This is in relation to day services closing and residents requiring replacement meaningful occupations, such as appropriate college courses. The registered person must ensure that arrangements are made for residents to engage in local, social and community activities. This is in relation to day services being closed down and concern being expressed about a lack of stimulation in the daily lives of residents. It is also in relation to staff not being available to take residents out on a one to one basis. The registered person must ensure that arrangements are made for the safe recording, DS0000018081.V291992.R01.S.doc Timescale for action 01/03/07 2. YA13 16(2)(m) 01/03/07 3. YA20 13(2) 01/02/07 Wharf Close (1) Version 5.1 Page 24 handling, administration and disposal of medication within the home. This is in relation to handwritten medication profiles, which provide conflicting and unclear information and in relation to omissions of signatures on MAR sheets. The safety of medication practice was a requirement on the last inspection report. 3. YA24 23(2)(b)(d) The registered person must ensure that the premises are kept in good repair internally and externally and that all parts of the home are reasonably decorated. This is in relation to the kitchen needing modernisation and a new cooker, to radiators that are uncovered, to the upstairs bathroom, which has stained and worn flooring and to lack of adequate facilities for sleep in staff members. This is a repeat requirement, which has been partially met since the last inspection. The outstanding issues must be addressed as a matter of urgency. The registered person must 01/02/07 not employ a person to work at the care home unless they obtain all of the information and documents specified in paragraphs 1 – 9 of Schedule 2. DS0000018081.V291992.R01.S.doc Version 5.1 Page 25 01/02/07 4. YA34 19(1)(b) Sch 2 Wharf Close (1) 5. YA35 18(1)(c)(i)(ii) This is in relation to the staff recruitment files within the home not demonstrating a robust procedure. One staff member had no documentation available, others had some but not all, and pro-forma’s, which should have been completed by HR, had not been. The registered person must ensure that all staff receive training appropriate to the work they are to perform and suitable assistance to obtain further qualifications. This is in relation to mandatory training needing to be updated and to specialist training not being adequately provided. 01/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA37 YA37 Good Practice Recommendations The appointed manager must ensure that her application for registration as manager is completed and sent to the Commission. Family Mosaic must ensure that they inform the Commission in writing of the appointment of a manager at Wharf Close. Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wharf Close (1) DS0000018081.V291992.R01.S.doc Version 5.1 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!