Inspection on 23/11/06 for Chelsea House

This inspection was carried out on 23rd November 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 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 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Chelsea House 15/05/07

Chelsea House 27/02/06

Chelsea House 30/01/06

Chelsea House 24/02/05

Chelsea House 29/06/04

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 Chelsea House 4 Winchelsea Road London N17 6XH Lead Inspector Caroline Mitchell Key Unannounced Inspection 23rd November 2006 10:00 Chelsea House DS0000010823.V316474.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 Chelsea House DS0000010823.V316474.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. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chelsea House Address 4 Winchelsea Road London N17 6XH 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) 020 8885 1898 Mr Wilhelm Dale Lewis Mr Wilhelm Dale Lewis Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last Key inspection 27th February 2006 Brief Description of the Service: Chelsea House is a small care home registered to provide accommodation and personal care for a maximum of three adults with learning disabilities. Mr Dale Lewis owns the home and is registered as the manager. Mr Lewis also provides a separate specialist outreach service for people with learning disabilities, under the umbrella name of Pashun Care Services. The home is a terraced house with three bedrooms. On the ground floor, there is a lounge, bedroom, toilet, kitchen and a separate dining room. On the first floor there is a bathroom with a toilet, two bedrooms and a small office. There is a small paved area at the front of the house and a back garden, which is accessible to service users. The house is located near the busy Philip Lane and close to a sports centre. There is easy access to shops, restaurants and transport facilities located along the high street at Seven Sisters. The stated aim of the home is to provide a holistic and high quality of care to service users with learning disabilities. The home also aims to provide practical help for service users and maximise their individual potential while adhering to the core values of showing respect for service users, encouraging local community participation and promoting independence. Placements at the home costs between £3430 - £1099 for each person per week. Service users are expected to pay separately for some items and activities, such as eating out. Following “Inspecting for Better Lives” the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Because the service users usually attend day services and there is rarely anyone at home during the daytime, and to ensure that the inspector could gain access to certain written records, the registered person was given 24 hours notice of this inspection. A new manager was present for the inspection. He was recently appointed and had only been in post for three weeks. The first two weeks were part of his induction. One of the Directors also provided evidence of a recent investigation and discussed the issues arising from this. What the service does well: What has improved since the last inspection? What they could do better: As a result of the previous visit it was also recommended that the policies and procedure be reviewed, to ensure that they are in line with current legislation. This has not yet been achieved, and this recommendation remains relevant at this inspection. The areas for improvement identified at this inspection include improving the way in which written plans and assessments and are dated to make it clear which are the recent documents, some work on infection control in the home, a minor repair to the bathroom, an improvement in the way in which weekend medication is dispensed. There is a need to improve the frequency of both staff supervision and staff meetings. The registered person needs to priorities NVQ training for staff. The staff records indicate that there Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 6 is still some room for improvement in the recruitment practices in the home. Requirements are made in respect of this, and one requirement regarding recruitment is restated. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the timescale given will lead the Commission to consider enforcement action to ensure compliance. There is a rich and diverse cultural mix in the service user and staff group, and there is room for more exploration and celebration of this. 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. Chelsea House DS0000010823.V316474.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 Chelsea House DS0000010823.V316474.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users’ can be confident that their individual needs would be properly assessed prior to admission. EVIDENCE: There have been no recent admissions to the home. The inspector saw the written records regarding the service user who was most recently admitted, which was around two years ago. The evidence supported that the admission had been carefully planned and several planning meetings had taken place to ensure that staff in the home were clear about the needs of the service users and what the risks were. The written records included detailed assessments made by social and health care professionals that were provided to the home as part of the admission process. Chelsea House DS0000010823.V316474.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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users’ needs are assessed, their personal goals are reflected in their individual plan and they are supported to take risks as part of an independent lifestyle. There is room for improvement in the way in which the plans and risk assessments are dated and reviews recorded. EVIDENCE: The inspector saw the written records for two service users and both included service user plans and risk assessments of a good quality, and that reflect the individuality of each person. However, the service user plans were in need of review, and a requirement is made in respect of this. Some risk assessments were not dated, so it was not clear which were the most recent, or when they were due for review. In addition, some risk assessments did include review dates, but it was unclear as to whether this had actually been done. A requirement is made in respect of these issues. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 10 The service users’ plans include specific sections regarding their choices. This runs through the assessments and plans. In speaking with the staff member it was evident that the underpinning values in the home are very much about providing service users with choices, supporting them to be independent and to make decisions. One service user has particularly challenging behaviour, which can include violent outbursts. The inspector noted that there is guidance in place for staff regarding ways of working with him that minimise the frequency and the impact of these incidents. This approach has been successful in that the number of these incidents has decreased, and there have been none recorded since July 2006. This particular service user can also be affectionate in a way that can be challenging, and there are also guidelines in place regarding how to work appropriately with him in this context. Staff had signed to indicate that they were aware of these guidelines. Chelsea House DS0000010823.V316474.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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to be part of their local community, they engage in appropriate social and leisure activities and maintain appropriate family links. There is a little room for more celebration of the rich cultural diversity in the home. EVIDENCE: Records reflect that the service users have full social lives. The service users like to go swimming regularly, bowling and other ad hoc activities, depending on what the individual would like to do. Appropriate records are maintained of these activities. Service users are supported to use the resources in the local community, and to take part in a range of ordinary, day-to-day activities. These include going shopping, attending day services, walks in the park, going to the cinema and going to the pub. The service users and staff come from lots of different cultural backgrounds, and whilst this is acknowledged and facilitated to some extent, the inspector feels that there is room for more celebration of such richness of cultural Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 12 diversity. Providing service users with more opportunities to learn about their own and each other’s cultures including festivals, food and art. There is also plenty of evidence that service users’ families are involved in their lives, and visit and telephone regularly. The manager told the inspector that he had already spoken with key members of all three service users’ families when they had visited or called over the last week or so. The inspector saw the records that are kept of what service users actually eat and these indicated that there is a varied and reasonably balanced diet on offer. In conversation with the staff member on duty it was evident that service users are encouraged to eat healthily, with fresh fruit and vegetables being provided. Chelsea House DS0000010823.V316474.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support to suit their individual needs. The registered person ensures that the healthcare needs of service users are assessed and recognised and that procedures are in place to address them. The arrangements in the home regarding medicines protect service users’ best interests. EVIDENCE: On each file examined there were guidelines relating to individuals’ daily routines from waking up, personal care, breakfast routines, day centre support and evening activities. The staff are instructed to respond sensitively and to be flexible when supporting service users with their personal care. The staff member on duty described the particular skin care routine that is necessary for one service user, who is from an Afro-Caribbean background. The inspector noted that service users had good quality health action plans included in their files. However, one service user’ plan was not dated so it was not clear whether it was recent and still relevant. A requirement is made in respect of this. The inspector saw the arrangements for storing, administering and recording the medication prescribed to service users in the home. The bubble packs are Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 14 used and the arrangements that were in place were acceptable. The monitoring record indicated that medication is stored below 25oC. Staff have received medication training and the certification for this is retained in each staff members’ personnel file. The inspector noted that the staff in the home dispense the medication into a dosset box, for one service user, when he goes to stay with his familly at weekends. It is required that a written record is kept when weekend medication is dispensed, and that two staff sign to indicate that the correct medication has been dispensed. It was also suggested that it is more appropriate for the pharmacist to dispense weekend medication. Chelsea House DS0000010823.V316474.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 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a clear complaints procedure in place. The recent adult protection investigation has been learning process for everyone in the home. EVIDENCE: The inspector noted that there is a clear complaints procedure in place and that no complaints had been recorded as being received in the home since the previous inspection. The concerns raised by the previous manager were dealt with through the local authorities adult protection procedure. This was dealt with through the local authority’s adult protection procedure and, although no concerns were found for the safety of the service users, the records of the way in which the home initially responded and investigated the issue could have been more organised. The inspector discussed the issues with one of the Directors, who said that this was the first time that the home had dealt with this kind of issue, and that some lessons had been learned. The inspector saw the written records of the issues and the investigations undertaken on behalf of the registered person. At the previous inspection the registered person was required to ensure that all staff record the exact details of the control and restraint technique used in line with the homes policy and procedure and record incidents of challenging behaviour, to ensure that staff are aware of, signed up to and work within any new agreed guidelines introduced to manage complex behaviours, and provide evidence that all staff have completed approved control and restraint training. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 16 The inspector was able to confirm that each of these issues had been addressed. The certificates of training were on staff members’ file for training that they had received in the protection of vulnerable adults, and in dealing with challenging behaviour, and control and restraint. The written records of incidents of challenging behaviour, and the details of the control and restraint technique used have been improved. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained and is kept clean and free from offensive odours throughout. However, there is room for some improvement in terms of infection control in the home. EVIDENCE: The home is a terraced house with three bedrooms. On the ground floor, there is a lounge, bedroom, toilet, kitchen and a separate dining room. On the first floor there is a bathroom with a toilet, two bedrooms and a staff office. There is a small paved area at the front of the house and a small patio garden at the rear, which is accessible to the service users. The inspector observed that the home was pleasantly decorated and furnished, and was warm, comfortable and homely. The staff member on duty told the inspector that the hall was due to be decorated and that new sofas had been ordered. The home has one bathroom with a toilet on the first floor, and there is a further toilet on the ground floor, providing adequate toilet and bathroom facilities for the three service users. The home was nice and clean generally. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 18 During the tour of the building the inspector noted that there are a number of wash hand basins in the home, in the upstairs bathroom, the downstairs toilet, the kitchen and the laundry room. However, apart from in the kitchen, there were no hand towels available. A requirement is made in respect of this. At the previous key inspection the registered person was required to ensure that the paintwork in the bathroom on the first floor was re- decorated and the tiles were re-grouted. This had been addressed. However, the sealant around the bath has become mildewed in places, and needs to be replaced. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There are sufficient staff employed to meet the needs of the service users and, although they benefit from a good level of training, the provision of formal staff supervision needs to be improved. Some pre-employment checks for staff are in place. However, in order to properly protect the service users it is necessary to improve the recruitment processes in the home. EVIDENCE: In speaking to the member of staff on duty it was evident that, although they had been through a difficult time, related to the various investigations arising out of the concerns raised by the previous manager, that the team was beginning to settle again. Due to the disruption in the management team, formal one-to-one staff supervision has not been provided as often as it ought, and a requirement is made in respect of this. Previously, the registered person has been required to ensure that applicants provide a full employment history including a written explanation of any gaps in employment. At this inspection some staff had not provided a sufficiently detailed work history, and no action appeared to have been taken to address the previous requirement. This requirement is restated. In addition, there Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 20 were a number of staff files that did not include two written references, and some of the written references that were on file had not been verified. A requirement is made in respect of these issues. In terms of training the inspector found that the registered person has ensured that staff have access to a very good range of training that covers the core issues as well ads specialist training that is relevant to the needs of these particular service user. However, there is room for more work to ensure that staff have NVQ training and a recommendation is made in respect of this. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A manager has been appointed and is settling into the home. There is a need for more regular staff meetings. The Service users can be reasonably confident that the home protects their physical safety and security through a proactive approach to health and safety. Although, some training is recommended for staff in infection control. EVIDENCE: A new manager has been appointed. He is currently undertaking training at the equivalent of NVQ level 4, by completing the Registered Managers Award. The manager told the inspector that he had received a good quality induction into the home, and was supernumerary for his first two weeks, as part of his induction. It is In terms of health and safety it is recommended that refresher training in infection control is provided to staff. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 22 Because of the nature of their disabilities, the service users’ views are sought on a day to day basis in ways that are relevant to them, rather than in formal meetings. However, the inspector noted that in the period between the previous manager leaving, and the current manager being appointed, the staff meetings haven’t taken place as regularly as they ought. A requirement is made in respect of this. Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 2 X 3 2 X Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 24 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. Standard YA6 Regulation 15 Requirement The registered person must ensure that two service users’ plans are reviewed and updated. The registered person must ensure that service users’ risk assessments are dated, and that there is clearer evidence that they have been reviewed. The registered person must ensure that service users’ health action plans are dated, and that there is clearer evidence that they have been reviewed. The registered person must ensure that a written record is kept when weekend medication is dispensed, and that two staff sign to indicate that the correct medication has been dispensed. The registered person must ensure that the sealant between the bath and the tiles in the bathroom on the first floor is replaced. The registered person must ensure that there are hand towels available in the upstairs bathroom, the downstairs toilet DS0000010823.V316474.R01.S.doc Timescale for action 30/12/06 2. YA9 13(4) 30/12/06 3. YA19 12 30/12/06 4. YA20 13(2) 10/12/06 5. YA27 23(2) 31/12/06 6. YA30 13(4) 16(2)(j) 31/12/06 Chelsea House Version 5.2 Page 25 and in the laundry room. 7. YA34 7,9,17,19 Sch. 2 & 4 The registered person must ensure that the staff application form is revised to ensure that applicants provide a full employment history including a written explanation of any gaps in employment. The previous timescale of 30/05/06 was not met. The registered person must ensure that every person employed in the home has two written references which the registered persons have satisfied themselves are authentic. The registered person must ensure that staff are provided with formal one-to-one supervision at least 6 times per year. The registered person must ensure that the staff meetings take place at least 6 times per year. 31/12/06 8. YA34 19(1)(c) 31/12/06 9. YA36 18(2) 31/12/06 10. YA39 18(2) 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard YA11 YA35 YA40 YA42 Good Practice Recommendations It is recommended that service users be provided with more opportunities to learn about their own and each other’s cultures. It is recommended that staff be provided with more opportunities to undertake NVQ training, that is relevant to the needs of the service users. The registered person should review the homes policies and procedures in line with current legislation. It is recommended that the staff be provided with refresher training in infection control. DS0000010823.V316474.R01.S.doc Version 5.2 Page 26 Chelsea House Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Chelsea House DS0000010823.V316474.R01.S.doc Version 5.2 Page 27 - 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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