Inspection on 21/04/05 for 11 Allenby Road

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

11 Allenby Road 31/05/07

11 Allenby Road 12/09/05

11 Allenby Road 26/10/04

11 Allenby Road 08/06/04

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

CARE HOME ADULTS 18-65 11 ALLENBY ROAD Maidenhead Berkshire SL6 9BF Lead Inspector Steve Webb Unannounced 21 April 2005 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 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 Stationary 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. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 11 Allenby Road Address Maidenhead Berkshire SL6 9BF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 5699131 Owl Housing Ltd Care Home 6 Category(ies) of Learning Disability (LD) - 6 registration, with number of places 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 26/10/04 Brief Description of the Service: The service is operated by Owl Housing Ltd. and is registered to provide accommodation and care for up to six service users between the ages of eighteen and sixty five, who have a learning disability. Most of the service users also have associated physical disabilities. The current service users all moved in together from the same hospital and have lived at the home since 1996. The accommodation is provided in a purpose built single storey unit in a residential area of Maidenhead. The home is staffed 24 hours a day. A new manager has been apponted and is undergoing registration. There is disabled access to all relevant areas of the building and each service users has their own bedroom. The property has its own landscaped garden with level patio areas, and is within easy reach of transport, local shops and leisure amenities. The home has appropriate links with local day centres and health professionals. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out between 10am and 3.45pm on Thursday the 21st of April 2005. The inspection included introduction to most of the residents, observation of resident and staff interaction, and discussion with the deputy manager, as well as examination of records and a tour of the home. Lunch was taken with residents. The manager was away on a training day. Observation of the interactions between staff and residents indicated positive relationships and warmth. The staff appeared to know the resident’s individual needs and personalities well. Residents seemed to feel very much at home. What the service does well: 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. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 7 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 standard(s) 1 and 2 Prospective service users would have a range of information available to them and their representatives about the unit. Although the current service users were admitted prior to current legislation, the available assessment documentation is out of date and requires reviewing and updating, as it would not be satisfactory for any new referrals. EVIDENCE: A statement of purpose and a service user handbook (utilising pictures, text and symbols, were present. Each service user has a copy of the handbook in their bedroom. The handbook contained a good level of detail but how much of this would be accessible to service users is unclear. The service user group have lived at Allenby Road since 1996, having all moved there from the same hospital. There have been no subsequent admissions to the home. Notwithstanding this, no copy of an Owl Housing preadmission assessment format could be located by the deputy manager. Only an old and undated East Berkshire NHS Trust admission/discharge procedure was seen. An up-to-date assessment format should be available. There was also a risk assessment procedure produced in June 1998, within the policy/procedure file, which is not satisfactory. Other policy and procedure documents appeared to need updating and these were often undated. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 8 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 standard(s) 6, 7 and 9 Service users day-to-day needs are reflected within their care plan and other file formats, although more long-term aspirations are harder to establish. Service users are involved in making choices in their daily lives and receive support from staff to enable them to do so. Individual risk assessments were in place to a standard format. Activity plans indicated that all of the service users were enabled to access community activities within a risk assessment framework. EVIDENCE: Each service user had a written care plan in place (called essential lifestyle plans), which contained a good level of detail and spelled out their care and support needs, likes and dislikes etc. although one of those examined was not dated as it should have been. There is a good individual profile to aid new staff in becoming familiar with each person. Challenging behaviour guidelines were in place where necessary, and each had an individual fire risk assessment, individual cross-gender care guidelines, and guidelines for responding to seizures. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 9 The plans are reviewed annually or earlier if required. Individual risk assessments were carried out to a standard format. The level of service users’ learning disability is such that it is not always possible to establish the aspirations of individuals beyond their immediate wishes, but staff and records demonstrated that they listened to service users and had developed an understanding of individual styles of communication. Service users are involved in making day-to-day choices around clothing, activities and food as well as being involved in menu planning. They are also involved in food shopping for the house and go out with staff support to purchase their own individual clothing and items for their bedroom. Some are able to make a degree of choice regarding holidays and all take some responsibility for cleaning and tidying their bedroom with support. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,13,15 and 17 Service users have a range of opportunities to take part in activities both in the home and out in the community. The majority of service users have regular family contact. One, who has no family contact, has an independent advocate. Service users enjoy the meals provided, although their potential for involvement would be enhanced by the proposal to combine the separate kitchen and dining rooms. EVIDENCE: A detailed weekly planner of day centre activities indicated that each service user had three or four 2 hour sessions at day centre each week involved in a range of crafts and activities, including line dancing, cooking, music, sensory sessions and pottery. In addition, service users go out regularly with staff support to local cafes, shops restaurants, pubs etc. There are also cookery, art, pampering sessions aromatherapy/massage and other activities available within the house. Some service users were seen to go out during the inspection. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 11 Two service users have holidays booked in June and two in July. The other two tend to have a range of day outings instead as this suits their needs better. Each service user receives the required inclusive paid holiday. Four of the service users have regular contact with family members, including visits to the home; some are taken out by visitors. One person has weekly visits from an independent advocate, and one has no contact with family. Family and advocate are invited to attend reviews at the home. The home has an adapted minibus to provide accessible transport for the residents who use wheelchairs. Service users were reported to have good appetites and those observed at lunch ate well. Two of the service users have their meals liquidised. Adapted crockery etc. was available to encourage independence, and staff offered any necessary support discretely. The current dining room is a little cramped but there are plans to consider knocking through and combining the kitchen and dining room into one large area. The inspector would support this as long as the necessary risk assessments are carried out, as it would enhance the opportunities for service users to experience the preparation of meals and perhaps take greater part. The current kitchen is really too small to easily involve service users in meal preparation, particularly those using specialist wheelchairs, although there is an area of adjustable height worktop and a sink, which is wheelchair accessible. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18, 19 and 20 The detailed information available on the needs and personal likes and dislikes of service users ensures that staff can offer support as individuals prefer. The service user’s physical and emotional health needs are well provided for and the home has good links with healthcare services. The OK Health-check system should further enhance this by providing a readily accessible monitoring system. Service users welfare could be compromised by medication errors despite the presence of the monitored dosage system and an apparently systematic training for staff, unless a more effective monitoring system is put in place. EVIDENCE: Service user care plans and other formats detail individual’s needs, likes and dislikes in terms of personal support, including the issue of cross-gender care. The home are beginning to complete ‘OK Health-check’ forms for each service user, which will detail needs across the health spectrum, and simplify monitoring of these aspects. All service users receive speech therapy support, and psychotherapy and physiotherapy support is available as required for individuals. The home has 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 13 good links with local health-care disciplines, including a dental service specialising in service users with learning disabilities. All staff receive medication training from a pharmacist as part of induction and are also in-house trained and monitored to assess competence. The home uses a monitored dosage medication system. The quantities of medication received, are recorded as part of the audit trail. A returns log was also in use and PRN medication is separately recorded and counted. A controlled drugs log was available if required. (Not needed at present). However, some gaps were present in MAR sheet administration records, despite reported weekly checks my management. It is suggested that a system of medication checks by shift leaders, be instigated, as part of the daily shift handover routine to ensure that any errors or omissions are quickly addressed. Staff should be reminded of the importance of medication records. It is also suggested that the drug information sheets for medication regularly prescribed, are obtained and filed in the unit for staff information. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22 Service users understanding of the complaints procedure is limited and they would primarily be reliant on staff and others acting on their behalf. The absence of the complaints log made it impossible to verify the reported absence of recent complaints, on the day of inspection. EVIDENCE: A written complaints procedure was in place, and available in symbol format. However the limited speech of most service users would mean that complaints would usually need to be made on their behalf in an advocacy role, by staff or relatives. The deputy reported that there was a complaints log but this could not be located during the inspection and should be replaced if it cannot be found. The deputy reported that there had been no complaints in the recent past. The manager is asked to confirm this in writing to the CSCI once the log is located. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24 and 30 The environment provided was, for the most part, appropriate, homely and safe, although some aspects require attention to address safety, and other works would enhance the homeliness and accessibility of the environment. The home was clean and hygienic, and free of unpleasant odours. EVIDENCE: The home is purpose-built, and all on ground floor level with ramps where required to ensure full accessibility for wheelchairs. Additional specialist equipment, including ceiling hoists and tracking, accessible bathing facilities, mobile hoists and specialist wheelchairs are provided to enable service users needs to be met effectively. Internal fire doors are equipped with electromagnetic holdbacks to maximise service user independence and mobility. There are two areas of garden available, both with level paved areas and fencing to prevent access to unsafe areas. Mobile ramps are provided at door thresholds. The home is, for the most part, homely and attractive, and communal areas have ample natural light. Bedrooms are individualised and reflect the interests of their occupant. Some also have sensory equipment provided. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 16 The hallway carpet was in need of replacement, which was reported to be due to be done in the near future. Some of the bedroom carpets were also stained and should be prioritised for early replacement. Whilst the dining room carpet was also due for replacement, this was on hold pending a decision on the building works to combine the kitchen and dining room. It is recommended that, subject to appropriate risk assessment, this works be carried out to enhance the environment for service users. This will improve mobility and access and enable greater potential for involvement in food preparation for all service users. It is suggested that a suitable non-slip flooring alternative to carpet be considered in the dining area. It was noted that the metal protective devices fitted to most doorframes to prevent wheelchair damage, presented a health and safety hazard in their own right. It was confirmed that one service user had injured their face on one of these when falling during a seizure. These devices should be removed promptly and replaced with a more suitable alternative. The home was clean and odour free. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35, 36 The staff team is effective, despite the level of vacancies, and this is optimised by the use of regular agency staff who are familiar with service users needs. Recruitment practice was satisfactory for the most part, to protect service users, but the manager still needs to ensure that the required evidence of the procedure is available on site. Staff induction and training systems are effective in meeting service users needs, but the manager needs to produce an overall training plan to monitor ongoing training needs. Service users benefit from a staff team that communicates effectively via regular team meetings and daily handovers, and staff receive regular support via supervision. An appraisal system is also required to periodically review staff development and training needs to maximise their ability to work effectively with service users. EVIDENCE: Of the twelve support worker posts, 5.5 posts were vacant and were being covered by bank or regular agency staff, familiar with the service users. The deputy reported that one new permanent support worker was due to start in May and another had been interviewed and the CRB was awaited. A further post had been offered and a reply was awaited from the applicant. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 18 Additional interviews had taken place the week before the inspection but the deputy was not aware whether other appointments had been made. A previous requirement to establish a system to maintain the relevant staff recruitment records on-site, had begun to be addressed and the manager should ensure that the required items are present for all recently appointed and future staff. The manager was reported to be in the process of producing a training plan for the staff team, which should be copied to CSCI on completion. The parent organisation provides an induction including core training, (food hygiene, moving and handling, fire safety, medication and epilepsy) Following this, the staff undertake the LDAF foundation training followed by NVQ level 2 then level 3. There is also a programme of other training available, which individual staff can access, and core training is periodically updated. The deputy outlined her recent and upcoming training to evidence the process. Training certification is retained on staff files in the unit. The new manager was described as a good leader who was able to delegate responsibilities appropriately to team members. The manager was providing supervision monthly, but the deputy was due to attend supervision training, prior to sharing this task. Team meetings were held monthly and minutes indicated an appropriate range of topics. The deputy was not aware whether an appraisal system had been established and the manager is asked to provide evidence of the appraisal system. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40 and 42 Some of the available policies and procedures require reviewing and updating to ensure they protect service users rights and best interests, adequately. For the most part the health and safety of service users is protected, but there are some areas requiring attention to improve this. EVIDENCE: A number of the available policies and procedures were old and in need of review and updating. Many were undated making it unclear when they dated from, and some were from the previous organisation. The parent organisation should undertake a full review of the policies and procedures. The majority of the routine health and safety servicing and certification was in place and in house alarm checks and fire drills were taking place. The fire drill records were detailed. There is an overall fire risk assessment for the home and individual fire risk assessments for each service user were in place. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 20 The fire brigade visited recently and produced a deficiencies notice. These issues should be addressed promptly, and the manager should report their completion to the CSCI. Certification for annual gas safety checks, portable electrical appliance testing and five-yearly electrical installation testing could not be located during the inspection and should be copied to the inspector. All staff receive training on first aid, food hygiene moving and handling, medication, rectal diazepam administration and epilepsy. As noted above, the doorframe protection devices fitted present a health and safety hazard and should be replaced. Accident records were examined and indicated six service user accidents since 8/6/04, one of which necessitated a visit to hospital. It is suggested that separate accident books and records should be kept for service users and staff/others to simplify the monitoring of these issues. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 11 ALLENBY ROAD Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x 2 x 2 x H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 22 NO 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 YA2 Regulation 13, 14 Requirement Copies of up-to-date preadmision assessment and risk assessment formats should be available in the home. Establish an effective system to monitor medication records for errors to enable timely action to address errors and omissions. The complaints log should be located or replaced. The absence of recent complaints should be confirmed to the CSCI in writing. Stained bedroom carpets should be prioritised replacement. Replace the metal doorframe protectors with an alternative which does not present a hazard. Supply a copy of the unit training plan to the CSCI. Supply details of the staff appraisal system in operation, to the CSCI. Review, and where necessary, update the policy and procedure documents available. Address the issues raised in the fire brigade deficiency notice and notify the CSCI of completion. Copy the missing safety certification to the CSCI. Timescale for action 28/7/05 2. YA20 13 28/5/05 3. YA22 22 28/5/05 4. 5. 6. 7. 8. 9. 10. YA24 YA24 YA35 YA36 YA40 YA42 YA42 23 13 18 18 12 & App.2 23 13 28/10/05 28/6/05 28/5/05 28/5/05 28/7/05 28/6/05 28/5/05 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA24 YA24 YA42 Good Practice Recommendations The proposed combination of the dining room and kitchen into one room should be pursued with due reference to risk assessment, to enhance the facilities for service users. Consider the replacement of the dining room carpet with a suitable non-slip alternative flooring. Consider the separation of service user and staff/others accident recording systems to simplify monitoring. 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading RG7 4SA 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 11 ALLENBY ROAD H52-H01 11 Allenby Rd V214364 210405 Stage 4.doc Version 1.30 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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