Inspection on 20/08/07 for Brackenbury Road, 37

This inspection was carried out on 20th August 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brackenbury Road, 37 23/02/09

Brackenbury Road, 37 27/05/08

Brackenbury Road, 37 29/11/05

Brackenbury Road, 37 11/07/05

Brackenbury Road, 37 18/01/05

Brackenbury Road, 37 19/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

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 Brackenbury Road, 37 Brackenbury Road 37 Brackenbury Road Hammersmith London W6 0BG Lead Inspector Sheila Lycholit Key Unannounced Inspection 20th August 2007 10:05 Brackenbury Road, 37 DS0000019145.V347702.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 Brackenbury Road, 37 DS0000019145.V347702.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. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brackenbury Road, 37 Address Brackenbury Road 37 Brackenbury Road Hammersmith London W6 0BG 020 8563 2125 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) info@yarrowhousing.org.uk Yarrow Housing Mr Chibuzor Nnanna Okerenta Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th April 2006 and 19th March 2007 Brief Description of the Service: Brackenbury Road is a registered care home providing accommodation and personal care for five men and women with a learning disability. At the time of this inspection there were four women and one man living in the home. Notting Hill Housing Trust owns the property and the care is provided by Yarrow Housing, a not-for-profit organisation. The home is well located, close to facilities in the local community and the shops and transport links of Shepherds Bush and Hammersmith. The home provides accommodation over three floors and is not accessible to people with mobility difficulties. Each person living in the home has a good sized single room with wash hand basin. Shared facilities include a bathroom, separate shower room, lavatories, sitting room, kitchen/dining room and garden. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Monday 20th August 2007 from 10.05AM until 2.30PM. Two residents were at home. One resident had spent the weekend with his family and would return later that day. Two residents were on holiday on the south coast with two members of staff. The Deputy Manager, who had done the sleep-in, was on duty. A bank member of staff failed to arrive for her 10AM shift. The Manager, who had completed an annual quality assessment questionnaire, came in early to speak with the Inspector. Each of the 5 residents had completed a pre-inspection survey form with support. Survey forms were also received from 2 families and 1 Social Worker. The Deputy Manager accompanied the Inspector on a tour of the building. The 2 residents who were at home showed the Inspector their rooms. What the service does well: What has improved since the last inspection? What they could do better: More regular residents’ meetings should take place, which are recorded in an accessible format. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 6 Yarrow’s complaints procedure should be displayed in the house, with copies made available to each resident. All staff must receive supervision at least 6 times a year. The Manager was not supported by Yarrow Housing senior staff to resolve the repair of fire doors, which were failing to close properly for over 6 months. Steps must be taken to ensure that all essential repairs are carried out promptly. Visits on behalf of the provider are not undertaken regularly in line with regulation 26. A risk assessment of the building, in addition to the fire risk assessment, must be undertaken, together with COSSH assessments. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brackenbury Road, 37 DS0000019145.V347702.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 Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Yarrow Housing provides clear, accessible information for existing and prospective residents. Staff work closely with the multi-professional Learning Disability Team to ensure that residents’ needs are regularly assessed and reviewed. EVIDENCE: Copies of the service user’s guide were seen on the 2 residents’ files looked at. The Deputy Manager was updating the guides and contracts, which were available on the PC, and was awaiting information from Yarrow Housing regarding current fees and charges. Information is available in an accessible format with symbols and illustrations, though staff do not currently have access to a colour printer at the home. Records show that residents’ needs are regularly re-assessed with relevant colleagues from the Learning Disability Team. There are no vacancies at 37 Brackenbury Road and no new residents have been admitted in the past 12 months. An admission policy and procedure is available. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. PCPs are increasingly developed, with good use of multi-media. Staff manage well the differing abilities of residents to take risks in the community. While residents are supported to take part in all aspects of the life of the home, participation would be enhanced by regular meetings. EVIDENCE: The PCPs and reviews of 2 residents were seen. The PCPs are in an accessible format and reflect residents’ short and longer term goals and aspirations. Notes of meetings showed that residents and their families had participated in the reviews, which had included visual presentations. The Social Worker of one resident commented on ‘ well presented PCP meetings including photographs and videos’. Residents are supported to take risks in line with their agreed PCP, for example to travel independently. The differing abilities and interests of residents and the wide age range are managed well by staff, who support people individually Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 10 or in small groups where possible. Risk assessments are comprehensive and are up to date. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported to take part in a range of social, leisure and community activities. Staff have taken steps to encourage residents to eat more healthily. EVIDENCE: Staff work with members of the Learning Disability Team to provide opportunities for residents to develop communication and interpersonal skills. There is a marked decrease in the number of incidents of verbal and on occasion physical aggression between certain residents. Activity plans show that residents attend a range of activities, including adult education classes, day services, the local gym and other leisure services. Two residents went bowling with the Deputy Manager on the day of the inspection in line with their programme. Staff have continued to accompany residents on holidays in the UK and abroad. The Deputy Manager and a Support Worker went with 3 residents to Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 12 Florida, visiting the theme parks and other attractions. Photos of the holiday and other activities are displayed in the house, which one of the residents showed the Inspector. Residents undertook a presentation to Yarrow’s Board on their return. Two residents accompanied by two staff had rented a house on the South Coast for a week at the time of the inspection. Records show that families are involved in reviews and are consulted appropriately. One resident regularly visits his family at weekends. Staff support residents in taking part in activities such as religious observance that affirm their ethnic and cultural background. Meals are eaten in the pleasant kitchen extension, which has a large dining table. Two residents were having breakfast at the start of the inspection. Discussion with the Deputy Manager indicated that more attention is being paid to healthy eating. Weight charts show that residents have successfully lost weight, though one family commented in their feedback that they thought that more could be done regarding improving fitness. One resident regularly sees a Dietician. Notes of staff meetings show that senior staff have reminded the team of the need to ensure that menus contain low fat dishes and that cakes and biscuits are to be avoided. On the day of the inspection, the fridge, which was clean and tidy, contained a selection of fresh vegetables. Fresh fruit is available and fruit salad is regularly included on the menu. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Support guidelines are well written and demonstrate staff’s thorough knowledge of residents’ needs. Clear records of health care appointments and their outcomes are kept, with issues followed up. The Manager must ensure that all staff, including bank staff, are competent to administer medication. EVIDENCE: The support guidelines for 2 residents were seen, which were detailed and well written. A separate record of health care appointments is kept for each resident, which shows that health concerns are followed up and action taken. Staff normally accompany residents to all health care appointments. Three of the five residents take medication regularly. One of the MAR sheets seen contained entries deleted by Tippex, rather than crossed through. The Manager confirmed that this practice had been discussed with the member of staff concerned. Training records indicate that some staff may be overdue for refresher training in the administration of medication. Induction records for all Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 14 staff, including bank staff, should confirm that they are competent to administer medication safely. The Deputy Manager said that discussions were taking place with the family of one of the older residents about her wishes regarding funeral arrangements and the drawing up of a will. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Yarrow Housing has a clear complaints procedure in an accessible format, though this needs to be made more available to residents. An up to date Safeguarding Adults policy and procedure is available. An earlier inspection this year indicated that the procedure had not been followed in relation to incidents between residents. EVIDENCE: One complaint was recorded in the past 12 months, which was resolved. Yarrow has an accessible complaints leaflet. Copies of the leaflet should be displayed in the home and residents provided with a copy. The Deputy Manager said that she would put a copy on the notice board in the kitchen. An inspection in March this year noted that incidents between residents, which had involved physical aggression, had not been discussed with the local Safeguarding Adults Co-ordinator. No further incidents have occurred. Training records show that while the majority of staff have attended training in adult protection, one member of staff who had worked at the home for over 12 months had still not attended training. Staff should attend adult protection training within 6 months of their appointment. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The house is in a good state of decoration internally and externally and is indistinguishable from other houses in the street. The single bedrooms are of a good size and reflect residents’ interests. Although the service has been without a cleaner for a number of months, staff have maintained a good standard of cleanliness. EVIDENCE: The building has been redecorated in the past 12 months and its appearance is much improved. New curtains have also been purchased. The two residents at home showed the Inspector their rooms, which were in a good state of decoration, with many personal possessions on display. The room of one resident was cleaner and in better order than at the last inspection, when it was clear that the resident needed more encouragement to keep her room clean and comfortable. One resident commented on the TV reception, which has been improved since the inspection in March. Digital TV has also been made available to all sets in the house. Residents are able to lock their rooms. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 17 The carpets, which were noted to be in need of replacement or re-fitting at the last inspection, remain in the same state. The Deputy Manager said that quotes have been obtained for new carpets, which it is expected will be fitted shortly. Although the home has been without a cleaner for a number of months, staff have maintained a good standard of cleanliness. The kitchen was clean and tidy and the cupboard under the stairs, which had been over-spilling into the corridor, had been cleared out. The laundry room was also in good order. Feedback from one family commented that their relative sometimes appeared to be wearing clothes that would benefit from being ironed. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Although staff absences have meant that bank staff have been used fairly frequently, the core team has remained consistent and staff are generally well supported. EVIDENCE: Staffing levels allow for 2 or 3 staff on duty during the day, with one member of staff sleeping over. At this inspection and at the previous visit in March a member of staff failed to arrive for their shift, though the Manager gave assurances that this rarely occurred. The team has been operating with 3 vacancies, as two staff have been on maternity leave and one on long-term unpaid leave. The posts have been covered by staff from Yarrow’s bank. One member of staff was returning from maternity leave the next week. Staff meetings normally take place every 2 weeks, though records show that longer intervals have recently occurred. Meetings are well recorded, with detailed notes emailed to each member of staff. New staff are recruited by Yarrow Housing’s HR Team, who undertake all appointment checks. Confirmation of CRB checks is emailed to the Manager, who is normally present at staff interviews. Yarrow Housing also includes residents who have attended relevant training in staff interviews. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 19 Staff have access to Yarrow Housing’s comprehensive training programme. Training records indicate that staff have attended a range of relevant training, though not all individual records were up to date. The Deputy Manager is enrolled on NVQ4 and one Support Worker is enrolled on NVQ3 but has temporarily put her studying on hold. Two staff are undertaking relevant qualifications in their own time. All new staff undertake the LDAF/Skills for Care induction programme. Records show that the majority of staff receive regular supervision, which is recorded. The records of one member of staff showed a gap of 5 months between supervision meetings. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home is well managed by the Manager and Deputy Manager. Recording is of a good standard. Senior staff have not received sufficient support from Yarrow Housing to ensure that essential repairs are carried out promptly. Visits on behalf of the provider are undertaken intermittently and not as required. EVIDENCE: The Manager completed a degree in Psychology last year and is undertaking further studies in his own time. He and the Deputy Manager normally work opposite shifts to ensure a senior presence at the home. Completed resident satisfaction surveys were seen on file and copies had been forwarded to Yarrow’s head office for inclusion in the annual report. One Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 21 resident regularly attends Yarrow’s tenants’ forum. Yarrow’s annual report is published in an accessible format. Policies and procedures are regularly updated and are available on Yarrow’s intranet. Recording is of a good standard. Staff record all financial transactions on behalf of residents. Yarrow’s finance staff visit the home every 3 months to carry out a check of the home’s finances, including residents’ money. Reports of these visits are on file at the home. Although valuable to safeguard residents from financial abuse, these visits do not meet the requirements of visits on behalf of the provider under regulation 26. Visits on behalf of the provider continue to be undertaken on fewer occasions than required by the regulations. Accident and incident records showed that these are recorded in detail. The risk assessment of one resident had been updated following an occasion when she went missing. The external doors were found to be properly secured at this unannounced visit. Staff receive training in health and safety as part of their induction. As some training records were incomplete it was unclear whether all staff had undertaken training in fire safety. The Deputy Manager asked for records to be updated by the Training Team. Fire points are tested weekly and a fire drill carried out monthly. Records of fire drills show that there were problems with the fire doors closing from November 2006 until the beginning of August 2007 when the system was successfully repaired. Correspondence on file shows that the Manager made many attempts to resolve the problem but was passed from one person to another. Concern about the failure to repair the fault was also included in the Inspector’s letter to the Chief Executive following the inspection in March 2007. A monthly health and safety check of the building is carried out. Recent checks have produced a detailed report with notes of action taken. A risk assessment of the building has still not been undertaken and COSSH assessments are not available. Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 X LIFESTYLES Standard No Score 11 3 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 2 3 3 3 3 3 3 2 2 Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA8 YA20 Regulation 12 13 Requirement More regular residents’ meetings should take place, with accessible notes made available. Tippex must not be used to make alterations on MAR sheets. The Manager must take steps to confirm that all staff, including bank staff, are competent to administer medication. The complaints procedure should be displayed in the home and copies given to each resident. Staff must attend training in safeguarding adults during their induction period. All staff must receive supervision, which is recorded, at least 6 times a year. A health and safety risk assessment of the building must be undertaken, together with COSHH assessments. Visits on behalf of the provider, which are unannounced, must be carried out at least monthly, with reports available. This was a requirement made at the random inspection on 19th March 2007. Timescale for action 30/09/07 30/09/07 3 4 5 6 YA22 22 13 18 13 30/09/07 31/10/07 30/09/07 30/09/07 YA23 YA36 YA42 8 YA43 26 30/09/07 Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brackenbury Road, 37 DS0000019145.V347702.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brackenbury Road, 37 DS0000019145.V347702.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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