Inspection on 15/08/07 for Autism Initiatives Respite Services

This inspection was carried out on 15th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Autism Initiatives Respite... 18/04/08

Autism Initiatives Respite... 13/07/06

Autism Initiatives Respite... 12/01/06

Autism Initiatives Respite... 09/05/05

Autism Initiatives Respite... 13/01/05

Autism Initiatives Respite... 31/08/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Autism Initiatives Respite Services 8 & 10 Barnsbury Road Walton Liverpool Merseyside L4 9TS Lead Inspector Debbie Corcoran Unannounced Inspection 15th August 2007 2:00 Autism Initiatives Respite Services DS0000025222.V345784.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 Autism Initiatives Respite Services DS0000025222.V345784.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. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Autism Initiatives Respite Services Address 8 & 10 Barnsbury Road Walton Liverpool Merseyside L4 9TS 0151 226 8604 F/P 0151 226 8604 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) www.peterhouseschool.org Autism Initiatives vacant post Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the person to be accommodated will be 17 - 65 years 13th July 2006 Date of last inspection Brief Description of the Service: 8 and 10 Barnsbury Road is registered to provide a service to up to 5 adults who have a learning disability. No. 8 provides accommodation for 2 service users whilst No. 10 provides accommodation for 3 service users. The service is provided by Autism Initiatives. Autism Initiatives was formerly called the Liverpool and Lancashire Autistic Society and it was established in 1971. The organisation provides a variety of services to adults and children who have autism. These include residential care, day care, supported tenancies, outreach, domiciliary care, respite and educational services. Autism Initiatives is a voluntary organisation with charitable status. The accommodation at Barnsbury Road comprises of two adjoining semidetached properties. Each house offers single bedrooms a shared bathroom kitchen dining and lounge areas. Local amenities include a sports centre and leisure facilities, entertainment complexes, various shops and access to public transport. The fees for staying at the home are £307.97 per night Monday to Friday and £749.60 for a weekend stay (Saturday to Monday). Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was not announced beforehand and was carried out over a period of approximately 4 ½ hours. During the visit there were 3 people staying at the home. One of these people was spoken with to obtain their views on the home. A member of the staff team and the manager were also spoken with during the course of the visit. Care plans, staff records, health and safety records and other relevant records were looked at. A tour of the home was carried out and all areas were checked. What the service does well: What has improved since the last inspection? A manager has been appointed to the home since the last inspection visit. The manager has many years experience of working with people who have autism and has previous experience of managing in a residential home. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 6 There appears to be a greater emphasis on supporting people using the service to use and develop their independent living skills. Picture cards are being used to make it easier for people using the service to make choices. 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. The summary of this inspection report can be made available in other formats on request. Autism Initiatives Respite Services DS0000025222.V345784.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 Autism Initiatives Respite Services DS0000025222.V345784.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information on the services provided at the home is available to enable prospective service users to make a choice as to whether the home is appropriate for them. An assessment of needs is carried out with a prospective service user before staying at the home so as to ensure their needs can be met. EVIDENCE: A statement of purpose and service user guide are available to current and prospective residents. These describe the services and facilities provided at the home. People who are new to the service are only admitted for a stay following an assessment of their needs. These assessments are carried out so as to ensure that the person’s needs can be met at the home. Assessment information was looked at for two of the newest people using the service. This showed that Community Care assessments are attained from Social Services and assessment information is attained from other relevant professionals as appropriate. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 9 In addition to this the manager of the home carries out an assessment of needs. The assessment tool and information in these relate specifically to the person’s needs in relation to living with autism. Along with this, risk assessments are carried out and these identify potential risks to people using the service and include guidelines to inform staff on how to best manage those risks. The manager gave a number of examples whereby people new to the service are given the opportunity to visit the home and get to know the staff and environment before they have an overnight stay. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each of the people using the service has an individual support plan. These do not include sufficient detail on the person’s needs for all people using the service, but support plans are in the process of being developed. Risks to the safety and well being of people using the service are assessed and plans are put in place to manage these. EVIDENCE: Each of the people using the service has a document entitled ‘about me’ and this describes the support they need in areas such as communicating, understanding, staff support, activities, meals, medication, health and safety. Each person also has a support plan which describes goals for their personal development and how to support the person with these during their stay. This may include supporting the person to develop their independent living skills, their personal care skills or learning new ways of interacting with other people. There were some good examples of information on the needs of the people using the service written as ‘guidelines’ for support. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 11 Information and support plans were looked at for all three of the people staying at the home. The quality of information on the needs of the people using the service and in their support plans varied. One plan included a detailed level of information on the person’s needs and their support plan was detailed. The information for the other two people staying at the home was not sufficiently detailed and therefore would not guide staff in meeting the needs of the person with any level of consistency. The majority of information regarding the people using the service was not signed and dated, this needs to be addressed. Some information in care plans had not been reviewed or updated for some time and this needs to be addressed. The manager reported that the ‘about me’ documents and support plans are still in the developmental stage for those people who were staying at the home but that work has been started to ensure that each person has a detailed plan. People using the service are encouraged to make decisions about their daily lives for the duration of their stay. Care plans include some information about the person’s preferences and daily routines and people are offered the opportunity to plan what they would like to do for the duration of their stay. Picture cards are being used to aid people who have limited verbal communication skills to make decisions about issues such as where they would like to go socially, activities they would like to be involved in and choices such as what they would like to eat. It was reported that these are proving a good success with a number of people using the service who are being encouraged to make choices. Risk assessments are carried out for each of the people using the service. These identify potential hazards to the person’s safety and well being and include detailed guidelines as to how to then manage the risk or prevent the risk from occurring. The risk assessments cover different aspects of the persons support. For example support with communication and expression or support with community access. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are supported in social and leisure activities for the duration of their stay. People who are staying choose their own meals. EVIDENCE: Each of the people using the service has a care plan and these include information on activities which the person likes to be involved in and includes information on the persons cultural needs. At the start of their stay each person has the opportunity to discuss what activities they would like to be involved in for the duration of their stay and staff then plan for these to take place whenever possible. A daily record is maintained for each of the people using the service and this includes information on what activities the person has had the opportunity to be involved in. These showed that people using the service are supported to be involved in a variety of community activities for Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 13 the duration of their stay. On the day of the visit each of the people using the service had plans for an activity and were being supported with these. In assessing the diet and meals available to people using the service menu records were examined, one of the people using the service was spoken with and the availability and storage of food was checked. This indicated that people using the service have a choice of meals and food. Information on the service user’s likes, dislikes and needs with their food and meals is recorded in their personal records. People using the service are supported to shop for their food and meals and prepare their meals where this is appropriate to their needs and wishes. Picture cards are used to aid people who have difficulty expressing choices, to choose meals and food. One of the people using the service is getting involved in producing these and has created some of their own. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are supported with their individual needs and physical and emotional well being for the duration of their stay. Medication is handled and administered appropriately. EVIDENCE: People using the service have a care plan which includes information on how to meet the person’s personal care needs, physical care needs and health care needs. Arrangements are made for people to visit a G.Ps or district nurse when this is required. Care plans provide information to staff on how to support people using the service with their emotional well being. When appropriate records include guidelines for support with specific activities. For example there may be detailed guidelines for supporting a person when they are out and about in the community or when they are using public transport, or if they have difficulty in managing social interactions. Polices and procedure used for the receipt, storage, disposal, and documentation of medications within the home are followed. Medication storage and records were checked and were found to be appropriate. Autism Initiatives Respite Services DS0000025222.V345784.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and practices are in place which aim to protect service users against abuse or neglect and systems are in place for dealing with complaints and allegations of abuse. EVIDENCE: The home has a complaints procedure which is time scaled appropriately. There have been two complaints made since the last inspection visit. The details of these were discussed with the manager and the discussion indicated that the complaints have been investigated and responded to appropriately. The home has a ‘service user protection document’. This provides a guideline for staff on how to deal with a potential adult abuse allegation. Staff have been provided with adult protection training. The home has further policies and procedures aimed at protecting service users including the management of service users money and financial affairs and a physical intervention policy. A record of key events is maintained for example incident reports and accident reports. These reports were checked and there were no particular issues identified as a result. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and generally presented to a satisfactory standard although there is room for improvement in a number of areas. EVIDENCE: A tour of the premises was carried out which included all areas. The home is split in to two separate houses each with it’s own front door. One of the houses can accommodate up to 3 people who use the service and the other accommodates up to 2 people. There is no direct access through from one to the other. Each side of the home provides a separate lounge, dinning room, kitchen and bathroom. The home environment is satisfactory in the main but there are some areas for improvement. These include; • Some of the paintwork and decoration around the home needs attention. DS0000025222.V345784.R01.S.doc Version 5.2 Page 17 Autism Initiatives Respite Services • • • • • • • The dinning carpet in number 8 needs to be cleaned or replaced. Spare mattresses stored in one of the bedrooms need to be removed. Bathroom tiles need repair in number 10. The Bathroom in number 10 needs redecorating. The flooring in bathrooms needs to be replaced. The hall in number 8 needs redecorating. The use of the dinning rooms to house tumble driers and laundry should be reviewed so as to make more appropriate use of these communal space. Some areas of the kitchens are in need of refurbishment. • In addition, the overall presentation of the home could be improved upon so as to make the home feel more welcoming and homely whilst also meeting the needs of the people using the service. The manager should produce a maintenance plan for the home to show how the above areas will be addressed and to indicate how the environment will be maintained. The manager has identified numerous areas for improvement to the home environment and has made a request to the estates department for these improvements to be made. Health and safety practices and procedures are carried out. These aim to ensure the home is safe, clean and free from hazards. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are flexible and based around the needs of the people using the service. Staff are provided with good training opportunities but the number of staff who hold a relevant qualification is low. Staff are not provided with regular supervision to look at their practice and development needs. EVIDENCE: As the home provides respite care the needs of the service user group change on a regular basis and therefore staffing levels are increased as required in order to meet the needs of the people staying. The staff roster indicates that when appropriate people using the service are supported on a one to one basis. Staff are provided with good training opportunities. One member of staff who was spoken with reported that they have been provided with training in topics such as health and safety, fire safety, food hygiene, moving and handling, medication administration and in topics relating to the specific needs of people using the service such as training in supporting people autism and supporting people who have epilepsy. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 19 There are seven members of staff on the staff team. Of these 2 have attained an N.V.Q (National Vocational Qualification) in care. The manager reported that the remaining 5 members of staff are working towards attaining a relevant qualification. The manager should aim to ensure that at least 50 of the staff team hold a relevant qualification. Discussions with one of the people staying at the home and staff indicated that staff are supporting the aims and objectives of the home in encouraging the people to make choices, develop their independent living skills and use their local community. Staff files were viewed in order to assess the staff recruitment and selection practices. These showed that all required pre employment checks are carried out before new staff start working at the home. The manager reported that new staff are going to be employed in the near future as there are a number of staff vacancies at the home. Agency staff are being used to fill these vacancies whilst new staff are employed. Staff supervision meetings and team meetings are not taking place on a regular basis. The manager reported that some of this work does take place on an informal basis. The manager must ensure that staff have the opportunity of having regular recorded supervision meetings and staff team meetings. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The designated manager of the home is not yet registered with the Commission. The quality of the service provided is not being checked on a regular basis. Health and safety practices and checks are carried out so as to safeguard the health and welfare of people using the service and staff. EVIDENCE: The home has a designated manager, however this person has not applied to be the registered manager with the Commission. This must be addressed and the home must have a suitably experienced, qualified and registered manager. The manager interacts with people using the service on a regular basis and has acted to improve the quality of the service provided to people. For example the service has developed in terms of supporting people to use and develop their Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 21 daily living skills and their communication skills. However, there is currently no evidence that a system for measuring the quality of the service is in use at the home. A quality assurance system should be in place and this should include surveying the people using the service and their representatives on the quality of the service. Feedback from this process should then be published and distributed. It is also recommended that an annual development plan is produced which reflects aims and outcomes for residents. Staff are provided with training in health and safety topics and the home has health and safety policies and procedures. Fire safety and health and safety practices are adopted. Records of fire and health and safety checks were checked and found to be up to date. Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X 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 3 3 3 x 2 X 2 X X 3 x Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA37 Regulation 8 Requirement An application for the registration of a manager must be made to the Commission. All repairs and maintenance work as identified in the report must be completed so as to provide a well maintained and homely environment to people using the service. Timescale for action 15/10/07 2. YA24 23 15/10/07 3. YA6 15 Each person using the service 15/10/07 must have a sufficiently detailed care plan which details how the person’s needs in respect of their health and welfare are to be met. These plans must be reviewed on a regular basis. A system must be established and maintained for reviewing at appropriate intervals and improving the quality of care provided at the care home. This is to include seeking the views of people using the service. 15/11/07 4. YA39 24 Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 24 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 YA6 YA24 Good Practice Recommendations Records should be signed and dated appropriately. A maintenance plan should be produced to indicate how the home environment will be improved, refurbished and appropriately maintained. 50 of the staff team should hold a relevant qualification in care. An annual development plan should be developed. This should be linked to outcomes for people using the service. 3. 4. YA32 YA39 Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Autism Initiatives Respite Services DS0000025222.V345784.R01.S.doc Version 5.2 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. 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