Inspection on 10/08/05 for 27 Wontner Road

This inspection was carried out on 10th 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 but made no statutory requirements on the home.

Other inspections for this house

27 Wontner Road 14/05/07

27 Wontner Road 17/05/06

27 Wontner Road 17/02/05

27 Wontner Road 06/09/04

27 Wontner Road 10/12/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Wontner Road 27 Wontner Road London SW17 9LH Lead Inspector Davina McLaverty Unannounced 10th & 31st August 2005 8.10 am 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. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wontner Road Address 27 Wontner Road London SW17 9LH 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) 020 8767 1621 020 8682 4906 Odyssey Care Solutions for Today Gladys Otudeko-Odulake CRH - Care Home 4 Category(ies) of LD Learning Disability (4) registration, with number of places Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Agreement to admit one named female service user over the age of 65 years. Date of last inspection 29th April 2005 Brief Description of the Service: Wontner Rd is a care home providing personal care and accommodation for 4 adults with a learning disabilty. The Care home is run by Odyssey Care Solutions for Today. The property is owned by Wandle Housing Association. The home is located in a residential area of Wandsworth, close to Wandsworth Common, shops, pubs and other amenities. The home is a three storey, large terraced house. The bedrooms are located on the 1st and 2nd floors. There is no lift access. There is a garden to the rear of the property. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over two half days in August. The inspector met one of the residents, four staff, including the manager. Records examined included care planning documentation, medication, training and staff files. A tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? What they could do better: Adequate numbers of staff must be rostered to ensure care needs can be met in particular during the morning shift, which is busy. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 6 Staff training in areas of food hygiene, manual handling, first aid and medication is regularly updated with records being available in the homes training file. A quality assurance programme needs to be fully implemented to ensure that the views of the residents, their relatives, health /social care professionals and stakeholders are taken into account and acted upon. 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. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.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 Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.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 The Statement of Purpose and Service Users Guide requires updating to ensure that up to date information is provided to residents/advocate to enable them to make an informed choice in regard to where they live. EVIDENCE: Both the Statement of Purpose and Service Users Guide must be updated to ensure that the information in them is current. Consideration should also be given to producing the documents in different formats (in particular the service users guide), which could better meet the residents individual needs e.g. audio, makaton. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.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, 7 & 9 The staff are continuing to develop systems of recording in respect of the care plans. Improvement was seen in both the care planning and risk assessment documentation. Staff have a good understanding of residents support needs and will involve the resident as far as possible in the process. EVIDENCE: At the last inspection senior staff reported that the organisation is moving towards a more person centred care planning system. However, this is not likely to be fully implemented until 2006 as training of all staff will need to be undertaken once the format has been agreed. Two care plans were examined and again the inspector noted improvements. Care needs were more detailed with guidance as to how the identified need was to be met. Evidence of involving the resident was seen in the records. Care documentation also contained the resident’s personal details, professionals involved in their care, communication needs and healthcare needs. Statutory reviews were also seen to have taken place for the residents whose files were examined. The reviews had included involvement with other professionals and relatives. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 10 Most of the risk assessments seen were up to date and were in areas such as mobility and travel outside of the home, as well as addressing residents challenging behaviour. The risk assessments encouraged residents to make decisions which may have a degree of risk. However, their right is limited if the risk is considered too great. A minor shortfall was seen in that one comprehensive risk assessment was not dated or signed with no date for review. All four residents are supported to manage their finances. The manager stated that receipts are kept and the staff coming on shift checks the balances daily. The organisation has a missing persons policy. Staff were aware of the necessary action to be taken in the event of a resident going missing. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.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) 13 & 14 The home continues to have appropriate activities in place for residents, which reflect individual choice. Links with the local community remain positive. EVIDENCE: Since the last inspection there has been little change in respect of activities for the residents. All four attend day services, two Monday to Friday and two for part of the week, as they are involved in other day activities. Activities were evidenced in care plans and in their individual books. The lounge was seen to have television and music equipment, although some of the residents also have their own their bedroom. Staff stated that they endeavoured to meet the individual needs of the residents e.g. one resident enjoys going for walks and on trains. Another likes going shopping in the west end, another likes the cinema and going out for meals. One resident likes to attend church and enjoys listening/watching brass bands play. One staff member stated that residents are eligible to vote although the majority of residents due to the level of their disability are not able to fully Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 12 understand the process. Another staff member stated that the residents are known in the community e.g. some local shops. It was also stated that staff would endeavour to encourage the residents to attend local events in the parks or to accept invitations from residents in other care homes. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.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, 19 & 20 The privacy and dignity of residents is protected with residents being involved in carrying out their own personal care as much as they are able, however, due to staffing levels particularly during the morning shifts, there is little choice as to who supports residents with personal care tasks. The health care needs of residents are met with evidence seen in care plans of multi- disciplinary working taking place. Appropriate procedures are in place for handling and administering medication. EVIDENCE: Documentary evidence was seen in the care plans of multidisciplinary input from health care professionals including: GP’s, physiotherapists, dietician, chiropody and occupational therapists. Staff in the home can refer residents to the local specialist community and support team for advice and support and staff stated that this has occurred in the past. A key worker system is in place to ensure that health care needs are co-ordinated and followed up e.g. hospital appointments and residents annual health screening. Staff reported that they had received training in administration. The medication training is part of the organisations core developmental plan training for all staff. However, evidence of this was not seen in the staffWontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 14 training log. Medication was seen to be appropriately stored and the policies and procedures were found to be in place. The residents are encouraged to do as much as possible for themselves in respect of their personal care. Guidelines are in place for staff to oversee this area of care. The inspector noted that the morning shift was extremely busy, in particular when one staff member is on duty. The inspector was concerned as to the safety of residents due to some of their challenging behaviour. At the previous inspection a requirement was made for there to be an immediate review of the staffing levels in view of the demands made on staff in the morning. This had not taken place although the inspector was informed that one of the residents would be moving to another Odyssey home in a fortnight. Staff reported that they felt safe but the shift was busy, due to the residents needing a lot of prompting and encouragement in respect of carrying out their personal care tasks. There is no gender choice as to who carries/supports residents with their personal care. Staff spoken to reported that residents raised no objections and that their privacy and dignity was always considered. The requirement regarding reviewing staffing levels has been re-stated. (See Standard 32) Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.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 An adequate complaint procedure was seen to be in place. EVIDENCE: The complaint procedure seen, detailed how to complain and who to talk to if the resident is still unhappy with the outcome following an investigation. The timescale for a response to the complaint is also detailed. The procedure also reflects CSCI details. The resident spoken to during this inspection was aware how to make a complaint but stated that they were happy and had nothing to complain about. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25 & 30 The premises are homely and were in a reasonable state of repair, although some attention is needed in some areas e.g. carpets. Bedrooms seem were personalised and reflected resident’s personality. The home was seen to be clean on the day of the inspection. EVIDENCE: The premises were seen to be in a reasonably good decorative state as were the bedrooms seen. The manager stated that some refurbishment would be taking place in the hallway to create a window to allow more light to come through, as the hallway can get quite dark despite high voltage bulbs. The inspector noted that the carpet on the stairs is beginning to lift in a couple of places, and underneath the step leading into the lounge. The manager reported that she was addressing this issue. The inspector noted that the carpet particularly on the second landing requires steam cleaning as it was badly stained in places. The front of the premises, particularly the window frames requires re-painting as bare wood is exposed in places. The open porch area requires cleaning to remove dirt and cobwebs. The small garden to the back of the house was Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 17 satisfactory although consideration should be given to improving the grassed area, which was seen to be full of weeds. Due to the needs and challenging behaviour of one resident in particular, blinds have been removed from the bathroom windows. The senior staff member stated that toilet paper, paper towels, soap and ornaments cannot be left in the bathrooms due to one of the residents putting the rolls down the toilet. This is a problem for the other residents when using the bathrooms and staff said that they endeavour to give the residents toilet paper soap etc when going into the bathroom. Consideration should be giving to re –referring the resident to the Community Specialist team for advice, as staffing levels particularly in the mornings, when there is currently only one staff member on shift compromises the above being carried out without significant delay at times. The home was seen to be adequately clean on the day of the inspection. A separate laundry room is available and three of the residents are supported to do their own washing. Policies and procedures are available to address infection control, which includes the safe handling and disposal of clinical waste. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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, 34 & 36 The staff team is committed and ensures that the residents receive consistent care. Permanent staff details were available in the home, which ensured that the residents are protected by the homes recruitment policy. Improvement is still required in the documentation in respect of staff training which was not found to be up to date, thereby resulting in staff development being compromised. However, supervision was seen to be taking place. EVIDENCE: At the previous inspection the manager reported that the home is understaffed, which effects the development of the service. At that time there was 2.5 vacancies, which is filled with bank and agency staff. The inspector was informed that one of the vacancies has been filled subject to satisfactory checks. Currently, the home operates with 1 staff member on from 7am11am, two staff members from 11-7pm, with an additional staff member between 5pm and 7pm. One member of staff sleeps in. The inspector raised concerns regarding safety in view of the dependency of three of the residents. The fourth resident requires a lot of prompting. The inspector was informed that one of the residents would be moving to another Odyssey home in two weeks. However, the inspector remains concerned that since last inspection in Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 19 April 2005 there has been no review or amendment to the staffing levels in the morning. This issue was also raised at one of the resident’s reviews when the day centre stated that greater attention should be paid to personal care and hygiene by the support staff. There also is no choice given to residents in respect of who supports them with their personal care. Gender issues could arise. This was discussed with staff who stated that they did not think this was an issue for the current residents who had all resided in the home for many years. Staff spoken to were positive about the organisations training programme. Experienced staff attend refresher courses. The record of training seen however, did not evidence that all staff have completed the core training and experienced staff had attended refresher courses. This information must be regularly updated. The home must have a current training plan for all staff in place. However, no staff currently working has achieved their NVQ Level 2, although two are due to start the Level three course next month. One of these staff already has the Learning Disability Award Framework certificate. Regular staff meetings were seen to be taking place. Staff spoke positively of these meetings, which provided a forum to discuss practice issues and share ideas. Staff supervision was seen to be taking place, staff sign their supervision notes to show agreement with its content. An annual appraisal system is also in place. Since the last inspection the manager has put in place the details of staff required in Regulation. This was seen to be satisfactory with all permanent staff. However, details of agency/bank staff were not available and must be addressed. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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) 38 & 39 The manager provides staff with good guidance and direction to ensure that residents receive consistent quality care. The systems for resident consultation have not been fully implemented with little evidence that service user views are sought. The home will benefit from full implementation of the organisations quality assurance system. EVIDENCE: The three care staff spoken to were all very positive about the management of the home. They felt that the manager was approachable and they felt consulted and thereby included in decision making. They were clear of their respective roles and all four staff (including the manager) had a good understanding of the residents needs. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 21 As stated staff meetings take place monthly and all spoke positively of them saying that the meetings provided a forum to share ideas and look at how they supported the residents to meet there individual needs. Staff spoke of the need to be fair towards all residents and to ensure that they were all provided with opportunities not just those residents who displayed more vocal or challenging behaviours. Residents meetings do take place but records showed that they were not consistent. The last meeting held was on the 28th of April 05. Records indicated that issues such as the menu, activities and day care are regularly discussed. The home has contact with residents relatives but their views as to the care their relative receives is not recorded. The organisations quality assurance policy could not be located during the inspection. Views of all interested parties should be periodically sought as regards the service delivery and any concerns or ideas where appropriate should be incorporated. Monthly visits to the home were found not to be regularly taking place. The inspector saw that following one visit, two monthly reports had been written. Regulation 26 states that the home must be visited monthly and a copy of the report made kept in the home as well as a copy being sent to the Commission. Since this inspection the inspector received copies of the June and July visit. The senior staff informed the inspector that the organisations policies and procedures are regularly reviewed and updated in light of changing legislation and good practice advice. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x x x Standard No 31 32 33 34 35 36 Score x 3 3 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wontner Road Score 2 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 2 x x x x G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 2 Regulation 6(a) Requirement The Registered Persons must ensure that the homes Statement of Purpose is updated. A copy of the revised Statement must be forwarded to the Commission. The Registered Persons must ensure that all risk assesments are updated, signed and given a date for review. The Registered Persons must ensure that all the stair carpets are secured. The Registered Persons must ensure that the porch area is kept clean. The carpets on the 2nd floor landing is cleaned to remove stains. The Registered Persons must ensure that sufficient numbers of care staff are working at the home to meet service users needs. This is with particular reference to weekday morning shifts ( timescale of the 1/12/04 1/2/05 & 30/6/05 not met). The Registered Persons must ensure that written confirmation is available in the home as to the checks which have been carried out on bank/agency staff. Timescale for action 30/10/05 2. 9 13(4) 30/9/05 3. 4. 24 24 13(4) 23(2) (d) 30/9/05 30/10/05 5. 33 18(3) 30/9/05 6. 34 7,9,19 30/9/05 Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 24 7. 39 24(1) (2) (3) 8. 39 27 The Registered Persons must 30/11/05 ensure that the quality system put in place must make provision for consultation with service users, their representatives and other stakeholders in the service ( Timescale of 1/1/05 not met) The Registered Persons must 30/9/05 ensure that monthly visits take place and copies of the written report are forwarded each month to the Commission. 9. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 1 18 24 35 35 Good Practice Recommendations The Registered Persons should consider producing the Service Users Guide in a more suitable format for the residents. The Registered Persons should ensure that residents have some choice as to which staff who work with them in particular in relation to personal care. The Registered Person should give consideration to liasing with the housing trust to consider redecoration of the window frames. The Registered Persons should give consideration to proving computer training to staff who require it. The Registered Persons should review the organisation of its staff training records to ensure that the required information is kept in one place. Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 25 Commission for Social Care Inspection Ground Floor - CSCI 41-47 Hartfield Road Wimbledon SW19 3RG 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 Wontner Road G54-G04 S10239 Wontner Rd V244316 100805 Stage 2.doc Version 1.40 Page 26 - 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. 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