Inspection on 24/05/05 for Alandale

This inspection was carried out on 24th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alandale 10/04/07

Alandale 08/11/05

Alandale 11/01/05

Alandale 03/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Alandale 9 The Drove Whitfield, Dover Kent CT16 3JB Lead Inspector Michele Etherton Unannounced 24 May 2005 9:30 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery 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. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Alandale Address 9 The Drove, Whitfield Dover Kent CT16 3JB 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) 01304 824904 Mr Paul Maple Mr Paul Maple Care Home 29 Category(ies) of Older Persons 29 registration, with number of places Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Residential care for people with a learning disability is restricted to 1 person whose d.o.b. is 20.10.1940 Date of last inspection 11.01.05 Brief Description of the Service: Alandale, is a large extended detached property. Currently Registered to provide accommodation for twenty-nine Older people, the Home offers a pleasant and spacious environment to live in. Located in a semi-rural setting on the outskirts of the village of Whitfield, the Home is within 5minutes walk of the local Pub and 10 minutes walk to the shops in the village, limited parking is provided outside the Home, although street parking is available on the main road. Access to rail transport, is some distance away, a bus service is available in the village. There are 25 single rooms, and 2 double rooms situated over two floors, access to all areas of the Home is provided by the use of a stair lift. Each bedroom has a private wash-hand basin and call bell, a cordless telephone is available to service users to make and receive calls in private. The owner/manager takes an active role in the day-to-day running of the Home, and employs a` care’ manager. In addition to care staff, the home employs ancillary staff, to provide cooking, cleaning, and maintenance duties. The Home has a range of communal areas available to its residents including a smokers’ lounge, dining area, and a choice of several large and small lounge areas, the Home also benefits from the addition of a conservatory. The Home has an enclosed well-maintained garden laid to lawn with a raised pond located to the rear of the Home Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over 5hrs and 50 mins. During the inspection a tour of the premises was undertaken, the provider and six care and ancillary staff’ were spoken with. In addition a relative and 12 service users were spoken with. A number of key standards were assessed during this inspection in addition to checks on progress made by the home in addressing outstanding requirements and recommendations. The home has made good progress in addressing some of the previous outstanding requirements and recommendations, achieving some fully and partially addressing others. Unfortunately, little progress has been made on one, that could compromise staff and user safety if not addressed, as a consequence this inspection has made this a requirement, with a timescale for achieving compliance. Service users, and a relative spoke positively about their experiences of the home and its staff. Staff were friendly and co-operative during the inspection process Two complaints have been received by the home since the last inspection, one of which has also been referred for the attention of the Adult Protection. A subsequent investigation by adult protection has concluded that the Home have no case to answer. No complaints have been received by CSCI in respect of this service. What the service does well: What has improved since the last inspection? What they could do better: Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 6 The home have been slow to address outstanding shortfalls and need to ensure adherence to timescales in achieving some requirements and good practice recommendations which impact on the health & safety of service users. The Home need to improve recording of decisions on documentation. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,6 Standard 6 is not assessed for this home as intermediate care is not offered in this service. The Home has made no progress on implementing improvements to the Statement of Purpose. The home has implemented good practice recommendations to improve assessment of service users, and ensures that service users are made aware of the terms and conditions of their stay. EVIDENCE: The Home provider/manager advised that information relating to environment standards met by the Home is still to be incorporated into the Statement of purpose and this remains an outstanding recommendation. The inspector viewed documentation relating to new service users admitted since the last inspection, and noted assessment information is in place and that the Home have addressed a previous recommendation in respect of how risk levels are determined. The importance of records dating, was stressed to the provider at inspection as a means of denoting that a clear distinction exists between the timeframes for assessment and admission, and consequently an opportunity for the home to make an informed judgement that it can meet a service users needs, it was recommended that documentation is dated and signed. New service user files viewed contained signed contractual terms and conditions. A relative spoken with confirmed the receipt of a contract in Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 9 respect of `top-up’ arrangements, and were very clear about their contribution towards their relatives care costs. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 The health and personal care needs of service users are met by the home through the provision of individual plans of care that provide access to routine health checks and more specialised health care needs. The Home need to evidence better contacts/decisions made with third parties and other agencies in respect of health or care needs of service users. The Home has incorporated good practice recommendations into its medication administration procedures in the home. Staff awareness of issues of respect and privacy need to be reinforced. EVIDENCE: Care plans for new service users were viewed at inspection, these were adequate and showed signs of review, however, the inspector stressed the importance of monthly reviewing accurately reflecting changes in care needs as there was a danger that only cursory checks may overlook some changes and become a token gesture, this was highlighted in one care plan viewed where the care plan was not reflective of dietary evidence noted in documentation elsewhere in the home and consequently needs further review, this was discussed at inspection. Feedback from service users indicated general levels of satisfaction around daily routines, which they felt staff understood, Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 11 but the home needs to more clearly evidence involvement of users or their representatives in agreement of care plans and these are recommendations. Strategies for management of some behaviours that may involve lack of privacy around freedom of movement, should be clearly detailed within an individual behaviour management guideline (see standard 18). Service users and a relative confirmed access to routine health care appointments, discussion with staff confirmed user weights are recorded regularly, and these were noted in care plans viewed. The Home advised that none of the present service users have a pressure sore. Although not fully assessed the progress made by the home in addressing outstanding recommendations for the medication standard were checked, the home has addressed four of the recommendations but needs to ensure that as directed by Doctor’ dosage instructions are discontinued. MAR sheets viewed although completed satisfactorily would improve user safety and the likelihood of medication errors by the addition of photographs which should correspond to those on MDS cards and this is a recommendation, discontinued medications should also be clearly marked as such on MAR sheets. Whilst all the service users spoken with and a relative spoke positively about the staff team who they found approachable, friendly and respectful, there have been two recent complaints that have been dealt with by the home and are issues of respect and dignity of service users. It is recommended that the home re-inforces the importance of maintaining respect towards service users and ensuring their dignity irrespective of time constraints experienced by staff, through its induction, foundation, supervision and team meetings Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 The Home provides opportunities for activities favoured by service users which they can choose to participate in or not. The Home has a flexible visiting policy and welcomes relatives and visitors. Residents are generally satisfied with the quality, quantity and variety of food provided for them. EVIDENCE: Discussion with service users indicated general satisfaction with the amount and variety of activities provided within the home. The Home has a busy atmosphere irrespective of whether activities are taking place, with the current user group, conversing with each other and a regular flow of visitors. There are strong group dynamics within the current user group and the Home manager and staff need to ensure that some service users are not marginalised as a result. Service users confirmed bingo, exercise, craft/painting sessions as well as visits from the music man. A list of forthcoming events are posted on the users information board. None of those spoken with indicated dissatisfaction with the present itinarary or a wish for additional activities. A relative spoken with during the visit stated they visited frequently and often unannounced they felt comfortable within the home and were made to feel welcome, interaction with the provider and staff was relaxed and informal. Service users confirmed visits from family and friends and visits Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 13 they make form the home to relatives homes. A menu is posted on the service users information board, alternatives to the menu were recorded, service users expressed satisfaction at the quality and quantity of food provided, with two indicating that portions were too large. The Home has recently been awarded a good Food award by the Environmental health officer. All staff are currently on a rolling programme of food hygiene training, this training is at an intermediate level and exceeds that of the standard basic mandatory training level. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The Home has an effective complaints procedure, that service users and their families are confident about using. The Home has made some progress in implementing measures for the protection of service users, but further developments are needed. EVIDENCE: The Home has addressed an outstanding recommendation in respect of updating the complaints procedure and also relocating the position in which it is displayed to make it visually more accessible to residents or their families. There have been two complaints since the last inspection, the Home has carried out a thorough investigation of both incidents and has resolved both to the satisfaction of the complainants. One of the complaints had also been referred to the adult protection team. The Whistle blowing policy has been reviewed but is still inadequate, this was discussed at inspection and remains an outstanding recommendation, staff spoken with understood whistle blowing and adult protection procedures. Service user files evidenced records of inventories of possessions. Behaviour management strategies in respect of one service user were discussed at inspection, any proposed strategies which will impact on the privacy and freedom of movement of a service user for their own safety, must be written into an individual behaviour management strategy which must be discussed and agreed within a multi disciplinary meeting involving the service user. The plan must be reviewed for effectiveness, this is in keeping with government good practice guidance and this is a recommendation. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,25, &26 The Home offers a pleasant comfortable environment for service users to live in which is clean, well maintained and generally safe. Some improvements to practice that the home has been slow to implement are required. EVIDENCE: The home has a maintenance person on the staff and routine repairs and redecoration are undertaken by them, they confirmed access to job sheets completed by staff who identify repairs or hazards needing attention, a programme of upgrading works are also ongoing, with the conservatory floor being replaced at the time of inspection. The maintenance person confirmed that a programme of radiator cover installation has commenced and they are hopeful that all radiators in bedrooms and communal spaces will be covered by the next inspection. Space limitations in some wash areas will require the home to develop risk assessments for those areas and radiators and this is a recommendation. Bedrooms and communal areas are maintained to a high standard of decoration and furniture and furnishings are of good quality. The home employs a number of domestic staff and cleaning schedules are in place, discussion with staff indicated that although the ground floor sluice is in use, commodes on the first floor are still being emptied in resident bathrooms Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 16 owing to practical and time issues, a procedure for the management of commodes has also not been produced. Discussion with the home to resolve the issue and provide a workable solution was undertaken at inspection and the home will identify an infrequently used bathroom on the 1st floor where commodes can be emptied, thus limiting opportunities for infection to spread, a robust cleaning schedule for that bathroom will be included in the supporting staff procedure, and this is a recommendation. Discussion with staff indicated a good understanding of the management of soiled and normal laundry within the home, no hand sluicing of washing and the use of alginate bags. Staff confirmed attendance on infection control training. Service users spoken with were generally satisfied with the laundry facilities, with some indicating that their families take some special items home to wash which may be sensitive to the high temperatures used in the home for washing, but were satisfied with this flexible arrangement. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29, 30 The home need to ensure that staff are visible throughout the home. The Home has made progress in addressing shortfalls within its recruitment procedure, that may pose a risk to service users. The Home has introduced a more comprehensive training programme for staff to ensure staff have the knowledge and skills to meet this standard EVIDENCE: Concern was expressed to the provider that at the commencement of the inspection, staff were not in evidence for 15 minutes in the main communal areas, it appeared that staff were congregated in one area of the home during this period, this is unacceptable and the it was made clear to the provider that staff breaks/training and meetings must not impact on safe staffing levels being maintained on the floor and this is a recommendation on this occasion as further discussion with service users, highlighted no concerns in respect of staff responses to call bells or availability to offer support. Three files of newly appointed staff were viewed at inspection, these provided evidence that the home is seeking POVA first checks prior to employment, and that the home has addressed an outstanding requirement. Staff files contained a majority of information required by schedule 2 of the Care Home regulations, and current photographs of staff have been taken and are waiting to be added onto files this remains an outstanding requirement. The quality or relevance of some references was discussed with the provider, who was clearer about the importance of relevant employment references over character references and will amend the staff application form to reflect this. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 18 The Home has taken on board previous criticisms of the induction and staff’ training programme and has invested in a Social skills council induction and foundation programme. All new staff’ have an induction file, these were viewed at inspection and a new staff member confirmed the induction programme is in place. All care will staff have a training file and a training profile and examples of these were viewed at inspection. All staff will undergo foundation training that will include the updating of mandatory core skills training. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36, & 38 The Home has made slow progress in providing formal supervision to care staff, which may pose a risk to service users in ensuring the delivery of care and development of staff is commensurate with the expectations of the standards. The Home has made some progress in addressing outstanding health and safety requirements, however, the inspection highlighted further shortfalls that could impact on the safety and welfare of service users if not addressed. EVIDENCE: The home has reintroduced formal supervision sessions for care staff, and evidence of the notes of these meetings were viewed at inspection. Frequencies of these sessions are not yet in keeping with the standard, and the format of the sessions is likely to evolve, until further progress is made in this area this remains an outstanding recommendation. As stated previously a programme of mandatory training is now underway and staff are completing training in food hygiene and infection control training, as this is still in progress this remains an outstanding requirement until achieved. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 20 The fire book was viewed at inspection and indicated checks and tests of fire fighting and fire detection equipment is taken place within appropriate timescales. The Home was still unable to evidence attendance at fire drills by staff and this is now a requirement that the home can provide evidence that all care staff including night staff have attended a minimum of two fire drills annually. The tour of the premises highlighted a number of bedrooms where users bedrooms are wedged open, although aware that this has been undertaken by staff at the request of service users it constitutes a breach of fire regulations. The Home will need to discuss with residents whether they need to have their bedroom doors open during the day, and where this is a preference the home will need to discuss with the fire officer the installation of magnetic door closures and this is a requirement. The Home has recently submitted a fire risk assessment to the fire officer, who has offered no amendments, this will need to be reviewed in view of the findings of this inspection. The Home is still to develop environmental risk assessments and this remains an outstanding recommendation. Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x 2 x 2 Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 22 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 29 Regulation 19(1) schedule 2 13(4)& 18 Requirement staff files to be updated to contain information as required in the regulation and schedule ( previous timescale partially met) All care staff to have received mandatory core skills training(previous timescale partially met)Home to reassess bedrooms where users are wedging doors, discuss installation of door closures with fire officer, revise fire risk assessment to incorporate these changes. Home to evidence attendance by all staff at a minimum of two fire drills annually. Timescale for action 31.7.05 2. 38 30.8.05 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. Alandale Refer to Standard 1 3 Good Practice Recommendations environment standards met information to be incorporated into SOP Assessment and other documentation to be signed and dated at all times. H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 23 3. 4. 7 9 5. 6. 10 18 7. 8. 9. 10. 25 26 27 38 Care plan updating to accurately reflect changes in care needs. Home to evidence involvement of users and relatives etc in agreement to care plans. a)Home to ensure that as directed by Doctor’ dosage instructions are discontinued. b) MAR sheets would be improved by addition of photographs on separator cards that should correspond to those on MDS cards C)Discontinued medications should also be clearly marked as such on MAR sheets Home to incorporate staff awareness of user respect and dignity issues within staff training, supervision and meetings Whistle blowing policy to be reviewed with reference to `no secrets guidance.Individual behaviour guidelines to be established for users whose privacy or freedom of movement may be impacted upon, which must be agreed by a multi-disciplinary meeting including th service user. Home to risk assess washrooms and radiators where covers cannot be fitted Home to identify one bathroom on first floor for emptying commodes, robust cleaning schedule to be produced and staff procedure to be developed Staff breaks, training or meetings are not to impact on the availability of staff on the floor at any time. Home to develop enviromental risk assessments Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection 11th Floor, International House, Dover Place Ashford Kent TN23 1HU 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 Alandale H56-H05 S23343 Alandale V225170 240505 Stage 4.doc Version 1.20 Page 25 - 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!