Inspection on 17/08/05 for 12-13 Exbury Place

This inspection was carried out on 17th August 2005.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

12-13 Exbury Place 27/01/09

12-13 Exbury Place 31/01/07

12-13 Exbury Place 21/02/06

12-13 Exbury Place 21/02/05

12-13 Exbury Place 15/07/04

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

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

CARE HOME ADULTS 18-65 12-13 Exbury Place, St Peter The Great, Worcester, WR5 3TP Lead Inspector Christina Lavelle Announced Inspection 17 August 2005 13.30 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. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 12-13 Exbury Place, Address 12 - 13 Exbury Place, St Peter the Great, Worcester, WR5 3TP 01905 611147 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) SCOPE Mr Andrew J Deakin Care Home only 4 Category(ies) of Physical Disability - 4 registration, with number of places 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: In addition to the categories of registration descibed on the previous page of this report the following condition of registration applies to this service:(1) Service users may also have learning disabilities that are associated with their physical disabilities. Date of last inspection 21 February 2005 Brief Description of the Service: Exbury Place offers personal care to four adults with cerebral palsy and/or similar physical disabilities. Service users may also have associated learning disabilities. Most service users have complex needs and are highly dependant. The aim of the service is to give service users the opportunity to have an independant lifestyle and to participate in the local community. The provider of the service is SCOPE who also run other local community services as part of a scheme called 1st Key Worcestershire. The property is owned by a Housing Association and is leased to SCOPE. Exbury Place is a bungalow on a large modern housing estate a couple of miles from the centre of Worcester. The home was opened in 1993 and was adapted for its purpose and so areas inside and garden are accessible to wheelchairs. There are local shops and amenities nearby as well as easy access to the many facilities of the city. The home has two vehicles providing suitable transport. Each service user has a single bedroom, none of which are en-suite. There is a shared sitting room and kitchen/dining area and a shower room and assisted bathroom. The kitchen has low level surfaces so that people in wheelchairs would be able to cook and assist with food preparation. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine announced inspection was carried out in four and a half hours on a Wednesday afternoon in the summer. The main aims were to review action taken to deal with issues raised from the last inspection. Also to check that the home was meeting it’s stated purpose and providing good quality care. Evidence was obtained in the following ways to assess the service provided. Comment cards were sent for service users and their relatives/visitors before the inspection asking for their views of the home. Questionnaires were also sent for staff about their training and experience of working in the home. They could also comment on what they felt was good in the home and if anything could be improved. The feedback received will be referred to in this report. Time was spent during the inspection talking with the manager, some staff and service users. Various records were checked relating to the care of service users, staffing, the premises and to aspects of health and safety in the home. The bungalow was looked around. Reports made on behalf of SCOPE following required monthly visits to the home gave further information about the service What the service does well: Exbury Place gives service users the opportunity to live in ordinary housing, which fits in well with the local community. The bungalow is homely and comfortable and is in a convenient location. The home’s vehicles also provide transport for service users to use facilities and services within the wider community. The property is suitably adapted and equipped to meet service users’ special needs and is fully accessible to wheelchair users. There was a relaxed and open atmosphere in the home and it was clear that staff and service users got on well with each other. Each service user has a keyworker from the staff team, which makes the care and support given them more personal. Service users had been helped to complete the comment cards which showed they liked living at the home and felt safe, well cared for and treated with respect by staff. Those people spoken with confirmed this. Relatives who commented said they were happy with the overall care provided. Service users were enabled by staff to maintain as much independence as they could. Staff were committed to helping service users lead full and interesting lives and the team seemed well motivated and to work well together. Staff ensured that service users’ personal and health care needs were met properly. New staff undertake training that is especially for people that work in care. This should help them know how and have the skills to do their job and provide good care. All staff also have to do the necessary health and safety training to help keep the home, service users and staff safe. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, & 5 Appropriate information is available to help prospective service users (with their families or representatives when applicable) to decide if they may like to live at Exbury Place and whether the home could meet their needs. Admission procedures are in place to make sure the home would be able to suitably meet service users’ needs and goals and that they wish to live there. EVIDENCE: The home provides the required information documents for current and prospective service users, including a statement of purpose, service users’ guide and a service level agreement (contract). It was not checked during this inspection whether the guide and contract are produced in other formats that may be more easily understood by the potential service user group. There had not been any new service users admitted to the home recently. However it was previously confirmed that SCOPE provide thorough admission procedures for when possible service users are referred for a placement at their care homes. This to include a full assessment of the prospective service users’ care needs carried out at their current residence and obtaining available information about them. Introductory visits to the home and a trial stay would also be arranged as part of the process followed by a review meeting to decide with everyone involved if the home can suitably meet their needs and wishes. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 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 standard(s) 6, 7 & 9 A comprehensive assessment and care planning system was used to identify service users’ needs and help staff know better how to meet them. A more person centred approach to care planning would ensure the support provided is always based on service users’ wishes and goals in their lives. Risk assessments were carried out to minimise risks to service users whilst allowing them to take responsible risks to promote their independence. EVIDENCE: One service user’s care records were looked at in detail and care planning and assessment was discussed with the manager and staff. There was helpful information about the person’s background, physical health, disabilities and reports made of any significant events in their lives. Their records also included a plan of care, their photograph and their preferred daily routines and likes/dislikes. Some personal information about service users had been recorded in a communal communication book. Consideration should be given to providing individual ongoing records, which would also ensure any information about each person could be accessed by them, or on their behalf, if they wished. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 10 The care plan covered all relevant areas of need, including personal care and to ensure their emotional well-being. Attention had also been paid to promoting the individuals’ communication and self-help skills. Care reviews had been held six monthly as expected, involving the service user and their family. Keyworkers were expected to take some responsibility for reviewing and updating their allocated service users’ plans. It was confirmed they tried to involve service users when reviewing and updating plans and when possible they signed their own plan. This could be further developed if a more person centred assessments and care planning system was introduced. Appropriate risk assessments had been carried out. They included any support needed in respect of moving and handling and such as going out alone in the community and holding their own bedroom key. These were used to provide guidance for staff and to help keep service users safe, whilst encouraging their independence through them taking some responsible risks. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 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 standard(s) 11,12,13,14&15 Staff enabled service users to lead full and active lives and encouraged their participation in the wider community. Service users were supported to maintain links with their families and friends. EVIDENCE: Service users’ care records included details of activities they enjoyed and had participated in each day and showed they pursued a range of social, leisure and other activities. Staff time was available for some one to one support. Jobs were not an option for service users, due to their profound disabilities. However some had attended courses at college, such as the use of computers. Service users also used local services (such as a café at the local supermarket and pubs) and at least one person was able to go out alone and had made friends in the community. The home’s vehicle provided transport for outings further afield and allowed them to use the cities facilities. Service users were involved in decisions about how they spent their time and their daily routines etc. to the extent they were able. Their independence was 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 12 promoted. One person had recently received a system to enable them to control their own environment e.g. to use their television and the call bell. The two families who submitted comment cards said they were kept informed about their relatives’ care and always made welcome by staff in the home. It was also evident from discussion with service users and staff that contact with their families was promoted and facilitated. Although Standard 17 on meal provision was not fully assessed service users confirmed they liked the food and could choose what they wanted to eat. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 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 standard(s) 18 & 19 Arrangements were in place to ensure the personal, emotional and health care needs of service users were appropriately met. This included obtaining input and support from relevant health care and other professionals. EVIDENCE: Service users’ plans reflected the assistance and support each person needed from staff for their personal care. Records were also kept of any health care input and of relevant physical checks made (such as weight) to ensure their health was monitored and their good health promoted. The home obtained ongoing support from health care professionals, including OTs, community nurses and Specialists. Regular health checks were arranged by keyworkers, who provided escorts when necessary. Although Standard 20 on medicines was not fully assessed the home provides policies and procedures on the safe handling of medicines. There was also information available to staff about the drugs prescribed for service users 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 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 & 23 A suitable framework of policies and procedures were in place to manage complaints and for the protection of service users from abuse or neglect. EVIDENCE: The home provides an appropriate complaints procedure and SCOPE also have a Complaints Resolution Manager to investigate complaints if necessary. One service confirmed they would feel able to talk to the manager or staff if they had any concerns and they clearly had great trust and confidence in their keyworker. The Commission had not received any complaints about the home. There were policies and procedures relating to safeguarding vulnerable adults from abuse or neglect, including whistle blowing. There is also an Adult Protection co-ordinator for SCOPE and staff had access to a copy of the local multi-agency procedures for Protection of Vulnerable Adults. Staff were clear about their responsibility to report suspicions or evidence of abuse or neglect. Arrangements had been made for the safe management of service users’ money and finances. At least one person’s family was appointee for their benefits. The home just helped them deal with their personal allowance and to draw cash when needed from their own bank account. Staff accounted for any cash spent by or on their behalf by keeping receipts and signed records. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 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, 25, 26, 27, 28 & 29 Exbury Place provides suitable ordinary housing and an appropriately adapted and equipped, homely and comfortable environment for service users. Arrangements were in place to maintain and/or upgrade the property, although one aspect of the premises still needed work to safeguard service users. EVIDENCE: The bungalow at Exbury Place fits in well with the local community and its location is convenient for local facilities and services. The impression obtained was of a very homely and comfortable environment, which was clean and tidy. SCOPE are responsible for the internal decoration and furnishings and the Housing Association for external and structural work of the property. The premises were observed to be in a good state of décor and repair and new carpeting had been fitted in the corridor recently and looked very nice. The garden had been cleared somewhat since the last inspection as required. The manager said The Prince’s Trust were soon to landscape the garden and provide another paved area and more parking space. Arrangements had also been made for the fencing that had fallen in recent high winds to be repaired. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 16 The communal space comprises a lounge with patio doors to the garden and a kitchen/dining area that has split-level working surfaces to enable people in wheelchairs to help with cooking and food preparation if they wish. There is an adapted shower with toilet and an assisted bathroom that has new overhead tracking. Other environmental adaptations and disability equipment are also provided to meet service users’ needs and there is a call bell alarm system. Service users’ bedrooms are all at least 12sq.m and are suitable for people who may use wheelchairs. None had en-suite facilities, other than a wash hand basin. All bedroom doors have locks fitted so that service users may have the key to lock their room if they want to. It was previously required that radiators must be guarded to prevent risk to service users, although some had still not be covered. This is the Housing Association’s responsibility and must be followed up. In the meantime any risk should be assessed and appropriate action taken to protect service users. The home provides policies and procedures for infection control and suitable laundry facilities are available situated in a separate utility room. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 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) 31, 32, 33 & 35 Service users benefit from living in an appropriately staffed home with a wellmotivated and overall suitably trained staff team. This will improve when a sufficient number of staff achieve an NVQ qualification. EVIDENCE: Staff were clear about the aims of the home and had a positive attitude to their job. They commented on the good atmosphere in the home and the open communication between staff and service users. The role of keyworker was well defined. Staff were committed to enabling their allocated service users to keep family contact and to enhance their lives through meaningful activities. Keyworker days were rostered which allowed one to one time for outings etc. The home was fully staffed currently and it was evident staffing levels were suitable to meet service users’ needs and keep the home safe. Relatives felt there were always enough staff on duty and most staff that they had time to provide personal care and to meet service users’ social and other needs. There is a comprehensive induction programme, which is based on relevant specifications for people working in care. A recently appointed staff member confirmed they had first worked “shadow” shifts and were about to finish their induction. They had completed most core safety training topics and hoped to do NVQ training and had also been expected to read all the home’s policies, 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 18 procedures and care records. This should ensure staff have the knowledge and can develop the skills needed to meet service users’ needs properly. Three staff already had an NVQ qualification and there were two staff undertaking this training. Over half the team should therefore achieve a qualification this year as the Standards specify. Other training opportunities relating to service users’ special needs, such as disability awareness and the management of challenging behaviour had been taken up. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 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) 37, 42 & 43 Systems were in place to promote the effective management of the home, including clear lines of accountability with the service provider. Whilst health and safety matters are very wide ranging overall service users and staff were protected by ensuring the provision and maintenance of a safe environment and through working practices. EVIDENCE: The manager (Andrew Deakin) is called the Community service manager and has responsibility for three 1st key homes with an office base at Unit 3 Lowesmoor Wharf, Lowesmoor, Worcester WR1 2RS. Mr Deakin has many years experience working for SCOPE and had managed these care homes since 2003. He is currently undertaking an NVQ 4 qualification in management and care and visits the home at least once a week. Day-to-day management was appropriately delegated to a team leader and senior support worker who had responsibility for staff rotas, co-ordinating training and supervising staff. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 20 There were clear lines of accountability within the home and with SCOPE. A representative of the provider visits the home monthly as required. Following these visits a checklist is completed and a short report made on service user’ and staff views, a copy of which is sent to the Commission. The home had adequate insurance cover in place and there was no evidence that it is not financially viable. One senior is the nominated health and safety co-ordinator and completes risk assessments relating to the premises and in respect of particular service users. In respect of maintaining health and safety the following areas were checked: • The fire log showed that required tests and checks on the fire safety system and equipment were recorded as having been undertaken at the specified intervals. Also that fire drills were arranged regularly, with service users involved. • Incident and accident records were maintained. There were no issued identified that appeared to adversely affect the health, safety and welfare of service users or staff in the home, other than the requirement carried forward regarding uncovered radiators. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 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 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score 3 2 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 12-13 Exbury Place, Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 3 E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 22 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 YA24 & YA42 Regulation 13 Requirement Radiators in the home must be guarded. (This was subject previously to an Immediate Requirement) Timescale for action By October 31st 2005 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 YA7 YA6 & YA10 Good Practice Recommendations A more person-centred approach to care planning and assessment should be introduced. Consideration should be given to recording all information about service users individually. This would make sure all records could be accessed by them and also be part of the ongoing record of their progress and events in their lives.. 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Hereford Area Office, 178 Widemarsh Street, Hereford HR4 9HN 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 12-13 Exbury Place, E52 E02 S18651 Exbury Place V229281 170805 Stage 4.doc Version 1.30 Page 24 - 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!