Inspection on 04/09/06 for Avenue Lodge

This inspection was carried out on 4th September 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Avenue Lodge 25/10/05

Avenue Lodge 30/04/05

Avenue Lodge 21/10/04

Avenue Lodge 02/06/04

Avenue Lodge 29/01/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Avenue Lodge 53 Avenue Road London SW16 4HJ Lead Inspector Liz O`Reilly Unannounced Inspection 4th September 2006 11:00 Avenue Lodge DS0000027251.V314489.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 Avenue Lodge DS0000027251.V314489.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. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avenue Lodge Address 53 Avenue Road London SW16 4HJ 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) 0208 764 6125 Mr Nizam Hosanee Mrs Anna Maria Oozeerally Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (6) Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th October 2005 Brief Description of the Service: Avenue Lodge is a care home for up to six adults with mental health needs. The home is owned by Mr N. Hosanee. The property consists of two terraced properties which have been joined together and extended. The home is situated in a residential area of Mitcham, close to local shops and public transport links. Unrestricted parking is available in the street. The property is not identifiable as a care home. The aims and objectives of the home are set out in the Service Users Guide with is provided to each resident. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector and consisted of two fieldwork visits to the home, discussions with residents and staff, observations and feedback from questionnaires sent to residents, staff and other people connected to the home. Completed questionnaires were returned by all residents, four members of staff and four other professionals. What the service does well: Avenue Lodge provides a comfortable, homely environment for residents. Staff are committed to encouraging and supporting residents to make their own decisions about their lives and to view Avenue Lodge as their home. Staff support residents to be involved in activities and the local community. The home has been successful in supporting residents to maintain or develop independence and confidence. Comments from residents included; “this is an excellent place to live”, “I like living here”, “this is a good place to live”, “we all get on well with each other here”. Residents felt that the staff were one of the “best things” about living at Avenue Lodge. Staff were described as “lovely”, “very nice”, “friendly” and “excellent”. Staff were observed to involve residents and to respect their privacy and dignity. Residents are consulted on what goes on in the home and offered clear choices on a day to day basis and through regular residents meetings. Residents are also invited to be part of the team in auditing the service. The manager takes particular care in the admission process. Time is taken to ensure that a new resident is introduced at a pace which suits them, that families or friends are involved and that staff time is available to introduce them to the home and the local facilities. Feedback from professionals indicated that this works well with new residents settling in well. The way in which new residents are introduced to the home was described as “excellent”. All feedback received from other professionals was positive with the home described as “providing an excellent service” for residents. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Avenue Lodge DS0000027251.V314489.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 Avenue Lodge DS0000027251.V314489.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 & 4 Quality in this outcome area is excellent. Residents are provided with and have explained to them information on what they can expect from the service. The admission process is based on the specific needs of each individual and staff are aware of the importance of providing additional support in the initial stages of admission to the home. EVIDENCE: All residents are supplied with a copy of the Service User Guide. They also have access to the Statement of Purpose which provides information on the aims, objectives and philosophy of the home. A statement setting out the rights of residents is on display in the home. Prospective residents are given the opportunity to visit the home, if necessary on a number of occasions, before making any decision about moving in. The needs of other residents already living in the home are taken into consideration when assessing any prospective new resident. The home is provided with copies of any assessments carried out by other professionals on the needs and wishes of the resident. Staff also visit prospective residents before they move in to get to know the resident and carry out their own assessments. The admission process is carried out with care and staff from the home will meet with carers both professional and informal to ensure the move to the home takes place at a pace suited to the individual. These assessments and visits help staff to get an understanding of the individual strengths, wishes and needs of the person and enable them to set Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 9 up an initial care plan. Staff time is allocated to provide additional support to residents when they first move into the home. Staff spend time going through information on the residents rights and support them in looking round the local community. Feedback from one professional made positive comments on the support provided by staff and in particular the manager, for a client who was moving into the home. Staff were found to take into account the personal circumstances of the client and their carer in supporting them during the move. Avenue Lodge DS0000027251.V314489.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. Care plans are developed to meet individual needs and wishes. Each plan is agreed with the resident. A key worker system is in place which allows for good personal one to one relationships between staff and residents. Staff support residents to develop independence and to understand their individual rights. Residents are regularly consulted on the way the home operates. EVIDENCE: Each resident is provided with an individual care plan. Residents confirmed they were involved in making up the care plans and all care plans were seen to be signed by staff and the resident concerned. Care plans cover the strengths and needs of individuals in relation to their physical, emotional, social and cultural well being. Staff take time to work with residents on assessments of their independence, choices, privacy and rights. Residents are also asked if they would care to provide a life history for their file. This provides staff with some insight into a residents previous life experiences from their own view point. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 11 Individual risk assessments are in place and are used to support residents to maintain or increase their independence. Through the care planning and assessment process staff gather significant amounts of information on the likes and dislikes of residents which assists in providing an individualised service. Care plans and risk assessments are reviewed on a regular basis with the resident and if required their representatives or other professionals. Residents informed the inspector that they made their own decisions about how they led their lives. One resident said that staff respected their privacy and that they could go to their room to be on their own if they wanted to at any time. Another resident said that they made their own decisions about what they did and when they got up or went to bed. Staff were seen to offer residents choices throughout the day. Residents said the they were consulted on life in the home through talking to the staff individually or through the residents meetings. The record of residents meetings confirmed that residents discussed issues they had with the group, their individual rights and were involved in planning activities. Avenue Lodge DS0000027251.V314489.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. Central to the aims of the home is the promotion of individual rights. This includes residents leading the life they have chosen within the home and in the local community. To this end staff ensure that residents have the information they need on what activities or services are available. Residents confirmed that they are free to have visitors and to meet with them in private. Residents were very happy with the food provided. EVIDENCE: Residents are offered opportunities to attend day and employment centres. At the time of this visit to the home one resident was attending a day centre and one resident attending a supported employment centre. One resident said they were going to go and look at a day centre with staff to see if they like it. Other residents said they were happy with occupying themselves with going out shopping, going to the betting shop, watching sport on TV, playing chess or reading. One resident felt they were “well looked after” and “really enjoyed celebrating birthdays, outings” and “loved going shopping”. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 13 Residents said they helped with some of the domestic tasks in the home. Individuals were seen to help with washing up, going to local shops and laundry. One resident said that staff used to help them with keeping their room clean and tidy but now they did this themselves. All of the resident group are able to go out independently but two residents prefer to go out in the company of staff and staff time is provided for this. Each resident has a travel pass. Residents do not go on an annual holiday from the home. All of the residents had recently taken a day trip to Littlehampton which all those spoken to had enjoyed. The inspector is aware having spoken to residents that they may not wish to take an annual holiday of a full week but the opportunity of shorter more frequent breaks is one area which could be developed. Staff are aware of the cultural and religious background and wishes of residents. Residents are supported to attend religious centres of their choosing if they wish. One resident attends a temple and one resident chooses to watch religious services on the television. Residents and staff celebrate Christmas and Diwali. All residents gave positive comments on the food provided in the home. Food is prepared in a small domestic style kitchen which is open to residents at all times. Staff prepare and cook the meals but residents can assist if they wish. The menu is discussed with residents on a regular basis. Residents informed the inspector that the meals were what they would normally eat and that they felt the staff were “very good” cooks. Staff regularly remind residents of their individual rights, in residents meetings, reviews and in talking to individual residents. All residents are registered to vote and supported to do so if necessary. The home has in place a policy on personal and sexual relationships. The registered manager discussed with the inspector ways in which residents can be reminded or informed of their right to relationships without needing to approach staff directly. This is an area which the registered manager agreed could be improved. Avenue Lodge DS0000027251.V314489.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. Medication is well managed with good records maintained. Staff ensure that the medication for each individual is reviewed on a regular basis. Residents are supported to attend regular health care checks. Staff are provided with training on health care in particular on mental health issues. EVIDENCE: The present resident group do not need high levels of personal care. The majority of the care provided is reminding certain residents about their personal hygiene or appearance. All residents are registered with local GP practices and attend the local surgery independently or with staff if they wish. The home has good contacts with community mental health workers. Staff support or remind residents to get regular dental or optical checks using community services. Staff keep a record of the weight of residents and take action should there be any concerns. At the time of this visit all medication was being administered and held by staff. Staff keep good records of all medication coming into the home, being administered and returned to the pharmacist. The medication taken by each individual is reviewed on a regular basis. The consultant visits the home every Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 15 six to twelve months and can be contacted by staff should they have any concerns. Staff have taken part in accredited training on the management of medication and are also taking part in a refresher course. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. Residents are well informed on how to make a complaint. Staff are provided with clear information on their role and responsibilities in relation to any allegation or suspicion of abuse. Residents expressed confidence in the staff, manager and home owner to deal with any complaint or concern they might have. EVIDENCE: Residents were found to be well informed on who to talk to should they have a complaint. The complaints procedure was seen to be on display in the entrance hall. The record of residents meetings showed that residents are reminded of their right to make a complaint and who they should approach. The home have systems in place for the recording of any complaint along with action taken and outcomes. The home had received no complaints over the last year and no complaints have been received by the CSCI. Residents expressed confidence in the staff and the manager to act if they have any concerns or complaints. All staff receive training on the protection of vulnerable adults. Staff were found to be well informed of their responsibilities to report any concern or allegation of abuse. Procedures for dealing with allegations of abuse are in place. Avenue Lodge DS0000027251.V314489.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, 27 & 30 Quality in this outcome area is good. Residents expressed satisfaction with the environment. Space is available for residents to meet with visitors in private. The domestic style furnishings and fittings assist in providing a homely atmosphere. Some work needs to be done on one of the bathrooms and the kitchen to bring them up to the standard of the rest of the home. EVIDENCE: Residents are provided with a comfortable and homely environment which is generally well maintained. Furnishings are of an adequate quality and suit the needs of individuals. Residents have access to two lounges, a dining area and a smoking room. The home has a large well maintained garden with a patio area and an aviary. Residents informed the inspector that they were happy with their own rooms. Bedrooms were seen to be personalised and reflected the individual taste and interests of residents. Two bathrooms are available on the first floor with a shower room on the ground floor. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 18 All areas of the home seen were clean and tidy. Residents are provided with a separate laundry room where they can do their laundry independently or with support from staff. It was noted that one of the bathrooms on the first floor is showing signs of wear and tear. This bathroom needs to be redecorated and refurbished within the next six months. It was also noted that doors on the first floor particularly the bathroom door were in need of sanding and sealing. All untreated doors need to be cleaned and sealed within the next six months. The kitchen is showing signs of wear and tear and will need to be refurbished within the next twelve months. Avenue Lodge DS0000027251.V314489.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, 34 & 35 Quality in this outcome area is good. Residents have confidence in the staff and staff have developed good relationships with individual residents. Staff are provided with good opportunities for training which assists in providing good standards of care. Staff are well supported and supervised. The recruitment process ensures that the appropriate checks are carried out before people start to work in the home. This assists in the protection of residents. EVIDENCE: The number of staff employed and on duty at any one time meets the needs of the present resident group. Staffing numbers are kept under review and adjusted if necessary. There are few staff changes within the home which assists with developing relationships with residents. Consideration should be given to involving residents more in the staff recruitment process. Residents made very positive comments on the approach of the staff. Staff were described as “very good” and “great”. Staff were seen to talk to residents in an appropriate manner and respect the privacy of individuals. Residents were seen to be included in conversations between staff with residents asked their opinions. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 20 Feedback from other professionals was also positive on the approach and work carried out by the staff group. Staff confirmed that they are provided with good opportunities for training. Records showed that staff have carried out accredited training on medication which has been backed up by updated training. Equality and diversity training is provided for all staff. One member of staff spoken to has completed NVQ level two training and is in the process of NVQ level three. Training has also included health and safety and abuse awareness. The staff records showed that checks are carried out before anyone starts to work in the home which assists in protecting residents. Criminal Records Bureau checks, appropriate references and information on previous experience were seen to be in place. Staff informed the inspector that they felt well supported by the registered manager. They receive regular one to one supervision and staff meetings. Records of supervision and meetings were in place. Staff felt confident about asking other members of staff and the manager if they were unsure about anything. The registered manager uses individual staff supervision and staff meetings to provide additional training. Discussions in one to one supervision cover a wide range of topics including depression, schizophrenia and support for those with mental health needs. Staff are also supplied with reading materials on mental health issues. Avenue Lodge DS0000027251.V314489.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, & 42 Quality in this outcome area is good. Very positive comments were received from residents, staff and other professionals on the management of the home. The registered manager is well qualified and has significant experience in supporting people with mental health needs. Systems are in place for monitoring and assuring the quality of the service. Residents are involved in the audit of the home. Staff make and record regular health and safety checks. EVIDENCE: Comments from residents, staff and other professionals were particularly positive about the approach of the manager. Residents said they saw the manager every day when she was on duty and could go to her with any concerns they might have. Staff feel well supported by the manager. Other professionals felt that the manager made sure that they were kept well informed and worked in partnership to the benefit of residents. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 22 An annual review of the care provided is carried out by the home. Questionnaires are provided for residents, staff and other people involved in the home. The results of these surveys are used to look at ways of developing the service. As part of this process certain areas of the home are audited along with the homes policies and procedures. Residents have become involved in this process with one resident involved in the audit of the fire precautions and another resident involved in the audit of the food provided. Facilities are available for residents to deposit small amounts of money in the home for safekeeping. At the time of this visit three residents were being supported by staff to manage their budget. All three had agreed to this. Records were found to be well maintained and accurate. Staff and the individual resident sign the record if any money is withdrawn. Staff make regular checks on the building and equipment to ensure the health and safety of residents, staff and visitors. Records showed the appropriate checks are being carried out. Avenue Lodge DS0000027251.V314489.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 4 3 x 4 4 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 3 25 x 26 x 27 2 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 01/05/07 1. YA24 2. 3 YA24 YA24 23(2)(b)(e) The Registered Persons must ensure that the first floor bathroom is redecorated and refurbished. 23(2)(e) The Registered Persons must ensure that all doors are cleaned and sealed. 23(2)(b)(e) The Registered Persons must ensure that the kitchen is redecorated and refurbished within the next twelve months. 01/05/07 01/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA14 Good Practice Recommendations The Registered Persons should ensure that residents are provided with short breaks or an annual holiday from the home. Avenue Lodge DS0000027251.V314489.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Avenue Lodge DS0000027251.V314489.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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