Inspection on 05/09/05 for 17 Shakespeare Road

This inspection was carried out on 5th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

17 Shakespeare Road 23/09/08

17 Shakespeare Road 22/08/06

17 Shakespeare Road 10/01/06

17 Shakespeare Road 13/12/04

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

CARE HOME ADULTS 18-65 17 Shakespeare Road Worthing West Sussex BN11 4AR Lead Inspector Mrs B Tye Announced Monday, 5th September 2005, V241129 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. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 17 Shakespeare Road Address 17 Shakespeare Road, Worthing, West Sussex, BN11 4AR 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) 07903 234457 Sutton Court Associates Ltd Mr Paul James Sullivan Care Home (CRH) 6 Category(ies) of Learning disability (LD) - 6 places registration, with number of places 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 - Up to 6 male and/or female service users in the category learning disability may be accommodated. 2 - Only persons between the ages of 18-65 years may be admitted/accomodated. Date of last inspection 13th December 2004 Brief Description of the Service: 17 Shakespeare Road is a care home registered to up to six service users in the category LD (Learning Disabilities 18-65 years). The establishment is a converted premises situated close to Worthing town centre. Public transport servcies are easily accessible. Accomodation is provided over two floors and all rooms are single occupancy with en-suite facilities. The service is privately owned and the registered provider is Sutton Court Nursing Associates. Mr N Ramdin is the Responsible Individual on behalf of the organisation. Mr P Sullivan is the Registered Manager in charge of the day to day running of the home. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over six hours. Prior to the inspection, information held on file was examined including the last two inspection reports and any official documentation relating to the home. During the inspection a tour of the home was undertaken and records relating to the residents care and health needs were examined. The inspector spoke to the manager and interviewed two staff members. Staff files and health and safety records were reviewed. In addition, the inspector had the opportunity meet five of the residents and to spend time with two of them. Seven feedback forms received by the Commission from relatives and residents also provided an insight into the care provided at the home. What the service does well: The home is well decorated with a good standard of furnishings providing the residents with a pleasant and comfortable living environment. Every aspect of the residents care is documented and clear action plans give staff clarity to provide specific care needs appropriate to individuals. Detailed risk assessments for individuals promote independent living for the residents in line with their assessed capabilities. Service users and feedback from relatives confirmed they were satisfied with the service provided. The inspector observed relaxed and confident interactions between residents and staff. Staff spoken to stated they found the management of the home to be inclusive and supportive. Administrative systems are well organised. All health and safety records are kept in good order. The activities programme on offer at the home is well run and varied offering residents the opportunity to pursue areas of interest. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 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. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 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 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 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 - 5 Prospective residents are provided with all the information needed to make an informed decision, prior to admission of the home. Where possible a transition period to the home is agreed between involved parties. Each potential resident is given the opportunity to visit and have a trial stay if required. Terms and Conditions for each resident is provided and kept on individual files at the home. EVIDENCE: A Statement of Purpose and Service User Guide was made available to the inspector. It was noted each document is provided in a format suitable for the occupants so each resident is aware of the service provided prior to admission. It was evident from the information seen on file and discussions with the manager that ‘a period of transition’ for each new arrival is seen as key to them feeling settled in the home. Each resident has the opportunity to visit the home prior to admission, as many times as they need to. This helps them to develop a sense of ownership. A contract of Terms and Conditions are provided to each resident on admission. A key worker assists individuals to understand its content prior to signing. Each contract is available in signs and symbols to assist new arrivals in understanding exactly what the home has to offer them. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 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 - 10 Individuals, their families or representatives are involved in producing detailed care plans which reflect their changing needs and personal goals. Detailed risk assessments have been completed for each individual and their environment. Residents are consulted on aspects of daily living and are able to participate in regular reviews. The home holds regular meetings for residents to discuss issues as a group. This information is minuted by staff and kept on file. EVIDENCE: The inspector examined four care plans. Each plan is generated from pre admission assessments, which relate to all aspects of the individuals health, personal and social care needs. All plans seen were detailed and easy to follow which means care staff can transfer the information into daily practice. Care plans viewed for residents contained information from involved professionals such as GP’s and Social Workers. In addition, management guidelines provide staff with detailed instruction relating to individual care such as; medication, home management, relationships and general living skills. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 10 A copy of this information is put in the communication book for staff to read and sign. This means staff can respond appropriately to individual need as required. Daily handovers between staff also ensure an information exchange occurs on a regular basis so that staff can keep up to date with changes and significant information as it occurs. Each plan contained detailed risk assessments and risk management for each resident and their home environment. This gives staff detailed information about how to deal with behaviours correctly and allows informed choices to be made in supporting individuals to achieve independent living. It was evident from the information seen on file and discussions with the manager that regular reviews occur to evaluate residents care and update changing needs as appropriate. All changes were dated and signed by the manger and resident, confirming the home includes residents in decisions about the care they receive. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 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 - 16 The outcome for resident’s personal development and activities provided was good. Discussion with a resident and evidence of detailed activities plans confirmed the home offered a good range of activities, which is appropriate to individual assessed needs and interests. EVIDENCE: The structured activities programme incorporates college attendance, with a range of outings, sports and leisure opportunities. Residents are encouraged to persue individual interests in the wider community such as shopping, dog walking, visits to local pubs and restaurants, swimming, horse riding and regular attendance at day centres. It is clear residents are provided with opportunities to develop their personal lives through activities and regular contact with family and friends. Goals have been set out in individual care plans to support this and there was evidence these are reviewed on a regular basis according to the individuals changing needs. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 12 A visitors policy is in place and there are private areas within the home for visitors to meet. The home provides transport to residents when needed and staff support individuals to attend appointments as required. Staff were observed interacting positively and respectfully with residents. Each staff member demonstrated their awareness of how to communicate appropriately with individuals in respect of their needs and behaviours. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 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 - 21 Some of the residents at Shakespeare Rd require personal care and all receive varying levels of staff support in their day to day living. Detailed careplans relating to health and personal requirements reflected the homes ability to meet assessed needs in this area. The home has clear guidance and procedure in administering medication. Records seen on the day of inspection showed that systems where being adhered to and monitored regularly by the management. EVIDENCE: Policies and procedures relating to all aspects of healthcare and medication were in place and up to date. Detailed healthcare needs are identified on individual care plans and record all aspects of care provided by the home and community health professionals. Charts for monitoring and reviewing different areas of health care for each of the residents were signed, up to date and in good order. This showed the home was regularly reviewing assessed needs and staff are accountable in meeting them appropriately. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 14 A keyworking system provides residents with the opportunity to talk through aspects of their care and make supported choices where needed. Bedtimes and morning routines are variable according to needs and wishes of individuals. Choices in these areas provide residents with a more homely environment. Individual files showed residents have access to community health specialists to ensure all aspects of their health care needs are fully met both in the home and wider community. All medicines are stored in a locked cabinet and audited on a regular basis by the manager and the local chemist. Each staff member has completed Medication Training and certificates were evidenced on staff files. This knowledge will reduce risk to service users and promote good practice in handling medication. One resident manages her own medication. Records demonstrated that this had been risk assessed by staff and a disclaimer had been signed. Following discussion with the resident, the inspector concluded the home had promoted her independence appropriately whilst considering and minimising potential risk. The home has a policy on ageing in place. The policy on death and dying needs to be replaced, as it was absent on the day of inspection. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 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 standard(s) 22 - 23 The home has a complete and full policy on complaints. Examination of training records for staff revealed that not everyone has undertaken Adult Protection training. Staff need to complete this training at the earliest opportunity to ensure appropriate responses should an incident arise. A requirement has been made in respect of this issue. EVIDENCE: The home has a detailed Complaints procedure and policy, which is included in the Statement of Purpose and Service Users Guide. This provides residents with clear information about how to complain. One resident said she felt able to complain about any issue should she need to. Feedback from family members to the Commission revealed most were unaware of the complaints procedure at the home. Following discussion with the manager it has been agreed he will send the relevant information to all family members to ensure they are clear and up to date with the homes complaints policy. The complaints log was examined and the inspector found incidents had been recorded appropriately. There have been no major incidents at the home since the last inspection and all entries had been signed off by the manager. Detailed risk assessments for daily living enable staff to respond appropriately to challenging behaviour and health needs, therefore reducing risk to individuals. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 16 Staff undertake Vulnerable Adults training as part of a rolling training programme. However, training records for staff revealed that not all staff members were up to date with this. The manager should ensure all staff members complete this training at the earliest opportunity. This will increase staff awareness and ensure appropriate responses should an incident of suspected abuse arise. Regular residents meetings provide individuals with peer support to discuss any issues of concern, although the most recent meeting was overdue at the time of inspection. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 17 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 - 30 The home overall offered a comfortable and clean living space and the standards were met, therefore providing a good outcome for residents. EVIDENCE: There is a large modern lounge with TV and stereo equipment for use by all residents. The dining room is adjacent to a light, brightly decorated kitchen, which residents have access to for cooking (with assistance) and drink making facilities. Residents rooms were a good size and furnished in their individual styles with personal possessions and pictures. One resident’s rooms was sparsely furnished with nothing on the walls. This was due to repeated damage and the need to keep the resident safe. Details were recorded on his individual care plan and had been agreed with the Social Worker. Another resident is missing a bed-base due to her repeatedly damaging the bed. The manager has ordered a specialist base to resolve the problem and was awaiting its completion and delivery at the time of inspection. Again, the inspector found these details were recorded appropriately on her care plan. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 18 Residents are responsible for cleaning their own rooms with assistance from staff. Some residents participate in cleaning the communal parts of the home under staff supervision to promote daily living skills and provide a sense of ownership. All bedrooms have locks on the door and lockable cabinets for residents to store items of value. Each bedroom has en-suite facilities. There are sufficient toilets throughout the building. A laundry room provides a large washing machine with sluice facilities and tumble dryer. Infection control training is provided to staff and policies and procedures were evidenced. This reduces the risk of infection spreading throughout the home. A fire alarm and emergency lighting system is in place. Records showed these are checked and serviced on a regular basis to ensure the safety of staff and residents. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 19 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 - 36 Following discussion with the staff at 17 Shakespeare Rd, the inspector felt they were clear about their roles and responsibilities within the home. The inspector noted there were some gaps in the recruitment procedure as not all relevant staff checks were in place. Two CRB checks are outstanding and need to be obtained at the earliest opportunity. Despite a full training programme being provided by the home, some staff still need to undertake Adult Protection training. Both these issues pose a potential risk to vulnerable residents and a requirement has been to ensure they are addressed. EVIDENCE: The residents care plans detailed the support they needed for maintaining and developing all aspects of daily living. Observations, discussions and records seen at the home confirmed this matched the care being provided by staff. Staff were observed speaking respectfully to residents and knocking prior to entering rooms. Observations of relaxed and friendly interactions between staff and residents demonstrated the positive relationships that had been achieved within the home. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 20 The home provides an induction and training programme for staff members, including specialist training relevant to individuals assessed needs. Although some staff training is outstanding and needs to be updated, particularly in respect of Adult Protection. A requirement has been made in respect of this. The home has achieved the national minimum guideline for National Vocational Qualification Level 2 or above with 60 completion by staff. The home currently has a full staff compliment and does not use agency workers. This provides consistency of care to residents. Recruitment procedures are in place but records indicated some staff checks were not up to date. Two CRB checks are outstanding and need to be obtained at the earliest opportunity. A requirement has been made to ensure all staff have relevant checks prior to commencement of employment. This will ensure vulnerable residents were protected from potential risks. Records showed the manager supervision sessions with staff were overdue. Supervision promotes good practice within the home and provides staff with clarity about their roles and responsibilities. This should occur no less than 6x annually. A requirement has been made in respect of this. The inspector viewed three monthly staff team meeting minutes. This provides staff with the opportunity to contribute to the running of the home and gain peer support in relation to practice issues. Feedback from residents, staff interviews and observations led the inspector to conclude that the staff functioned effectively as a team and were supported by the management on a day to day basis, in doing so. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 21 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 - 43 It was clear the management style promotes the well being and best interests of the staff and residents. Good practice and record keeping in the home was evident. This was supported by efficient administrative systems, which promote the health, safety and welfare of the residents. EVIDENCE: The home has up to date policies and procedures in line with current legislation to safeguard the rights and interests of the staff and residents. Discussions and observations confirmed staff are given clear direction in their roles and found the management of the home to be supportive and open. Although, good working practices would be monitored by management more effectively through provision of regular staff supervision and staff completion of all relevant training. Requirements have been made in respect of these issues. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 22 Overall, efficient administrative systems are in place to support staff in their day to day care provision and ensure accountability in relation to work practices. Enviromental risk assessments were seen on file. These were termed as Hazard Reports and had been completed on all areas of the homes environment to minimise risk to staff and residents. All care records were kept in a locked cabinet to maintain confidentiality. An Annual Quality review report had been completed and included feedback from residents and families. This is available to visitors of the home alongside the most recent inspection report from the Commission. The inspector examined all safety records and concluded they were up to date and in good order. The records seen, showed that the home promoted the welfare and safety of its residents. 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 23 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 17 Shakespeare Road Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 3 H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 34 Regulation 19 Requirement The Registered Person shall not employ a person within the home without obtaining documents specifed in Para. 1-7 Schedule 2. (CRB checks) The Registered Person shall arrange training staff to prevent abuse and risk of harm to service users (Update Adult Protection Training) The Registered Person shall supervise staff no less than 6x annually Timescale for action 6th December 2005 6th December 2005 6th December 2005 2. 23 13 3. 36 18 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 21 29 Good Practice Recommendations To provide an up to date policy and procedure in respect of Death and Dying. Service users are provided with the specialist equipment they require. (Provision of specialist bed base at the earliest opportunity) 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 17 Shakespeare Road H60-H11 S61335 17 Shakespeare Road V241129 050905 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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