Inspection on 15/06/05 for 42 Barry Road

This inspection was carried out on 15th June 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

42 Barry Road 10/11/06

42 Barry Road 23/01/06

42 Barry Road 30/03/05

42 Barry Road 08/02/05

42 Barry Road 02/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 42 Barry Road Oldland Common South Glos BS30 6QY Lead Inspector Christopher Lewis Announced 15 June 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 42 Barry Road Address Oldland Common South Glos BS30 6QY 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) 0117 9329705 0117 9329705 admin@aspectsandmilestones.org.uk Aspects & Milestones Trust Mr Martin Rogers Care Home for Younger Adults 11 Category(ies) of LD Learning Disability registration, with number LD (E) Learning Disability - over 65 of places (11) 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 11 persons aged 18 years and over. May include persons aged 65 years and over. Date of last inspection 30 March 2005 - Unannounced. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: 42 Barry Road is registered to accommodate up to eleven active adults with learning difficulties, which may include people over the age of 65. The home is operated by Aspects and Milestones Trust. The home is on the edge of Oldland Common village within walking distance of shops which include a post office, public house, chemist and other stores. The property is a Victorian detached house which has been extended to create a large ground floor purpose-built area. The original building also houses a self-contained first floor flat which has the potential to be independent from the rest of the home for either a single person or a couple. All communal areas are on the ground floor and consist of a modern and spacious lounge with a partial glass roof with ten bedrooms leading off from this area. There is also a more traditional and comfortable front lounge in the older part of the building, a smaller lounge and a dining room and kitchen. The large and well maintained rear garden is fully accessible to service users. There is parking available to the front of the premises. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_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 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_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 and 4. Available information about the home was good with a well-written and attractively presented Service User Guide. The assessment and administrative process is well-established with potential service users being offered the opportunity to visit and have short stays at the home to see if it offers the facilities they require. EVIDENCE: A Statement of Purpose and a Service Users Guide is available and it gives an excellent and very readable overview of the home and what it provides. The user guide contains details of both 42 Barry Road and the self-contained first floor flat at 42a Barry Road. The guides contain colour photographs of not only the interior and exterior of the home, but also photos taken on trips out and at local functions. Full community care assessments of the needs of new services users have been done, including their health, personal and social needs. Input from professionals outside the home has been sought on a regular basis to ensure that service uses receive the best care available. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 9 Admissions are arranged initially via the organisation’s HQ who then contact the Managers’ of individual homes within the organisation. The home is in the process of considering the admission of a new service user who, at present, lives in Cardiff. He has visited the home twice and if the possibility of him moving in goes any further, he will spend three or four days at Barry Road to see if he really likes the place. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_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, 8, 9 and 10. Service users care plans are in place, though some shortfalls identified at the last inspection remain. Service users are consulted about life at Barry Road and their independence is encouraged. information about service users is kept safe and confidential. EVIDENCE: At a previous inspection, a requirement had been made that care plans were to be updated and reassessed by 30th June 2005. Some of the work has been done, but many care plans are still out of date. As the inspection was conducted on June 15th, there was around three weeks left to complete this task. The Manager is confident that this will be achieved and he assured the Inspector that this will be done despite him being in the process of changing systems overall to make them more user-friendly. Many of the service users at Barry Road have been in care for virtually all their lives which inevitably had led to a great deal of accumulated paperwork and perhaps some complacency in the past about how their needs will have changed as they grow older. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 11 A requirement was also made at the last inspection that service users participate in meetings at the home. Since that inspection, two service users’ meetings have been held. Notes for their meetings (held on the 28th March and 28th May) were seen. These notes needed tidying up, though they gave a reasonably accurate reflection of the topics covered. The Inspector was told that the outcomes of these meetings will form an agenda item for future staff meetings. Service users continue to plan their meals and to contribute to the variety of menus. The Home is geared up around the fact that independence is a major priority for service users, particularly as many may have come to Barry Road from long-stay placements such as hospitals where such independence was not encouraged. Risk assessments to cover aspects of daily life were in place and have been reviewed. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14 and 17. The staff at Barry Road continue to work hard at enabling service users to participate in the life of the home and of the local community and to promote service users leisure and social activities. The food provided is nutritous and of a well-balanced variety. EVIDENCE: Communication between service users and staff continues to be helped by programmed one-to-one sessions. One service user has no speech whatsoever but staff are able to communicate with him by means of hand gestures etc and he has a good comprehension. All the other service users are able to communicate verbally, some more than others. Service users help to keep their rooms clean – all those seen by the Inspector were very well kept and personalised. Service users were seen by the 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 13 Inspector to be accessing all areas of the home with confidence and to be treated with respect and care by the staff. Service users attend such places as Kingswood and Blackhorse RAC (although the Manager commented that many residents were getting rather too old for their activities), Soundwell College, Longwell Green Luncheon Club and “Hop, Skip and Jump”, which is designed for those less able than others. Hop, Skip and Jump is held in the campus of a local school which helps with local community integration. A large chart on the office wall is used to keep track of who is where during the day. Besides their regular activities, service users continue to go out a great deal on other occasions to such places as country parks, skittles and so on, as evidenced by the daily records book. Recently, the Manager has encouraged attendance at local car boot sales. Efforts to get members of the community into the home have not proved too fruitful; by attending such activities such as car boots sales, service users are becoming more known and thus more integrated into the local community. The home’s mini-bus is well-used and two trips were made during the time the Inspector was in the home. Local shops and super-stores are visited and journeys further a-field to such places as Weston-super-Mare are taken, particularly in the summer months. Service users are encouraged to help with menu planning; menus were examined and the food provided was seen to be of a good variety. There has apparently been some issues recently over the home’s food budget being overspent which it is presumed will not impact in future on the provision of well-balanced meals. Service users told the Inspector that they were happy living at Barry Road. One expressed some dissatisfaction about the one-to-one session being cancelled recently but appeared satisfied that the Manager was to investigate this matter. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 14 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 and 21. Staff support service users in a caring and helpful way. Healthcare professionals are involved in the care planning process. Procedures for the control and distribution of medication appear adequate and there are policies in place to deal with the illness and death of any service user. EVIDENCE: The Inspector observed the staff on duty on the day of the inspection interacting in a sensitive and caring way with service users. The service users approached the staff with confidence and it was evident that good relationships had grown between staff and service users. Staff spoken to by the inspector demonstrated a commitment to providing a good standard of care, guiding service users into making choices on what to eat, wear, how to respond to one particular service user’s occasional aggressive out-bursts and so on. Staff were also seen to be offering appropriate anger management suggestions to the service user who appeared to be losing their temper. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 15 Many adaptations are fitted within the home to ensure that service users are able to overcome any problems with washing etc. The files revealed regular support for service users and staff from outside health professionals such as occupational therapists, physiotherapists, chiropodists etc. The intervention of such in the local community, support and local day care teams was noted. One service user is blind and is receiving appropriate outside support. There is one general practitioner for all the home’s service users. No service user is able to take their own medication. A medication policy is in place and medication is dispensed through a blister pack system supplied by the local pharmacy. A sample audit conducted by the Inspector showed no apparent errors. Medicines are kept in a locked cabinet. The pharmacy regularly collects unwanted medication. The Manager (who possesses, among other things, a general nursing qualification) explained that many service users have had their medication greatly reduced since joining the home. Recently a service user in his nineties died. He had been eventually admitted to hospital after staff had supported him at Barry Road for as long as possible. His death and its impact has been discussed among staff and service users with people having individual managerial support if required. Two staff found it a particularly difficult time, largely because of issues in their own lives. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 16 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 and 23. A system for dealing with any complaints by service users is in place and policies and procedures for the protection of vulnerable adults are also wellestablished. EVIDENCE: The Inspector examined the records of complaints which is now kept at the home. One complaint has been made since the last inspection. The record was detailed and outcomes were recorded. Policies and procedures for the protection of vulnerable adults were in place, based on the Department of Health guidance “No secrets”. The Manager has attended a course on Vulnerability on 16th May 2005. Policies in general are gone through regularly with staff and the Manager has devised a check list where staff sign once they have read (and, it was emphasised, understood) a particular policy. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_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, 25, 26, 27, 28, 29 and 30. Barry Road is clean, well maintained and adequately equiped. Bedrooms reflect the Homes promotion of independence. Specialist equipment is in situ for the service users who may require it. Communal spaces are comfortable and well-kept. EVIDENCE: 42 Barry Road is an extended Victorian detached house in keeping with the properties in the area. The first floor of the original building is able to be used as a self-contained first floor flat with its own amenities and entrance. Recently, it has been used as ordinary bedrooms. The Home overall is bright, cheerfully decorated and well-maintained. Furniture and fittings were of good quality though some were beginning to show signs of age. Rooms were clean and tidy. Bathrooms were clean and well-kept with adaptations fitted. Further adaptations may be needed with the 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 18 Home’s aging population and also to meet the physical needs of a new service user. The rear garden is beautifully kept, with chairs, patio furniture and so on. The Manager commented that they hoped to get an “outside” pet, such as a rabbit or a guinea pig as it is felt that many service users would benefit from helping to care for such an animal. Relationships with neighbours are fine – the property on one side is a care home for the elderly. All bedrooms meet the spatial standards requirements and are single occupancy. Rooms were inspected with the permission of service users. All were clean and well kept and reflected the interests of individual occupants with a very homely feel. Residents spoken with said they were comfortable with their rooms. The Home has toilets and bathrooms in close proximity to all bedrooms and communal spaces. Two bedrooms have en-suite facilities. All were hygienically kept and evidence was seen that they are cleaned throughout the day. Communal spaces are on the ground floor and consist of a large, modern lounge which looks out onto the accessible rear garden. One service user uses a smaller room as her own private space. There is a traditional-style comfortable front lounge in the older part of the building (which the Inspector was told gets little use at the moment). It looks out over fields opposite the Home. There is a domestic-style dining room and well-equipped kitchen. Overall, the Home was clean, tidy and well-maintained and free from odours. Infection controls were in place. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_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) 31, 33, 34 and 36. Staff at Barry Road are clear about lines of responsibility. There are sufficient numbers of staff on duty at all times. Recruitment policies are satisfactory with some difficulties. Staff are properly supervised. EVIDENCE: The Inspector noted from observation, discussions with staff and the Manager and a review of records that clear lines of accountability exist within the Home. Job descriptions were available although much of the Human Resources material is kept at the organisation’s HQ. The Inspector saw that there was excellent interaction between staff and service users including those whose behaviour may, at times, have caused some disquiet, both to staff and other service users. Staffing levels appear appropriate to meet the needs of the eight service users accommodated. All staff are first-aid trained. No staff have left since the last inspection. A permanently employed member of staff is now on duty at all times. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 20 Staff records are still patchy; in particular a requirement that a note of CRB number and the date of issue are kept at the home has still not been met- this needs to be put in place by 30th June 2005 to comply. The Inspector examined supervision records and found them detailed and upto-date with targets and deadlines set. Copies of supervision records are given to staff – none seen were actually signed off by the worker concerned. It is considered to be better practice to make sure that the member of staff signs (and therefore “owns” and agrees with) the supervision record and the goals set therein. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_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) 37, 38, 40 and 42. Barry Road is well run and the Manager demonstrated a good style of leadership and is well qualified. Quality assurance issues highlighted at the last inspection remain. Policies and procedures are in place to protect service users. The Home is generally safe and service users are happy and protected; however, an issue over fire safety needs to be addressed. EVIDENCE: The Manager, Mr Rogers, holds qualifications in general nursing, nursing those with a learning disability and has also achieved the NVQ 4 in Management. He is an NVQ assessor and also an NVQ verifier for Level 2 and 3. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 22 Team meetings are held regularly; notes were seen from the April and May meetings. Every 6 to 8 weeks, team meetings are held outside the home, giving staff the opportunity to open up in different surroundings. The Inspector saw that the Home operated an open door policy with service users entering the office at will to engage in general interaction. Service users told the Inspector that they were happy and treated well. One service user expressed dissatisfaction about not having received a recent one-to-one session, but seemed satisfied that the Manager was intending to deal with this matter. A lack of an overall quality assurance system remains an issue; the Manager assured the Inspector this was being dealt with and it was confirmed that he has until the 30th August to comply. A service satisfaction questionnaire for service users has been devised towards the quality assurance goal; the Manager appears keen to create proper tools and to seek methods that will pay more than lip service to quality assurance which is a reassuring attitude. The Inspector noted that policies were in place to cover such matters as bullying, equal opportunities, disciplinary procedures and so on. A requirement made at a previous inspection that staff sign that they had read and understood policies is now covered by a policy contact sheet devised by the Manager. Freezer and fridge records were examined and were in order. Fire records were inspected; two drills per year have been done, though it was noticed that it was difficult to get service users to react sometimes. A full fire system check had been undertaken on 13th January 2005; a new panel was recommended and it is a requirement that this is actioned. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_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 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 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 x 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 x 3 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 42 Barry Road Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 x 2 x Version 1.30 Page 24 D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc 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 YA6 YA34 Regulation 15 Requirement Timescale for action 30/06/05 30/06/05 3. YA39 4. YA42.1(ii) The Registered Person must ensure that all service users plans are reviewed and updated. 19(1)(i) The Registered Person must ensure that all of the required staff employment records are held at the home. 21, 24, 26 The Registered Person must ensure that a quality assurance system is developed and implemented that can be used to measure/audit the quality of services provided. 23(4) A new fire-control panel must be fitted as recommended by the contractors. 30/08/05 30/08/05 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. Refer to Standard YA36 Good Practice Recommendations Supervision records should be signed off by workers and managers. 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 42 Barry Road D56_D05_S3392_42BarryRoad_V229194_150605_Stage 4.doc Version 1.30 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. 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!