Inspection on 21/03/06 for Bowden Derra Park

This inspection was carried out on 21st March 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bowden Derra Park 20/02/07

Bowden Derra Park 06/07/05

Bowden Derra Park 26/01/05

Bowden Derra Park 11/05/04

Bowden Derra Park 16/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Bowden Derra Park Polyphant Launceston Cornwall PL15 7PU Lead Inspector Philippa Cutting Unannounced Inspection 21st March 2006 09:30 Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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 Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bowden Derra Park Address Polyphant Launceston Cornwall PL15 7PU 01566 86230 01566 86803 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) Bowden Derra Park Limited Mr Maurice Clement d`Entrecasteaux Care Home 46 Category(ies) of Learning disability (46) registration, with number of places Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Total numbers not to exceed 46 of whom up to 20 may have an associated physical disability Service users to include up to 31 adults with a learning disability (LD) to be accommodated in Bowden Derra House (Main House) Service users to include up to 5 adults with a learning disability (LD) to be accommodated in Medrow House Service users to include up to 10 adults with a learning disability (LD) to be accommodated in Orchard House 6th July 2005 Date of last inspection Brief Description of the Service: Bowden Derra Park Ltd is a privately owned company that provides care and accommodation for up to 46 people with a learning disability in one of three houses. The Main House has rooms on the first floor and ground floor where there are also three communal sitting rooms and a large dining room. Orchard House provides care and accommodation for people who may present with challenging behaviour. Medrow House is situated on the limits of the campus and is home to service users who have been identified as people who would benefit from a more independent life style where they could participate in the running and organisation of their home. There are large grounds surrounding the home, which is situated on the outskirts of a village approximately seven miles from Launceston. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place between 9.45am & 5.0pm on a weekday. Reece d’Entrecasteaux, the registered manager and Jonathon Steed, manager, were present to answer queries and provide information. The premises were toured, records reviewed, staff & service users met and general observations made. The inspector was shown a number of new initiatives that have been, or are about to be introduced. Those relating directly to service users have been designed to provide more information in a more accessible format. Others pertain to better practice. Issues raised at the last inspection had been addressed and there was discussion about various situations that had arisen since then. The management team at Bowden Derra is proactive in tackling problems in order to reach solutions before a crisis occurs. The home celebrates its 25th Anniversary this year and has planned a number of events to mark this. The service users knew of the plans and told the inspector some of the events that were due to happen and issued an invitation to join them. What the service does well: Staff training receives priority. The induction programme aims to provide new staff with an overview of the care in the different parts of Bowden Derra so that people can be fitted into the area where they will be best suited. A varied programme of activities is sought for service users that tries to provide them with opportunities to develop personal and social skills. The inspector witnessed the behaviour of one service user in particular that suggested that this had been successful for her. Service users’ needs are kept under review and where it may be beneficial for people to move to a different part of the home, ways in which this can be accomplished – without moving service users who do not wish to move – are discussed. So far the home has been able to manage this either through vacancies occurring or by a service user asking to live elsewhere in the home so that a mutually beneficial swap has been arranged. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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 Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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): These standards were not inspected. EVIDENCE: Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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): 6,7,8,9 Care plans are available for all service users. The current plans are going to be augmented by an additional system that will provide more information and guidance to carers, to advise them of each service user’s wishes in the way care is provided and ways in which service users can become more independent. Service users are encouraged to be as participative as possible with risk being assessed as part of this process. EVIDENCE: The home has prepared individual care plans for each service user that it reviews regularly. These include details about people’s wishes and choices. Risk assessment forms an important part of this. Now, as a response to a previous inspection, Life Books are being introduced. These will be compiled for and with all service users and will provide information about people’s functional ability, the areas in which they need help and how they wish to receive any such help. The issue of choice was discussed. The inspector felt that it was good that a reviewer from another agency such as Adult Social Care (Social Services) had Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 10 seen some of the service users who have been in the home for a long time as this provided a fresh pair of eyes. However the inspector also felt that it was very important to ensure that service users understand the steps & commitment that might be needed to translate aspirations into actions, otherwise false hopes and expectations can be created for the service users. Service users’ finances were not inspected on this occasion. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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): 11,12,13,14,15,16,17 Interactions were observed that indicated that service users are developing their social and personal skills. Opportunities to do this underpin the care provided as much as possible. EVIDENCE: Personal development and the opportunity to develop their social skills are the basis of many of the activities and leisure opportunities in the home. There was a discussion about how an activity enjoyed by a person could be developed to link into personal aspirations for that person. The home continually seeks situations for education, leisure and social stimulation for its service users; advice is sought from other professionals or relevant people regarding this when needed. It uses facilities offered by a wide range of organisations including Link into learning, Colleges and Leisure/ sport centres. The inspector noted two people in particular who, through an improved diet and regular exercise, have lost several stone and become more active as a Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 12 result. One person showed a spontaneous affectionate response to carer. This would have been unlikely several months ago. Other instances of how service users have developed social skills that are enabling them to be more independent were identified. Contact with families and other people important to a service user are encouraged. The registered manager said that Bowden Derra was planning a number of events this year to celebrate its anniversary and families etc would be included. However the home respects a service user’s wishes if contact with a person is not wanted and will protect the service user from unwanted contact. A programme of healthy eating is encouraged for all service users. The registered manager discussed the strategies that might be used to help anyone with a poor appetite who preferred to snack on junk foods rather than a more balanced diet. A choice of menu is provided with food being served in the manner most suited to peoples’ needs, i.e. a regular meal, cut up, mashed or being fed etc. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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): 18,19,21 Service users’ health care needs are addressed by care staff with support from professionals from various fields, as needed. EVIDENCE: Care plans contain detail about the care people need, who should provide this and guidance as to how this should be provided. There are notes alerting staff to any particular problems with possible warning signs if applicable. This is especially relevant for any service user who experiences epilepsy. The inspector was told that the home is about to change its current recording system so that the care plans detailing the personal support and care needed by a service user is retained in their own rooms. This system is already in place in sister home to Bowden Derra and works well. These records, coupled with completing Life Books, is likely to take several months to accomplish but will provide carers with a full record of each service user’s preferences which is immediately to hand. Appointments for service users to see other professionals ancillary to medicine are made as needed. These can be on a regular basis for services such as chiropody or for specific reviews/assessment. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 14 Whenever possible a person is cared for at their life’s end in the home with the help of the community nursing service if needed. If hospital admission is indicated staff from the home visit frequently or will stay with a service user if necessary. The medication policies have all been revised and have incorporated advice from the adjacent home’s nursing team. A copy was provided for the inspector. A tightened procedure has been introduced for controlled drugs or those to be considered a high risk. Medication may only be administered by a member of staff who has completed the home’s training. This is organised via a nominated workbook dealing with the care and administration of medicines. Staff commented that although the new procedures may take a bit more time, they prefer it as the fell it is safer. The new system was not inspected in practice on this occasion so will be a focus of the next inspection. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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): 22,23 Staff receive training and updates on the protection of vulnerable adults (PoVA). The home has a complaints procedure in place that is available in different formats. EVIDENCE: At the time of this inspection no complaints have been received by the home or Commission for Social Care Inspection. Staff receive training and information on matters relating to PoVA. The complaints procedure is available in different formats for service users but the registered manager agreed that not all of the service users would be able to action a complaint if they were unhappy about something. However he felt that most had an opportunity to talk to someone else, at a day centre etc, if there were a difficulty and would do so, or – more likely - any distress or problems would be shown through a change in behaviour. Staff are sufficiently aware of people’s needs that they would report any changes or challenge actions of other people including staff. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 The home comprises three distinct areas each of which has an identified aim. Arrangements are planned for the redecoration in the Main House & Medrow but otherwise occupants are encouraged to arrange their individual rooms to reflect their interests. EVIDENCE: On arriving at the home the inspector saw that footings had been put in for a new building. The registered manager said that this was as far as the building was likely to proceed for the time being. The work had been done to comply with planning rules, to prevent granted planning permission from lapsing. The registered providers are aware of the spatial standards and national minimum standards for any new build. It would be prudent to discuss any proposals for major change with the Commission for Social Care Inspection before these take place. The three properties were all visited. Orchard House has completed a major refurbishment apart from carpet for a couple of rooms, which is imminent. The provision of more suitable flooring in the bathrooms and toilets is an improvement as it reduces any odour problems. Service users are encouraged to personalise their rooms and most had done so with help where needed. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 17 Medrow House has not yet been redecorated. Colour schemes were being planned at the last inspection in July but a date to start work had not been given as far as the staff were aware. Work to paint & repaper the central hall, landing and some communal areas in the Main House is about to begin. New carpet has already been laid but redecoration will provide a boost, as the present scheme is looking ’tired’. One room on the first floor will also be done. Water damage from a leaking valley has been repaired and dried out here. The flooring in the bathrooms and toilets in the Main House have been replaced to good effect. There are rooms upstairs in the Main House that are large and arranged so that there is little privacy for the service users. This does not appear to cause the service users a problem but they may have become used to the situation. This accommodation is an example of custom & practice that needs to be considered against updated standards. Service users’ rooms in the ground floor wing in the Main House were otherwise seen to be in good order with people’s own belongings around them. One person had complained of being cold. It would be helpful to monitor the temperature in that room to ascertain whether the room is in a cold spot as afar as the central heating runs go or whether that person has a particular problem making him feel cold. The inspector noted that the programme to complete radiator guards was not yet completed. This needs to be given priority as it has been drawn to the management’s attention before. The home seeks advice regarding equipment to assist service users although the majority of people living at Bowden Derra are not dependent on such items. Some thought could be given to the seating in communal rooms. There are some specialist chairs that were purchased for specific service users but now that there are a number of older people, as well people who are short, a variety of chairs with differing heights, to supplement suites, should be considered. An Occupational Therapist might provide further advice if this was needed. The houses were seen to clean and apart from any décor issues, generally in good order. The laundry was not inspected on this occasion. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,3,2,33,34,35,36 Training to ensure that staff receive the training and support they need to care for service users is regarded as important and all staff are expected to participate in the courses that are organised. Staff were generally enthusiastic about this support. EVIDENCE: The registered manager said that the home now employs 130 people in total – this includes administration, housekeeping and maintenance staff. The system whereby care staff are invited to spend time in the home before proceeding with an application and then working in all parts of the home as part of their induction is still in place. A problem with statutory checks noted previously has been rectified and all staff have Criminal Records Bureau applications & PoVA checks in place before starting work. The induction programme now includes written questionnaires to ensure that information is fully understood. The registered manager commented that helping service users learn to be independent, rather than doing everything for them, is an issue that some staff have to master. Training is afforded priority with National Vocational Qualifications and the Learning Disability Award Framework (LDAF) courses being undertaken by Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 19 staff. There are three managers within the Bowden Derra campus with their registered manager’s award. Team leaders are expected to work towards NVQ Level lV. A chart of training opportunities and the take up is maintained in the office and a record of completed courses filed in individual staff files. Documented supervision & appraisals are in place. In discussion a member of staff told the inspector that staff often sat in the communal areas during their breaks and watched the television. The veracity of this statement was not tested but it should be, as on the face of it, it does not sound like good practice. If true, service users’ preferences may be being compromised. If staff choose to spend their breaks with service users, this could be a different scenario. The registered manager should investigate what is happening and also consider what facilities are available for staff to have a break or if they need to make private calls etc. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41 The management team promotes the welfare of the service users at all opportunities. Procedures are reviewed and renewed if this is felt to provide a better service reflecting new practice. Statutory records are maintained to safeguard service users but more information is needed in the reports by the responsible individual to reflect this. EVIDENCE: A registered manager who is supported by two other managers runs Bowden Derra. This provides good cover and support for team leaders as well as an opportunity to discuss new ideas and initiatives for the home. It is likely that effective quality assurance and monitoring will play a greater part in inspections in the future. The home may therefore wish to consider Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 21 how to promote this. Meetings with service users are arranged but it is not easy to reflect the views of less vocal service users. The present monthly report under regulation 26 is sparse with the information it contains. An alternative sample will be included with this report so that other formats can be considered. It is important that inspections by the responsible individual are recorded even when the responsible individual might be in the home on a very regular basis. Statutory records are otherwise satisfactory. It was noted that all incident forms are seen by a manager before being filed and where necessary cross-referenced with an accident form. One such entry was queried as, in the inspector’s opinion, there was insufficient detail. MAIN HOUSE Time was spent in the Main House although a majority of service users were out at day centres or other organised activities. Staff provided activities on an individual basis for the remaining service users in the afternoon and spent time with people, the most of whom were chatty and relaxed. The service users within the Main House have a variety of needs varying from older people needing considerable amounts of help with personal care to younger service users learning personal & social skills on a one:one basis. The registered manager said he felt that the mix did not appear to cause problems as people were free to move around the homes and some liked to visit people in different parts, sometimes choosing to eat with them. ORCHARD HOUSE. Apart from looking at the environment the service users living here were going out so were only available briefly. Unusually they were going as a group, but the team leader was present. In the brief time the inspector was with them some positive interactions were noted. The tenor of Orchard House was calm. Staffing levels in Orchard House are high as most service users are cared for on a one:one level. MEDROW HOUSE Three service users from Medrow House were spending the day in the Main House –two older service users do so regularly and a third person had stayed back for an appointment. The staffing of Medrow House needs to be kept under review along with its purpose. The registered manager said that at present he felt age should not be the determining factor for living in Medrow but more importantly people’s level of independence. This is agreed but the home needs to demonstrate that it is the service users’ choice to spend their days in the Main House rather than a necessity, as Medrow is not staffed by day (unless someone is ill). Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 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 X 2 X 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 X STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 4 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 4 3 4 3 3 3 X X Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 23 NO 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 YA24 Regulation 23 Requirement The home must advise the Commission of the time scale for the completion of radiator guards throughout the home as this has become – in the Commission’s view - a priority for the safety of service users. Timescale for action 30/04/06 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 YA24 YA24 Good Practice Recommendations The home should monitor the temperature in a room if a service user complains of being cold so that a satisfactory solution can be found. The provision of alternative height seating should be considered in communal rooms, with advice from an Occupational Therapist or similarly appointed person if needed. The arrangements & provision for privacy in large double rooms needs to be considered. The facilities for staff to use during their breaks should be clarified to ensure that it does not impose on service users. Regulation 26 reports from the responsible individual would DS0000008982.V276205.R01.S.doc Version 5.1 Page 24 3 4 5 YA25 YA31 YA36 Bowden Derra Park benefit from amplification. Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Bowden Derra Park DS0000008982.V276205.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!