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Inspection on 25/05/05 for 183 Ashby Road

Also see our care home review for 183 Ashby Road for more information

This inspection was carried out on 25th May 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 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service demonstrated that it made every effort to encourage service users to be involved with day to day decision making and had adopted a person centred approach to care planning and goal setting.

What has improved since the last inspection?

The service has successfully recruited a full staff team since the last inspection, and no longer uses agency staff to supplement the numbers. The rear garden has been transformed since the last inspection to create, better access and an outdoor seating area, a venture that was reported to have involved service users.

What the care home could do better:

Areas for future consideration were discussed fully and included, ensuring that risk assessments and action plans explicitly detail the action required to reduce the risk. Where as required medication is prescribed specifically to support service users at times of high anxiety or to reduce the incidence of challenging behaviour. A clear protocol for it`s administration must be agreed and be available for staff to follow.

CARE HOME ADULTS 18-65 183 Ashby Road Burton on Trent Staffordshire DE15 OLB Lead Inspector Wendy Jones Unannounced 25 May 2005 15:00 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. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 183 Ashby Road Address Burton on Trent Staffordshire DE15 OLB 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) 01283 542636 01283 563447 Robinia Care Homes Mrs Jean Thomas Care Home 5 5 Category(ies) of LD registration, with number of places 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) 5 LD - aged 18 to 26 on admission Date of last inspection 13 September 2004 Brief Description of the Service: The service is provided from a large semi detached property, located on a busy main road, in a residential area of Burton-on-Trent. It is close to local amenities and within walking distance of local shops, park area and pub. The service has its own vehicle but is also close to piblic transport links. The home provides for up to 5 service users in single occupancy bedrooms, none have en-suite facilities, all have wash hand basins fitted. Communal space is provided in a pleasant lounge, dining room and spacious well equipped kitchen. The service is registered to provide care for persons over the age of 18 years who have a Learning Disability. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 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 on 25 May 2005. There were three service users in the home and two staff. The service had one vacancy; since the last inspection one service user had left the service and another had been admitted. The inspection involved some conversation and discussion with all service users in the home. It also included discussion regarding the last inspection requirements to ascertain compliance; observation of the environment and interactions between service users and staff; inspection of care records, staff rota’s, complaints records, fire records, staff, team leader and service users meetings; a sample of service users menu plans and medication records. Since the last inspection the service has successfully recruited a full staff team, What the service does well: What has improved since the last inspection? What they could do better: Areas for future consideration were discussed fully and included, ensuring that risk assessments and action plans explicitly detail the action required to reduce the risk. Where as required medication is prescribed specifically to support service users at times of high anxiety or to reduce the incidence of challenging behaviour. A clear protocol for it’s administration must be agreed and be available for staff to follow. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 6 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. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 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 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 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. The homes Statement of Purpose and Service User Guide were of a good standard, providing service users and prospective service users with details of the services the home provides, enabling them to make an informed decision about admission. The service demonstrated it’s commitment to meet the needs of service users. The Statement of Purpose and Service User Guide provided information to prospective service users, regarding it’s ability to meet the needs of service users. Prospective Service Users have opportunities to visit the home and for short stay’s prior to moving in. EVIDENCE: Records seen demonstrated that each service user had access to a service users guide at the time of admission. The document was quite user friendly, detailing the type of service provided. It included a complaints procedure, and a statement of the terms and conditions of residency detailing the cost of the service. The pre admission assessments carried out by social workers were comprehensive and supported by the organisations own assessment of need. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 9 Records confirmed that prospective service users were offered introductory visits and overnight stay’s prior to making the decision to move into the home. Each new service user was admitted subject to a trial period, before each party committed to a more long-term arrangement. It was not established at this inspection how the service included other service users in this decision making. A requirement of the last inspection included the need to provide staff with Mental Health training by 26/11/04. Minutes of a staff meeting following that inspection recorded that this training was to be provided by a psychologist. It was confirmed from discussion with Mr Ward that the training had not occurred. He also indicated that some training had been arranged. It was of concern that the service had not complied with the requirement for training within the agreed timescale. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9. The standard of care planning and risk assessments was good. Assessment information was detailed and addressed most of the identified risks. Care planning was comprehensive, reviewed regularly and involved service users. EVIDENCE: A sample of care plans evidenced that they reflected the assessed needs of service users, were subject to regular reviews and in the sample seen involved the service user, who confirmed by signature he was aware and agreed with the plans, this was confirmed from discussion with a service user. The records seen showed evidence of agreed goal setting and appropriate support provided to service users to enable them to achieve their aims. Individual risk assessments were in place, to address the known and assessed risks to service users. It was of concern that in one example where a high risk was identified the records did not have an explicit action plan to instruct or guide staff to properly support the service user. It was suggested that some training in counselling skills should also be considered. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 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) 12,13,16,17. Service users were supported to access a range of social, recreational activities that are located in the community and were socially valued. Dietary needs of service users were known and understood and efforts were being made to provide a balanced and varied selection of food to ensure good nutritional intake EVIDENCE: Weekly participation plans showed that service users were provided with opportunities to attend college, be involved with the Princes Trust scheme, to access recreational and leisure facilities and to access local community amenities. There was an example of a service user exercising his choice not to attend a planned activity after trying it, and of staff support to access an activity of his choice. Menu’s were agreed weekly, this was to assist with shopping and to form a framework from which service users could make a selection. A sample of an 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 12 individual menu plan was provided for inspection purposes and demonstrated that efforts were being made to support service users to choose a healthy diet. It was confirmed with Mr Ward that the food budget for the home was calculated at £160 per week. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 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) 19,20. The health care needs of service user were adequately met. The medication systems were satisfactory, requiring some amendments to ensure that they are robust enough to ensure service user safety and health. EVIDENCE: From a sample of care records it was evident that service users were supported to access community based health services ie G.P, dental and ophthalmic services. Records indicated they received regular health checks. There was also evidence of referral to specialist services as necessary including consultant psychiatry, psychology and neurology. Specific health issues included epilepsy. Records showed that regular reviews of epilepsy management had taken place. Medication was administered from individual blister packs, and was appropriately stored. None of the service users were reported to self medicate. Administration records were generally well maintained, with one example of medication not signed for, it was confirmed from the blister pack that the medication in this case had been administered. A number of service users were prescribed as required medication; it was of concern that there was a lack of clear guidance or instruction for staff 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 14 regarding the appropriate use of this medication. A requirement of this report is for protocols for administration of as required medication to be developed, following discussion and in agreement with the prescribing health professional and service user. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 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 satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. Arrangements for protecting service users are satisfactory to ensure that service users are not placed at risk of harm or abuse. EVIDENCE: The service had a complaints procedure, the details of which were included in the Service User Guide. Records of complaints and grumbles were seen, to confirm the effectiveness of the procedure. The majority of records included the action taken by the service to resolve the complaints, with the exception of a complaint dated from 31/01/04. While it was accepted that the complaint was made some time ago, the need to demonstrate how the complaint was addressed was discussed. Since the last inspection the service has reported one issue of service user on service user abuse, the records provided indicated that appropriate action was taken at that time to safe guard service users. Mr Ward stated that staff had received training in the Protection of Vulnerable Adults; evidence that this training and other statutory training had taken place was requested. Mr Ward stated that since the incident referred to above, there had not been an another incident of challenging behaviour that had required staff to use restraint techniques. He indicated that staff had received training in conflict management, which included de-escalation methods and breakaway techniques, some additional restraint techniques were also taught. It was not 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 16 possible to confirm at this inspection if the training provider was accredited with the British Institute for Learning Disability, or if the training met the guidance for good practice. The service should provide this information to the CSCI. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 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) 24,27,28,30. The appearance of this home created a comfortable environment for those living there and those visiting. The safety of service user and staff was compromised by some poor maintenance. EVIDENCE: The home is a large semi detached property set close to the centre of Burtonon-Trent. It is located on a busy main road and provides limited parking to the front of the property. The home provides accommodation over 3 floors. The ground floor is accessed via large hallway, leading directly to a pleasant and well maintained and furnished lounge, a separate dining room, with patio doors leading to the rear garden. A pleasant and well equipped kitchen, with a separate utility room containing the laundry. There was also an office/sleep in room with en-suite facilities off the kitchen. Areas for action included the need to deep clean or replace the flooring in the hallway which showed evidence of staining. The kitchen door leading to the 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 18 back exit/entrance was designated as a fire door, during the inspection when there were service user and staff in the immediate vicinity it was wedged open. While this may be appropriate during the daytime hours the service must ensure that fire safety is not compromised at night, by removing the door wedge or providing a self-closure linked to the fire alarm system. The gardens to the rear of the property had been developed since the last inspection to create an attractive staged access to a very pleasant patio and lawn area. Two fencing panels were to be replaced following discussion and in an arrangement with the neighbours. Bathing facilities were located on the first floor of the home and consisted of a bathroom and wc and a separate shower room and wc. Mr Ward discussed an on going problem with maintaining hot water temperatures at times due to recurring maintenance issues with the boiler. Bedrooms were provided on the first and second floor, all were for single occupancy and all were fitted with wash hand-basins. A second floor bedroom was seen with the kind co-operation of the occupant and was appropriately furnished. This room had been reported as inadequately heated at the last inspection. It was confirmed with the service user that the although at the time of this visit the heating was adequate, there continued to be an on-going problem with the main heating system which necessitated the use of an additional electric heater. This matter must be satisfactorily resolved. The service should give consideration to the provision of a wc on the second floor for the benefit of service users. The home also had a cellar, accessed via the utility room, this useful additional space, housed the mains electrical meter, was used to store cleaning chemicals, Christmas decorations and paint. The room had smoke/heat detection fitted. It was of concern that the electric meter was secured to a loose board which, as a result, appearing to put some weight bearing pressure on the electrical cables. There were a number of holes in the ceiling exposing the ceiling cavity, presenting an increased fire safety risk. An immediate requirement was made to address these matters. The cellar was also used to store old records, including care records. Due to the damp environment it was of concern that these important documents, which must be kept for a minimum of three years could be affected by the conditions. Alternative storage arrangements must be made. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 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) 32,33,35. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. Suitable training was provided by the home to meet the needs of service users. EVIDENCE: Since the last inspection the service has successfully recruited a full staff team, precluding the need for the use of agency and bank staff. Three of the new staff were undertaking induction training linked to the learning disability award framework guidance. Four staff had been recruited from overseas, were reported to have settled well and considered to be valued members of the staff team. Staffing levels on the day of inspection, were two care staff, one team leader and the manager, during the early shift from 7.30am-3pm, five care staff were deployed for the afternoon/evening shift from 2.45pm-10pm, 1 sleep in staff and 1 waking night staff. The high level of staffing provided was to reflect the enhanced care requirements of a number of service users, for example one service user was allocated 1:1 care for 15 hours per day. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 20 National Vocational Qualification (NVQ) trained staff included the manager reported to have NVQ4, a team leader undertaking that training, 2 care staff training at NVQ level 3, and future plans for 4 staff to be enrolled on NVQ training courses in September 2005. The service was asked to provide evidence to the CSCI that all staff had received mandatory training including health and safety, manual handling, infection control, basic food hygiene, Vulnerable Adults training and have sufficient staff trained to provide first aid. Mr Ward indicated that all staff had received training in meeting the needs of persons with aspergers syndrome and autism. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 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) 41, 42. The management arrangements were adequate to provide service users and staff with the support they required to receive and deliver an effective service. The health and safety of service users was compromised by the poor maintenance in the cellar. EVIDENCE: The manager had been approved as the registered care manager for the home, and had previously provided evidence of appropriate qualifications and training. Records showed that staff meetings were arranged on a monthly basis, separate monthly, service user meetings were also recorded. Team leaders meetings were planned monthly, records showed they had occurred bi monthly. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 22 Records relating to fire safety indicated that weekly fire alarm test were carried out, emergency lighting checks and monthly fire drills. A requirement of this report is to ensure that night staff participate in at least 2 fire drills per year. Other fire safety matters are referred to earlier in this report. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 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 2 3 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 2 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 2 3 2 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 183 Ashby Road Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 1 1 x E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 24 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. 2. Standard YA3 YA26 Regulation 18(1)c 23(2)(p) Requirement Mental Health Training must be provided ( previous time scale 26/11/04). The registered person must ensure that the central heating system is working reliably to provide hot water and sufficient heating when required( previous time scale immediate as agreed). The registered person must provide evidence that a quality monitoring system has been implemented (previous time scale (08/12/04). The registered person must ensure that fire safety is not compromised by repairing the hole on the cellar ceiling The registered person must ensure that fire safety is not compromised by the practice of wedging open the kitchen fire door. The registered person must ensure that each night staff paticipates in a minimum of 2 fire drills per year. The carpet in the hallway must be deep cleaned or replaced. Medication must be signed for at Timescale for action 25/06/05 26/06/05 3. YA39 24(1)(a)( b) 25/08/05 4. YA42 13, 23 26/05/05 5. YA42 13, 23(4) 26/05/05 6. YA42 13, 23(4) 25/06/05 7. 8. YA24 YA20 23 13 06/06/05 On every Page 25 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 the time of administration 9. 10. YA20 YA41 13 17(1) Clear guidance or protocols must be in place for the administration of as required medication. Alternative more appropriate storage must be provided for the old records currently stored in the damp cellar. Where significant risks to service users been identified, risk assessments must include explicit action plans for staff to follow to reduce that risk. occasion 25/06/05 13/06/05 11. YA9 13 26/06/05 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 YA32 YA35 Good Practice Recommendations 50 of care staff should be trained to NVQ level 2. Evidence of mandatory training should be provided. 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 183 Ashby Road E09 E51 S4911 183 Ashby Road V234692 250505 Stage 4.doc Version 1.30 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!