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Inspection on 12/01/06 for Carlton Avenue (64-66)

Also see our care home review for Carlton Avenue (64-66) for more information

This inspection was carried out on 12th January 2006.

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 no outstanding requirements from the previous inspection report, but made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents` assessed needs and personal goals are reflected in their care plans. Care plans clearly indicated the involvement of residents and are written in the first person. Residents take part in a number of activities within the care home and their choices are assessed through the care home`s care planning processes. Residents access some facilities within the community and this is an area that the care home aims to develop as the weather improves. Arrangements are in place in order to support residents to access appropriate health care facilities. Residents live in accommodation that is homely and comfortable. The home offers clean and hygienic accommodation to residents. There was no Registered Manager at the time of the unannounced inspection. Residents, however, benefit from having a Manager in post.

What has improved since the last inspection?

Seven of the eight requirements arising from the previous unannounced inspection have been complied with.

What the care home could do better:

The care home must ensure that it offers accommodation to potential residents whose needs fall within its registration category. The care home needs to ensure that individual risk management solutions identified in their risk assessments are acted upon to ensure their safety A number of building items requiring attention were noted and are included in the requirements below. The laundry facilities do not present as offering a safe working environment for staff and requirements arose regarding this standard. The Manager must submit an application for registration to the Commission for Social Care Inspection. This is required. There were no identified means by which the views of residents, their relatives and stakeholders are sought concerning the quality of care and support available to them in 64-66 Carlton Avenue, as is required. This must be worked as part of the care home`s annual development. The care home`s policies and procedures largely promote the health, safety and welfare of residents with one requirement arising from the standard.

CARE HOME ADULTS 18-65 Carlton Avenue (64-66) 64-66 Carlton Avenue Kenton Harrow Middlesex HA3 8AY Lead Inspector Ms Sue Barker Unannounced Inspection 12th January 2006 16:40 Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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 Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carlton Avenue (64-66) Address 64-66 Carlton Avenue Kenton Harrow Middlesex HA3 8AY 020 8907 4918 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) Care Management Group Ltd Mr Vernon Anesto Ambris Care Home 9 Category(ies) of Learning disability (9), Physical disability (5) registration, with number of places Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 29th August 2005 Brief Description of the Service: 64-66 Carlton Avenue is a care home that is registered to provide personal care and accommodation to 9 adults aged 18-65 years who have learning disabilities, of these 9 residents, 5 may have addition physical disabilities. The Registered Provider is Care Management Group Limited and the Responsible Individual is Mr William Buckingham. There was no Registered Manager at the time of the unannounced inspection. Ms Donna Thompson had recently been appointed as the care home Manager and is to submit an application for registration to the Commission for Social Care Inspection. The care home is located at the end of a cul-de-sac and backs onto a park. It is close to the Kenton Road that offers community shopping and transport facilities. The home has it own adapted transport facilities. Bedrooms are located on both floors of the building and there is an internal passenger lift. All bedrooms are single and have en-suite facilities. Five of the bedrooms are adapted for residents who have additional physical disabilities. There is a large garden to the rear that can be accessed from the building. The care home achieved registration on 26/11/04. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection commenced at 4.40pm on a cold January evening and ended at 9pm. It is the second statutory inspection of the care home during the year commencing 1/4/05. The Inspector was pleased to meet and greet 6 of the 7 residents living in the care home at the time, as well as staff on duty. Most residents communicate non-verbally. The Inspector observed the pattern of life in the care home, care practice and interactions between residents and staff, in addition to viewing statutory records. Staff presented as knowledgeable about residents’ needs and behaviours. There were four care staff on duty and the Manager kindly remained in care home for the duration of the unannounced inspection. Most residents use wheelchairs to mobilise within the care home. There were 2 residential vacancies at the time of the unannounced inspection. Staff vacancies The Commission for Social Care Inspection has received 2 completed ‘Comment Cards’ from residents’ relatives/visitors. Feedback was positive. The Inspector is grateful to those in 64-66 Carlton Avenue for their time and the assistance received during the unannounced inspection. The Inspector was made most welcome. The key standards were assessed during the 2 statutory unannounced inspections of 64-66 Carlton Avenue during the year commencing 1/4/05 What the service does well: Residents’ assessed needs and personal goals are reflected in their care plans. Care plans clearly indicated the involvement of residents and are written in the first person. Residents take part in a number of activities within the care home and their choices are assessed through the care home’s care planning processes. Residents access some facilities within the community and this is an area that the care home aims to develop as the weather improves. Arrangements are in place in order to support residents to access appropriate health care facilities. Residents live in accommodation that is homely and comfortable. The home offers clean and hygienic accommodation to residents. There was no Registered Manager at the time of the unannounced inspection. Residents, however, benefit from having a Manager in post. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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 Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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): 3 The care home must ensure that it offers accommodation to residents whose needs fall within its registration category. EVIDENCE: The key standard was assessed at the previous unannounced inspection. As indicated above the care home is registered to provide personal care to 9 adults aged between 18 and 65 years who have learning disabilities and of this number 5 residents may have additional physical disabilities. During the unannounced inspection it was evident that 6 to 7 residents have additional physical disabilities and use wheelchairs to mobilise. Ms Thompson indicated that further residents are to be assessed for vacancies in the care home. In the Inspector ‘s opinion the dimensions of the communal space within the building present as insufficient for all residents to spend time in the lounge together or have their meals together, if that is their wish and where more than 5 residents use wheelchairs to mobilise. 4 bedrooms are not registered to accommodate adults who use wheelchairs to mobilise and do not offer sufficient space for those who do. This particularly applies to the en-suite facilities. Where the care home plans to accommodate residents whose needs fall outside its registration, a prior application for variation of the conditions of registration must be submitted to the Commission for Social Care Inspection, with information about how the care home is able to meet the needs of the potential resident. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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 & 9. Residents’ assessed needs and personal goals are reflected in their care plans. Care plans indicated the involvement of residents. The care home needs to ensure that individual risk management solutions identified in their risk assessments are acted upon to ensure their safety. EVIDENCE: The Inspector viewed a sample of 1 care plan in respect of a resident living in 64-66 Carlton Avenue. The care plan presented as well documented, though there was a great deal of documentation with 2 sets of care plans. It included assessments and care plans by the resident’s Local Authority. The care home’s assessment included aspects relating to the resident’s health, skills, what is important to me, what I enjoy, what I really like, leisure activities I go to and family contact. The care plan for the resident was dated September 2005 and it was to be reviewed in April 2006. There was a clear indication of the resident’s goals and indication that the resident was involved in putting together the care plan. A review had been held on 28/11/05. There was some specialist guidance available to staff in respect of the individual resident. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 10 Ms Thompson indicated that she was investigating advocacy services for residents in the care home. There was indication on file of the pattern of resident’s daily lives. Residents have named key workers from within the staff team. The Inspector viewed comprehensive risk assessments in respect of individual residents, their use of the building and community facilities. Risk assessments in respect of one resident’s use of the bathroom indicated that the radiators should be covered. The Inspector did not view any such covering during the unannounced inspection. It must be ensured that any identified risks to the health and safety of residents are, so far as is possible, eliminated. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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): 12 & 13 Residents take part in a number of activities within the care home and their choices are assessed through the care home’s care planning processes. Residents access some facilities within the community and this is an area that the care home aims to develop as the weather improves. EVIDENCE: Within the care home there is a sensory room, lounge and dining room in which recreational and leisure pursuits were being made available to residents during the unannounced inspection. Later in the evening most residents were seated in the lounge with the TV on. Residents also had their own recreational and leisure equipment in their bedrooms. The Inspector viewed examples of the non-verbal communication tools used by staff in order to develop effective communication with residents. Staff are to also to undertake appropriate training. Residents attend day placements. There was indication in the care plan viewed of the resident’s preferred leisure pursuits. All residents were at home during the unannounced inspection. Ms Thompson indicated that she hope to develop more early evening and weekend activities Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 12 for residents in the community, when the weather improves. The care home has its own transport facilities. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 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): 19 Arrangements are in place in order to support residents to access appropriate health care facilities. EVIDENCE: Evidence was available concerning the range of preventative health care checks available to and medical appointments attended by residents living in 64-66 Carlton Avenue. This included speech and language therapy, chiropody, district nurses and optician. The Inspector viewed guidance for staff on resident’s medical condition, for example epilepsy. This included the circumstances in which staff must call the resident’s GP and emergency services. One member of staff had escorted a resident to A & E on the day of the unannounced inspection. A number of residents are fed through peg feeding tubes and Ms Thompson advised the Inspector of the health professionals who are accountable for this procedure. The Inspector viewed ‘My Health’ booklets for each resident. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 14 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): EVIDENCE: These key standards were assessed at the previous unannounced inspection. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 15 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 & 30 Residents live in accommodation that is homely and comfortable. A number of building items requiring attention were noted and are included in the requirements below. The home offers clean and hygienic accommodation to residents. The laundry facilities do not present as offering a safe working environment for staff and requirements arose regarding this standard. EVIDENCE: The Deputy Manager kindly showed the Inspector around the care home’s communal areas and bedrooms. The building achieved registration in November 2004 and retains a new feel. It was found to be warm, bright, clean and comfortable with a number of homely features. The Inspector viewed a daily cleaning checklist for the care home. The home was free of offensive odours. The décor is beginning to show signs of damage and redecoration will require inclusion in the care home’s annual planning. Most areas of the building felt comfortably warm apart from one bedroom. An ‘Immediate Requirement Notice’ was issued to increase the heating levels in Room E without the use of portable electric heaters. The Registered Provider Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 16 submitted an ‘Action Plan’ to the Commission for Social Care Inspection and subsequently confirmed that the required works had been carried out. A number of requirements requiring attention are included further in this report. The home is close to community transport, leisure and shopping facilities in Kenton and Harrow. The house is in keeping with others in the immediate vicinity. The premises were noted to be clean during the unannounced inspection. The care home has a laundry that is located in an area of the home that does not required washing to transported through areas where food is stored, prepared, served and eaten. The laundry is very small in size. It contains a washing machine and dryer and little in the way of shelving and storage facilities. This room was also very hot when the dryer was in operation. The laundry door was labelled ‘fire door’ and was propped open. There was no door closure mechanism on the door. The Inspector observed supplies of protective clothing for staff to use. A number of requirements were identified concerning standard 30. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 17 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): EVIDENCE: These key standards were inspected at the previous unannounced inspection. There remains an outstanding requirement in respect of Standard 35. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. There was no Registered Manager at the time of the unannounced inspection. Residents benefit from having a Manager in post. The Manager must submit an application for registration to the Commission for Social Care Inspection. This is required. There were no identified means by which the views of residents, their relatives and stakeholders are sought concerning the quality of care available in 64-66 Carlton Avenue. This is required. The care home’s policies and procedures largely promote the health, safety and welfare of residents with one requirement arising from the standard. EVIDENCE: There was no Registered Manager at the time of the unannounced inspection. The Inspector met with Ms Donna Thompson who had recently been appointed as the new manager for the care home. Ms Thompson is to submit an application for registration to the Commission for Social Care Inspection. This is required. Ms Thompson had worked in the care home for some time. The Inspector noted no issues concerning the management of the care home during the unannounced inspection. Ms Thompson advised the Inspector of Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 19 the line management structure for the care home within the Care Management Group. The home does not have a computer and the Inspector would recommend this provision in order to facilitate the production and updating of complex ranges of information about residents and their needs. Ms Thompson advised the Inspector that there is a Quality Assurance Officer in the Care Management Group Head Office. Otherwise it was unclear as to what extent an annual review of the quality of care and support available in 64-66 Carlton Avenue had been carried out. This is required. The review must include consultation with the residents, their representatives and stakeholders. A copy of any report arising from this review must be forwarded to the residents and Commission for Social Care Inspection. A representative of the Registered Provider visits the care home on a monthly basis and a copy of the report of the visit is forwarded to the Commission for Social Care Inspection. There is as range of policy guidance for staff in the office. There are first aid boxes within the care home. Staff are testing and recording the temperatures of the fridge and freezer, as well as food served to residents. A record is also maintained of the temperatures of the hot taps in the building. They are mostly at or less than the stated safe temperature of 43°C. There are facilities in the building for the safe storage of chemicals. Risk assessments had been developed in respect of residents and the building. The Inspector did not view any Fire Risk Assessment for the building or evidence of any other of the required fire safety checks. This was discussed with Ms Thompson and is required. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 20 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 x 1 x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Carlton Avenue (64-66) Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x 1 x x 2 x DS0000062165.V269718.R01.S.doc Version 5.0 Page 21 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 YA3 Regulation 14 Requirement Where the care home plans to accommodate residents whose needs fall outside its registration category, a prior application for variation of the conditions of registration must be submitted to the Commission for Social Care Inspection, with information about how the care home is able to meet the needs of the potential resident. It must be ensured that any identified risks to the health and safety of residents are, so far as is possible, eliminated. Provide adequate facilities for the disposal of cigarette butts on the patio. Ensure that there are adequate ventilation levels in the ground floor bathroom. This room was very hot after use. Ensure that staff lockers are not placed in residents’ communal space. The first floor bathroom is quite small, and the Inspector gathered, is not much used by residents. Review the appropriateness of this facility in DS0000062165.V269718.R01.S.doc Timescale for action 12/05/06 2 YA9 13 12/04/06 3 4 YA24 YA24 16 23 12/04/06 12/04/06 5 6 YA24 YA24 23 23 12/04/06 12/05/06 Carlton Avenue (64-66) Version 5.0 Page 22 9 YA30 23 10 YA30 23 11 YA37 9 12 13 YA35 YA39 18 24 14 YA39 24 15 YA42 23 terms of the needs of residents with report to the Commission for Social Care Inspection. Ensure that an appropriate door closing mechanism is fitted to the laundry’s fire door as approved by the Fire Safety Officer. Review the lay out, ventilation and dimensions of the laundry to ensure that adequate space, storage and facilities are available to ensure the provision of a safe working space for staff and residents. The Manager must submit an application for registration to the Commission for Social Care Inspection. This is required. Training targets for NVQ of at least 50 should be achieved. An annual review of the quality of care and support available in 64-66 Carlton Avenue must be carried out. This is required. The review must include consultation with the residents, their representatives and stakeholders. A copy of any report arising from this review must be forwarded to the residents and Commission for Social Care Inspection. It must be ensured that there is a Fire Risk assessment for the building. This is required. 12/04/06 12/05/06 12/04/06 12/08/06 12/05/06 12/05/06 12/04/06 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 Refer to Standard YA37 Good Practice Recommendations The home does not have a computer and the Inspector DS0000062165.V269718.R01.S.doc Version 5.0 Page 23 Carlton Avenue (64-66) would recommend this provision in order to facilitate the production and updating of complex ranges of information about residents and their needs. Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Carlton Avenue (64-66) DS0000062165.V269718.R01.S.doc Version 5.0 Page 25 - 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!