Inspection on 03/10/06 for Arbor Way

This inspection was carried out on 3rd October 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arbor Way 07/03/06

Arbor Way 13/09/05

Arbor Way 14/03/05

Arbor Way 10/06/04

Arbor Way 29/01/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Arbor Way 78a Arbor Way Chelmsley Wood Solihull West Midlands B37 7LD Lead Inspector Donna Ahern Key Unannounced Inspection 3rd October 2006 13:50 Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 1 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 Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 2 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 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. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arbor Way Address 78a Arbor Way Chelmsley Wood Solihull West Midlands B37 7LD 0121 788 1937 0121 7881945 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) H4037@mencap.org.uk Royal Mencap Society Mrs Gillian Cox Care Home 5 Category(ies) of Learning disability (5), Physical disability (1) registration, with number of places Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user over the age of 65 years. Date of last inspection 7th March 2006 Brief Description of the Service: 78a Arbor Way is a 5-bedded detached property located in a quiet side road in Chelmsley Wood. The Home is registered to provide long-term placements for adults with a learning disability and physical disability. The residents receive accommodation; full board, twenty-four hour care and supervision as required. Bromford Carinthian Housing Association who are accountable for major works and the external maintenance of the building owns the property. The Home and staff are managed by MENCAP. The provider also takes responsibility for general internal decoration, carpets, furniture and so on. The Home, which blends in with its surroundings, is easily accessible by bus and close to local amenities such as shops, library and Doctors surgeries. Services are organised on a group living basis. Communal space includes a sitting room, dining room, conservatory and good-sized garden. Whilst all four of the bedrooms on the first floor are fitted with wash-hand basins, bathing and toilet facilities are shared, the only bedroom with an en-suite is located on the ground floor. There is a stair lift providing access to the 1st floor. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The fieldwork visit was unannounced involved one inspector and took place on an afternoon and evening lasting six hours. This was the homes first key inspection for the inspection year 2006-2007. During the visit the inspector met with all five service users currently living at Arbor Way, observed the opportunities and support provided to them, looked at the premises, and read records about care, staffing, and health and safety. Time was spent with the manager and discussions took place with three support staff. A pre-inspection questionnaire was completed by the manager and returned to CSCI prior to the fieldwork visit. Information from this was used to help compile this report. The home is required to report incidents, accidents and other events that occur in the home to CSCI. These are called regulation 37 notifications. All information reported via a regulation 37 notifications since the last inspection was analysed prior to the fieldwork visit. What the service does well: What has improved since the last inspection? Good progress had been made on previous requirements. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 6 Risk assessments and guidelines had been implemented for the use of wheelchairs so that service users are supported safely. Manual Handling risk assessment were in place so that staff know how to support service users safely. The lounge has been redecorated and new furniture and carpet provided so that it is comfortable for service users. Staff have completed training on Supporting Ageing People, Various aspects of Autism, moving and handling updates, Epilepsy, Person Centred Planning and Medication training. The manager and two support workers were due to attend a seminar on Parkinson Plus. It is positive that as well as mandatory training updates, training specific to the needs of the individuals who live at Arbor Way has also been completed. This ensures that staff have the knowledge and skills to meet service user needs. The manager completed the registered managers award in July 2006, which was a condition of registration. 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. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 the following standard(s): 1,2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is information available to support prospective service users in making a decision about a future placement in this home. EVIDENCE: Arbor Way is registered for five people who have a learning disability. People’s needs are complex and include additional health needs and mobility difficulties. There have been no admissions since the previous inspection. So it was not possible to assess the pre assessment process. The organisation has an admission criterion to follow in the event of a new referral to the home. It includes visits to the home and overnight stays and the assessment process. The Statement of Purpose and Service User Guide has been kept under review and included information about what service users have to pay for such as toiletries and activities. Both documents are available in a format that is easy to read and on audiotape so that it is more accessible to service users. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 the following standard(s): 6, 7, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users care plans are detailed documents. They are kept up to date. Staff have the information they need to support service users. There is evidence that care plans are being develop so that they are more person focused. EVIDENCE: Two service users care plans were seen. These contained detailed information about the person’s communication, personal care, social needs and health needs. There was evidence that staff are involved with working alongside service users to develop their care plan. The care plans included pictures, photographs and different recording methods so that the care plan is more person centred. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 10 Care plans are reviewed on a weekly basis and review sheets had details of what action is to be taken to keep the care plan current. Staff spoken with said the care plan is a working document. The manager said there is ongoing development of care plans so that they are comprehensive and reflect service users changing needs. Annual reviews take place with the placing authority and other relevant people such as staff at the day centres that people attend. This ensures that service users needs are kept under review. A number of risk assessment were on each person’s file including bathing, mobility, use of wheelchair, accessing the homes transport. Some of these were seen. These had been kept under review and specified the support service users required from staff to meet their needs safely. Service users have limited communication needs. Staff spoken with recognised the challenges this presents. Staff engaged directly with service users and were observant of peoples facial interactions and gestures. Weekly service users meetings take place and pictures and photographs are used to assist with communication in the home. Minutes of meetings were detailed and indicated that service users are kept informed of day-to-day matters. The manager recognised the need for ongoing work and development in this are so that where possible people receive the information, assistance and communication support they need to make decisions about their life. There are procedures in place to promote the confidentiality of information about the people living in the home. Information required on a daily basis is kept in a locked cupboard in the lounge all other information and files are kept in a locked cupboard in the office. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are supported to have a meaningful lifestyle, engage in appropriate activities and enjoy a healthy diet. EVIDENCE: Four of the service users attend a day centre and college. One person needs have changed which has had an impact on their daytime opportunities. Staff were exploring possible opportunities so that the service user gets the chance to enjoy activities they like and that are appropriate to their needs. Service users needs are changing. The manager said that they are reviewing people’s day care so that service users are able to do what they want according to their health and needs. Some service users are indicating that five days at the day centre is too much for them. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 12 Care plans had details of the different places that service users have been to. These include where they have been, who went with them, and what they did. Recordings seen indicated that service users are supported to access facilities in the local community such as the local shops, cinema and theatre. Service users are supported to maintain personal and family contact. There is a “contact form” on care plans, which is a running record of the service users contact with their family and friends. This includes details of visits and phone calls and any relevant information to do with the specific contact. Service users are involved in areas of daily living although it is limited due to peoples needs. Service users were seen taking their plates to the kitchen and supported to make a drink after their meal. Four service users went on holiday to Spain and stayed at a hotel. One service user went to America to meet up with their family. Staff supported service users on both holidays. The menu is planned during the weekly service users meeting. Menus seen had a variety of food and included healthy options and service users cultural and dietary needs. The support service users received around meal times was good. Service user choice to eat later or away from other people was respected and well managed by staff. A record is kept of what service users eat so that staff can monitor that service users have a balanced diet. There were ample food stocks and a choice of drinks. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are well supported to undertake a range of healthcare monitoring appointments, and the staff had sought advice from health professionals. Service users are protected by the homes medication procedures. EVIDENCE: Service users have complex needs including health needs and deterioration in mobility. Some of the peoples needs have changed considerably over the last twelve months. The manager and staff team have worked closely with other professionals in ensuring service users receive the right care and support. The manager recognises the need to keep service users needs under close review. Support plans had details regarding how service users should be supported with aspects of their personal care needs. This ensures that people receive support in the way they prefer. There was good detail of how service users independence should be promoted throughout personal care. One support plan stated that the service user should control the button for the specialist bath they use. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 14 The support plan had photographs and pictures of the equipment with clear instructions and detail on how to use it. This ensures that staff know how the equipment should be used safely and appropriately to meet service users needs. Some minor additions was required to peoples support plans so that it was explicit how night staff support and monitor service users. Service users personal appearance was good. They wore clothing appropriate to their age, culture and time of year. There was evidence of much individual support for service users who had indicated they wanted to wear make up and jewellery and they had been given assistance to achieve this. The manager has continued to develop health action plans with the support of the community nurse; a health action plan is a plan of what a person needs to do to stay healthy. The health action plans had identified action points. Specialist equipment provided in the home includes a specialist bath, lifting aids and a stair lift. Service records were available stating regular service of the equipment had taken place. Manual handling risk assessments were seen and had been kept under review. Risk assessments and guidelines had been implemented for the use of wheelchairs so that service users are supported safely. Medication records were sampled. Medication Administration Records (MAR charts) had been signed when medication had been administered. Medication is stored in a locked wall mounted cupboard in the staff room. Support plans had details of the medication service users take and how people should be supported to take their medication. Multidisciplinary advice had been sought over the practice in place to support a service user with taking required medication. This practice must be kept under review. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The arrangements for the service users to make a complaint are adequate. The adult protection procedure must be developed so that the homes procedures protect residents from abuse. EVIDENCE: The complaint log seen indicated that the provider had not received any complaints since the previous inspection and CSCI had not received any concerns, complaints or allegations about the home. The complaints procedure is in an accessible format for the service users who currently live in the home. There is a system in place for the recording and logging of regulation 37 notifications, which are a record of any incidents occurring in the home, that impact on service users. Entries seen indicated that the manager had taken appropriate action to safeguard service users. The organisation’s policy on Adult Protection required some amendments as raised in previous inspection reports so that service users are fully protected by the organisations procedures. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 16 The staff files sampled indicated that training in the area of Protection of Vulnerable Adults had been completed so staff have the skills to recognise and respond if a service user was at risk of harm. Staff files sampled indicated that the required CRB checks had been completed prior to employment ensuring the protection of service users. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 the following standard(s): 24, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users live in a homely, comfortable environment, which meets their current needs. EVIDENCE: Arbor Way is a domestic style home. It was clean, homely and comfortable. There is good communal space with a pleasant conservatory at the rear of the house and a well-kept garden. The lounge has been redecorated and new furniture and carpet provided so that it is comfortable for service users. Four of the residents use a wheelchair all can transfer and have varying degrees of mobility. Manoeuvrability of wheelchairs within the house is restrictive. Specialist equipment provided in the home includes a specialist bath, lifting aids and a stair lift provides access to the first floor. People’s current needs were being managed. The manager was aware of the need to ensure that adaptations and equipment are suitable and meet service users assessed needs. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 18 Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staffing levels must be kept under review. The management structure must be formally reviewed so that service users benefit from a well supported team. EVIDENCE: There is a flat line management structure with a team of support workers. There is no senior support worker or deputy manager. If and when the manager is not on duty or on annual leave there is no one in a senior role to take a lead. Previous inspection report required that these arrangements must be reviewed with CSCI so that the home has an effective staff team, with sufficient skills and experience to meet the needs of service users. This remains outstanding and the provider is again required to review the staffing structure. Due to the changes in need of one service user staffing levels had been increased from two to three staff on duty at core times. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 20 There were 70 care hours vacant, which are of a result of increased staffing levels to meet service users needs. Two staff were appointed in recent months. Staff spoken to were positive about the support they receive from the manager and how they work as a team. The staff induction pack was seen this includes emergency procedures that staff must follow and reference to other policies and procedures. Staff had signed to confirm they had read and understood the information. Since the last inspection staff have completed training on Supporting Ageing People, Various aspects of Autism, Moving and Handling updates, Epilepsy, Person Centred Planning and Medication training. The manager and two support workers were due to attend a seminar on Parkinson Plus. It is positive that as well as mandatory training updates, training specific to the needs of the individuals who live at Arbor Way has also been completed. This ensures that staff have the knowledge and skills to meet service user needs. Staff recruitment files were seen. They contained all the required documents and ensure that service users benefit from appropriately recruited staff to protect them from harm. Staff have received support and development sessions with the manager on a monthly basis. These sessions take place so that the manager can discuss with staff their work with individual service users, policies and procedures and training and development issues. Minutes of staff meetings were available and indicate regular meetings take place in the home, which ensures good communication so that service users are supported by an effective staff team. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users health, safety and welfare is promoted and protected. EVIDENCE: The manager was registered with CSCI in September 2005 and completed the registered managers award in July 2006, which was a condition of registration. The manager has continued to develop the service. She is open in her approach. Policies and procedures are made available to staff and are discussed in one to one sessions and during staff meetings. Health and safety is well managed. A number of records were checked and were up to date indicating that service users health and safety is protected. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 22 Fire tests and servicing had been undertaken as required. There was good information available about the specific needs of individual service users and how they should be supported in the event of the fire alarm being activated. The fire, electrical and gas supply had been serviced and tested as required. Records showed that staff do regular checks on the hot water delivery temperatures so that service users are protected from the risk of scalding. The manager completes monthly safety audits. These had good detail and cross-referenced to relevant documentation such as changes to risk assessments. The homes continuous improvement plan was seen it involves service users and staff views and includes action points from CSCI inspection reports. The organisations service manager completed a monthly visit to monitor the home a report is produced with action points. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 3 Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA18 Regulation 12 (1) a, b Requirement Some minor additions was required to peoples support plans so that it was explicit how night staff support and monitor service users. The Organisations Adult Protection policy required review. Previous requirement 31/05/05. Staffing levels and the staff structure for the home must be formally reviewed with CSCI. Previous requirement 30/11/05. Timescale for action 31/10/06 2 YA23 13 (6) 30/11/06 3 YA33 18(1)(a) 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA7 YA6 Good Practice Recommendations To continue to develop communication systems within the home to assist service users with decisions about their own lives. To continue to develop care plans that are person centred. DS0000004494.V311834.R01.S.doc Version 5.2 Page 25 Arbor Way 3 YA39 To develop the quality assurance system so that the views of other professionals and stakeholders are sought. Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Arbor Way DS0000004494.V311834.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!