Inspection on 21/06/05 for Bowley Close, 5

This inspection was carried out on 21st June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bowley Close, 5 24/07/06

Bowley Close, 5 06/10/05

Bowley Close, 5 18/01/05

Bowley Close, 5 19/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 5 Bowley Close 5 Bowley Close Farquhar Road SE19 1SS Lead Inspector Rehema Russell Unannounced 21st June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 5 Bowley Close Address 5 Bowley Close, Farquhar Rd, SE19 1SS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 670 8662 No fax machine ChoiceSupport@ChoiceSupport.org.uk Choice Support Care Home 4 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 18th January 2005 Brief Description of the Service: The aims and objectives of the home are to provide support and accommodation to four adults with learning and physical disabilities who may have little or no verbal communication skills. It is a purpose built bungalow located in a cul de sac close to the centre of Crystal Palace. It opened in 1989. There are several other care homes grouped together in the close, all of which are managed by a voluntary organisation called Choice Support.The home aims to provide a comfortable, homely atmosphere in a safe and clean environment. The home is close to local facilities such as shops, cafes, pubs, a park and a sports centre. Public transport routes are also close by. The close is situated off the side of a steep hill, making pedestrian travel for wheelchair users and people with limited mobility difficult. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a Tuesday afternoon between the hours of 3 p.m. and 7 p.m. There were no resident vacancies at the home and during the course of the inspection all four residents were observed and communicated with, two support workers were spoken with, documents were seen and the building was toured. All residents are non-verbal. Two residents can understand what is said to them but have very limited response abilities. The manager was not present at the home but the inspection was facilitated well by the two support workers who were on duty and the manager was contacted by telephone after the inspection to follow up on certain previous requirements. What the service does well: 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. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 standard(s) 2, 3 and 4 Prospective residents’ individual needs and aspirations are assessed and residents have opportunities to visit and “test drive” the home prior to admission. EVIDENCE: Three of the residents had been at the home for many years. The admission procedure for the fourth and most recent resident to be admitted was looked at. The home had followed a thorough admission procedure which had included several visits to the prospective resident in her previous home and several visits by the prospective resident to 5 Bowley Close. These visits included an overnight stay by the prospective resident and another included accompaniment by a relative, the manager and a member of staff from her previous home. A full assessment had been undertaken, incorporating a Community Care Assessment from the receiving authority plus the previous Placement Review from the placing authority. The home had written care guidelines and had assessed religious and cultural needs prior to admission in order to meet these needs once the resident was admitted. From observation of the resident and evidence from staff and written documentation, the placement had been successful. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 standard(s) 6, 7 and 9 Residents’ assessed and changing needs are reflected in their individual Plans and regularly reviewed. However implementation is not always evidenced in the diary or other records. Residents are assisted to make decisions about their lives and are supported to take risks as part of an independent lifestyle. EVIDENCE: 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 10 All four residents have care plans in place. These are reviewed six monthly by the manager and keyworker. The social worker, advocate, family members and involved professionals are also invited to attend the six monthly reviews. Inbetween the manager and keyworker carry out further reviews via monthly recorded keyworker meetings. The files for one resident were perused in detail. The service user file was in good order and evidenced referral to health and care professionals and alternative therapists arising from care plan goals. It contained the reports made by these professionals and also recorded when sessions, such as aromatherapy, had been cancelled or restarted. This file also contained skills teaching guidelines, individually tailored for the resident and with review dates set. The personal centred plan (PCP) included a comprehensive profile of the resident and their needs and also an action plan and timescale of how and when the resident’s ‘dreams, hopes and wishes’ were to be fulfilled. A weekly plan for the resident incorporated these goals, as did the daily shift plans, but the activities planned on these documents did not fully correlate with the activities recorded in the home’s diary. Therefore, although support workers spoken with at the home were fully acquainted with the planned activities and actions for the resident and could state when and how these were carried out, documentary evidence was inconsistent. A third file for this resident was the service delivery (SDP) plan file which included an individual personal planning profile, 6 monthly reviews with new goals set, SDP goal record sheets and keyworker meetings. The SDP goal record sheets had goal targets set for April 2005 but were not signed and did not indicate whether the goals had been met or not. The keyworker meeting for 4th April 2005 noted that some of the goals for the resident had not been met due the inconsistency of staff and the lack of a driver (these issues will be addressed later in the report under Staffing). The majority of the keyworker meeting notes were not filed in date order and some were not in the correct section of the SDP file. It was not clear to the inspector why there were three separate files relating to the care of each resident. These files contained a wealth of relevant information but had the potential for duplication of information and difficulty in correlating all of the goals, plans and reviews. The Registered Person should review the system of care plan files to ensure they are manageable and give a clear and easily accessible picture of the care planned for each resident. The Manager must ensure that all documents are properly signed and dated and filed correctly. Verbal and documentary evidence indicated that residents are encouraged and supported to make decisions about their lives, with staff demonstrating a good knowledge of the various ways in which the body language and behaviours of residents could be interpreted to indicate their choices and preferences. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 11 Individual risk assessments are kept in the service delivery plan file. They were appropriate to individual resident’s needs and had 6 monthly review dates noted. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 standard(s) 12, 13, 14, 15 and 17 Residents are supported to take part in age, peer and culturally appropriate activities, to be part of the local community and to engage in appropriate leisure activities. Appropriate family relationships are facilitated and residents are given a varied and nutritious diet. EVIDENCE: None of the four residents are from visible minority ethnic groups but two residents are of Greek origin and are regularly taken to a Greek centre where they can enjoy culturally appropriate food and interests and listen to their mother-tongue. Staff noticed that one of the original residents of the home, who can understand what is said but cannot communicate with others, has appeared to be much happier and relaxed now that another Greek resident has been admitted. Staff believe that this is because he enjoys hearing his mother-tongue. They have therefore learned a few rudimentary Greek words and intend to formally learn the language so that they can communicate with both residents in their own language. This commitment to residents’ care is to be highly commended. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 13 Verbal and documentary evidence showed that residents are supported to access local shops, banks, cafes and parks, to take rides in the home’s car, and to attend the parent organisation’s pop-in, where they can join in activities such as bingo. Appropriate indoor activities are also provided, such as television, music and puzzles, and one resident has a piano in their bedroom. Staff support residents to maintain contact with family members by making welcoming visits and by dialling family members who are abroad so that residents can hear them and ‘keep in touch’. Two residents have family members to usually visit regularly but are currently sick, and staff have been solicitous in applying for counselling for one of these residents whose mother is seriously ill and unlikely to be able to visit again. They have planned a visit to the hospital for this resident. Residents are also supported to maintain contact with friends, either by being supported to visit them at nearby homes or by having them to tea at the home or seeing them at activity centres. Menus were seen and indicated that residents receive a varied and nutritious diet, based on their choices and preferences. Menus are planned on Sundays and staff described the various ways that residents were able to indicate preferences. These included a thumbs up sign, selecting from pictures, and a verbal indication of yes and no. Staff ensure that a Greek meal is provided at least once per week. The inspector asked one resident about the food at the home and he smiled and made a positive noise (“mmmm”). Alternatives to the planed meal are noted appropriately on the menus. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 standard(s) 18, 19 and 20 Staff provide sensitive and flexible personal support and ensure that residents’ physical and emotional health needs are met. Medication is stored and administered appropriately. EVIDENCE: Observation of staff interaction and verbal evidence (including an affirmation response from one resident), plus documentary evidence in care files, indicated that staff provide sensitive and flexible support in a way that maximises residents’ privacy, dignity and independence. Staff were observed to deal with anti-social and challenging behaviour appropriately, and to respond to residents’ behaviours and body language with sensitivity and understanding. Residents’ were well groomed and age appropriately dressed and the home had a range of technical aids and equipment to maintain residents’ health and independence. For example, one resident had a bed which could be raised from the back and another had a ripple bed. There were guidelines for staff in regard to same sex personal care for the female resident of the home. Care files, shift plans and the diary indicated that staff ensure that residents’ healthcare needs are assessed and monitored and that they have full and regular access to appropriate healthcare professionals and specialist teams. Storage, administration and recording of medication was checked and found to be in good order. A tablet count is made daily, which is good practice. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 standard(s) 22 There is a clear and effective complaints procedure and staff ensure that residents’ wishes and interests are acted upon. EVIDENCE: Staff spoken with were familiar with the complaints procedure and how to access this on behalf of residents. There had been no complaints received by the home since the previous inspection but the manager had made a complaint on behalf of residents to the quality assurance manager of the parent organisation. This complaint was seen and had been dealt with appropriately with full records maintained. The home has also ensured that all residents have an independent advocate. As residents are non-verbal, staff interpret their body language and behaviours to ascertain any problems. Staff said that if this interpretation led them to believe there was a potential complaint, a best interests meeting would be held to which the independent advocate would be invited. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 standard(s) 24, 25, 26, 27 and 30 Residents live in a homely, comfortable and safe environment, with bedrooms that suit their needs and lifestyles and promote their independence. The home is clean and hygienic throughout. EVIDENCE: The home is a purpose built bungalow and is accessible by all the service users, including wheelchair users. It is located in a cul-de-sac with several other purpose built homes, which affords it an extra level of security as all of the other homes are also staffed and therefore aware of security issues. All rooms of the home are comfortable and homely and are fitted and furnished to a good standard. All bedrooms are much larger than the minimum size requirement and the furniture and fittings of the bedrooms are of a particularly high standard. All bedrooms have double beds and have been personalised according to the individual needs and interests of the occupant. For example, one bedroom has been organised so that the resident has a separate living room area with music and television. Another resident bedroom had two 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 17 double wardrobes, television, drums and other personalised activity articles. All bedrooms are within easy reach of toilet and bathroom facilities. There are two bathrooms, one with hoist and bath chair and another with a walk in shower. Both bathrooms have toilets and there is also a separate toilet available. All bathrooms and toilets have disability equipment suitable to the individual needs of residents. The lounge is large, comfortable and well furnished and staff said that new furniture, including settees and tables, had been ordered. The kitchen was clean, well ordered and appeared in good condition but staff also said that new units had been ordered. There is a separate large laundry room, well equipped and with a good quality washing machine and a new drier. There are appropriate systems in place for dealing with clinical waste and for substances hazardous to health, and the home was clean, hygienic and free of unpleasant odours throughout. There is a garden surrounding three sides of the home, which is generally well kept and has facilities for residents to sit outside. However the garden table is old and should be replaced and the canopy umbrella should be provided with an adequate base. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 There is an effective staff team and specialist services are secured from relevant professionals as appropriate. EVIDENCE: The previous report highlighted the effect that four staff vacancies were having on continuity of care at the home and made a requirement regarding this. At this inspection it was found that the home now has the full complement of permanent support workers, with one remaining vacancy of the assistant manager post. One of the support workers is acting up into this role and her support worker post is being covered by a permanent bank worker who only works at this home and is therefore familiar with the care needed for each resident. Staff felt that the previous period of reliance on agency and bank workers had resulted in the poorer quality of daily diary recordings and the cessation of some regular resident activities. However, they believed that now they are almost fully staffed that these two areas would improve. There was ample documentary evidence in resident care files that health and care specialists and specialist teams are used in order to assess and provide for residents’ needs that cannot be met by the home’s staff. For example, one resident had received input from the Community Team, Physiotherapy Service, Speech and Language Therapy Service and the Eating & Drinking Service, as well as complimentary health services and the full range of NHS services. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 19 Staff confirmed that regular team meetings are held, at which they can contribute to care and other issues at the home, and said that their ideas and suggestions are always listened to and acted upon. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 and 42 Residents benefit from a well run home and their health, safety and welfare is promoted and protected. EVIDENCE: The previous inspection report had found that although the manager had been in post for over a year an application to the CSCI for registration under the Care Standards Act 2000 had not yet been made. To follow up on this the manager was contacted by telephone after this inspection and informed the inspector that an application to register had been made to the CSCI and was currently in the process of implementation. The process had been delayed because one aspect of the form had not been fully completed but the manager said that this had now been remedied. In regard to the leadership and management approach at the home, staff said that they found the manager very open and positive, that supervision was of 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 21 positive and useful benefit to them and that they felt that their views and suggestions about the home were listened to and acted upon. Selected areas of safe working practices were checked and observed at the home. The fire book showed that all required checks and services were being made. Fire drills are held at least three-monthly and are thoroughly recorded. Hazardous substances are stored safely, food hygiene principles were observed to be followed during the preparation and serving of the evening meal, residents were observed to be physically guided and supported adequately and suitable risk assessments were seen in residents’ files. The previous report had required that the two outstanding recommendations arising from a food hygiene authority visit were implemented and that a current certificate of gas safety be obtained. The manager was contacted after the inspection and confirmed that the gas certificate had been obtained and that one of the food hygiene recommendations had been implemented, with the second recommendation having just been agreed by the Housing Association to be implemented by them. A requirement has been made for the Registered Provider to inform CSCI of when the second recommendation will be implemented. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 3 x x 3 Standard No 11 12 13 14 15 16 17 x 4 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 5 Bowley Close Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x x 3 x G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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 6 Regulation 17 (3) (a) Requirement The Registered Person must ensure that all documents are properly signed and dated and filed correctly. The Registered Person must ensure that the application for manager registration to the CSCI is facilitated as speedily as possible. The Registerd Person must inform CSCI of the date when the second food hygiene recommendation is to be implemented. Timescale for action 30 September 2005 30 September 2005 31 August 2005 2. 37 8 3. 42 16 (2) (g) 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 6 Good Practice Recommendations The Registered Person should review the system of care plan files to ensure they are manageable and give a clear and easily accessible picture of the care planned for each resident. The Registered Person should ensure that entries in the diary fully and accurately reflect the activities that individual residents have undertaken. G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 24 2. 6 5 Bowley Close 3. 24 The Registered Person should replace the garden table and should provide a base for the canopy umbrella. 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 Page 25 Commission for Social Care Inspection 46 Loman St Southwark SE1 0EH 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 5 Bowley Close G52-G02 7064 5 Bowley 233941 210605 Stage 4 .doc Version 1.30 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!