Inspection on 05/01/06 for Cherry Tree House

This inspection was carried out on 5th January 2006.

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

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

Other inspections for this house

Cherry Tree House 23/04/07

Cherry Tree House 09/09/05

Cherry Tree House 16/12/04

Cherry Tree House 16/04/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Ashwood House (Leyton)

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

CARE HOME ADULTS 18-65 Hainault Road (49) 49 Hainault Road Romford Essex RM5 3AA Lead Inspector Mr Roger Farrell Unannounced Inspection 5th January 2006 11:15a Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hainault Road (49) Address 49 Hainault Road Romford Essex RM5 3AA 01708 735387 01708 735387 rita@outlookcare.org.uk 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) Outlook Care Mrs Rita Evelyn Hall Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th September 2005 Brief Description of the Service: 49 Hainault Road is a registered care home that provides accommodation and support for up to five people. Opened in 1991, it is run by Outlook Care Limited, a not for profit organisation that operate a range of accommodation and support services for vulnerable adults in North East London and Essex. Following a merger, there is another Outlook Care home in a ‘Hainault Road’ elsewhere. It has therefore been decided to rename this house, the residents having chosen ‘Cherry Tree House’. Residents who live at this care home have experienced mental health difficulties in the past. Four of the residents are over sixty. Staff are on hand to help them with their day-to-day living needs. A fifth resident joined this established household group in May 2005, one person having moved out last year. The original funding was a block contract operated by Barking, Havering and Brentwood Health Care Trust as part of the closure of old style long-stay wards. Outlook Care took over the running of the home from the Trust six years ago. The house is a detached property on a corner plot just beside the busy A12 duel carriageway. The building is owned and maintained by North East Thames Housing Trust. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 5 January 2006, between 11.15am and 1.30pm. The manager, Rita Hall was involved in a meeting until 12.30pm. This allowed the inspector the opportunity to meet with three residents in the main lounge, to speak separately with the most recent resident – and for these four residents to show him their bedrooms. The deputy was on duty, and was helpful in assisting with some checks, such as explaining the medication arrangements. Later, the manager was able to give an overview of how the home has been running, including how the needs of residents who are growing older are being monitored. The last inspection was on four months earlier. At that time all the main standards were checked, and were all satisfactory, therefore no ‘requirements’ were set. A copy of the September report is available at the home, or can be found on the internet at www.csci.org.uk. It was not necessary to set any requirements at this recent visit. The inspector would again like to thank the residents for the warm welcome he receives. And for the efficient way the manager deals with his enquiries. What the service does well: The home is an end of terrace property in a residential area, close to local shops and amenities, and has good transport links. The house is well maintained and decorated, with many homely touches. East Thames Housing Trust own the house, and are responsible for building maintenance. The manager says she is satisfied with the level of support provided by the landlords. The top ‘commendable’ rating is again awarded for the high housekeeping standards. This is a well-established household group. Two of the original residents moved here in 1991 when the home opened. Another joined the group in 1996, and the fourth person arrived in 1999. The fifth person moved in last May. The documentation covering his assessment and move-in arrangements were thorough. The way in which this service user’s file had been set-up resulted in the ‘commendable’ score being awarded at the last inspection for support plans. Such achievement shows a continuation of the team’s ability to target help where needed - through understanding individual’s abilities and offering assistance only where this is essential. One comment from a staff member summed up this approach - “The overall quality of care provided to residents is excellent. It allows them to maintain an independent lifestyle but with lots of care and encouragement on hand when needed.” One relative wrote –“I am very happy with the home. [My relative] has been well looked after. Lovely staff, very caring. I am happy with the home.” Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Good information is available about this home. Outlook Care have a good set of guidelines and assessment forms covering move-ins. These were used during the introduction of the new resident, showing a thorough approach to assessment and planning. EVIDENCE: There is a detailed and attractively presented ‘statement of purpose’. This is in a format that is understandable to service users, including the using pictures. Of an equally high standard is the ‘service users’ guide’, that also makes good use of pictures. They cover all areas asked for under these standards, including a section on service users’ views. Copies of these and other main documents are available in the hall, along with a pictorial version of the complaints’ procedure. Both the service users’ notice board and the one for staff have on display an appropriate range of up-to-date information. At the last visit the manager gave a description of the planning, introduction and move in of the new resident, including consideration of the age difference of this person compared to the four established residents. The inspector looked at the paperwork covering the move in. This showed that the organisation’s policy, ‘Referral Procedure – Residential Care’, was followed. The service user’s file contained the required range of information. This included – a good referral report from the social worker; the organisation’s referral form; the manager’s detailed assessment and checklist; planning and progress reports Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 9 covering the introductory visits and stays, and the early period following moving in. The standard format ‘health file’ and ‘pcp file’ had been set up, and this had a copy of the recent CPA review. Good links had been established with staff at the resource centres the resident attends during the week. Good attention to detail evident in this documentation, including picking up on an error in the main social work report, shows a very high standard of practice and manager coordination. At this recent visit this resident confirmed his satisfaction with the move-in and how he has adapted to this setting. Residents’ files have signed copies of the contracts issued by Havering Housing Consortium to the original tenants; the more recent version of the Licensee Agreement provided by East Thames Housing Association; and letters from Outlook Care on rent adjustments. There is also a pictorial licencee agreement. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10. Outlook Cares’ service user file format was mainly developed to cover services for people with a learning difficulty. Previous reports have praised the way that this home has developed a care plan and monitoring system appropriate to the needs of people who have had mental health needs. This system continues to be used effectively, including monitoring needs such as decreasing mobility. EVIDENCE: The manager and team continue to operate a very high standard of care planning and monitoring files. In addition to Outlook Care’s main ‘pcp’ format, there are well-arranged ‘health care files’. The ‘pcp files’ continue to be used as the main method of including residents in making choices. Additionally, the ‘health files’ have a more detailed practice planning system with relevant observations and monitoring suited to this service user group, including needs associated with getting older. They are efficiently arranged into modules, are kept up-to-date, and entries are well expressed. That the new resident’s file had such a comprehensive range of worthwhile information, including liaison with others, meant that the top ‘commendable’ score was awarded at the last visit for Standard 6. He, and the deputy who is his ‘keyworker’, described how independence and self-care skills are being encouraged. At this visit he was being guided with keeping his room clean, and went off to collect his own medication supply. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 16 and 17. Residents continue to be supported to be involved in activities and social networks appropriate to their age, abilities and preferences. EVIDENCE: Some residents have been involved in supported employment in the past, but a number now consider themselves retired. There is a good tradition of all residents helping with household tasks. Residents do their own laundry with some minimal assistance. They help with meal preparation and prepare their own snacks. All use keys to the front door and their bedrooms. Each person’s file has details of regular social and leisure activities. As appropriate, options to be involved in groups for older persons have been offered and arranged. Four service users described to the inspector how they spend their time during the week, and social events they attend. One person talked about her involvement in a theatre troupe, another commenting on how good these shows are performed by this ‘Real Life’ group. Three residents who had been on the group holiday to Lowestoft said how much they had again enjoyed their Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 12 summer break. One person commented – “We still do go out as a group, but now it is more ‘one-to-one with a staff member.” All comments made about the standard meals by the four residents at home were again favourable. Two residents explained how they assist with the main weekly supermarket trip. One person said – “Yes the meals are very nice, they’re alright. We all help choose. If it is not what you like, you can have other suggestions.” Another person commented – “We go in and out of the kitchen as we like and do our drinks or snacks or have cake. When we go shopping we do look around the stalls in Romford Market before getting most things from Sainsbury’s.” Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19. This home is able to show it supports individual needs in an appropriate manner. This continues to be delivered in a way that maintains personal independence. The systems for monitoring physical health remain very good. Satisfactory arrangements were found covering safety with medication. EVIDENCE: At this visit the inspector was given an update on the person with the highest physical dependency needs, including the use of a walking aid that has been monitored by an occupational therapist. He was shown the aids that have been fitted in the bedroom, and how the ‘walk-in’ shower is still appropriate for use by this person. The ‘health files’ are still being maintained to a high standard, showing good health care monitoring and a sensitive approach to supporting residents with their personal care needs. Success is also being achieved in helping the most recent resident get dental care. At a visit last year one relative commented – “My [relative’s] mental and physical well being has improved no end. The house and carers are what all homes should be like. The staff are very good at their jobs.“ The home uses the Boots’ monitored dose system. Medication is kept in a locked bureau in the dining area, and separated in boxes for each person. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 14 Residents are encouraged to take their own medication under supervision, though there is a need for two staff to be involved in giving one person their liquid medication. Residents have their own signing sheets, as well as staff signing the mar charts. At this visit the inspector observed residents taking their mid-day medication, overseen by a staff member. All arrangements checked were satisfactory, including the files that contain guidance on the main types of drugs being used. There is a medication hand-over sheet. Where appropriate, the date had been written on when a package was opened. The supplying pharmacist had last done a check in July 2005, with an internal audit carried out on 24 October 2005. All staff have done the more detailed ‘Safe Handling of Medication’ course, and there were copies of their annual reappraisals. The staff member supervising medication was able to give correct answers regarding purpose of types of drugs. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The necessary range of information on complaints and concerns are readily available. The manager and staff are fully aware of the steps that must be covered if they suspect or are made aware of a problem affecting a service user’s wellbeing. EVIDENCE: The home has a copy of Outlook Care’s complaint pack. This includes identifying a complaint’s contact person; a complaints flow chart; a large print version of ‘How to Make a Complaint’; and a complaint contact card. There was also a laminated picture complaints guide in the hall, along with a supply of the complaint forms. Information on the Commission is included. Last year a relative wrote – “I’ve only ever had one complaint and that was years ago, relating to only one member of staff. The staff always tell me about inspections. The care and commitment of staff is very good.” Copies of ‘No Secrets’, and the organisation’s relevant policies on adult protection are available, including on whistle-blowing, and Havering Council’s local guidelines on adult protection. There was also a copy of the General Social Care Council’s Code of Practice, extracts of which the manager has on display in the office. Staff have confirmed that they had been briefed on the role of the GSCC, and all staff have signed to say they have been issued with a copy of the Code of Practice. In his last meeting with staff they gave satisfactory answers on protection issues. Details of how to contact advocacy services are on display. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. This house is well suited to the needs of residents, including the person who has now developed some problems moving around. Residents and staff take pride in maintaining the house in an excellent standard, and one residents efforts means that this also includes the garden. EVIDENCE: The house is on a corner plot adjacent to a dual carriageway, but this does not seem to adversely affect the residents’ use of the garden, which is well screened and delightfully maintained by one of the residents. The main shared area of the house is the combined ‘L-shaped’ lounge and diner. This is well decorated, has good home entertainment equipment, and is comfortably furnished. All residents have their own bedrooms that reflect their individual tastes. The house is well served for bathrooms, with two upstairs, and a spacious showerroom on the ground floor with a walk-in shower. There is a separate toilet on the ground floor. All were found to be clean, with fresh towels and soap, and have suitable locks. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 17 One resident has now uses a walking frame, an occupational therapist having carried out an assessment at the house. This person’s bedroom is on the ground floor. She uses the walk-in shower, which has a seat. Other than a grab rail and a shower seat, no other environmental adaptations are currently needed. There is an assistance call system that is turned on for one resident, but has not been used. An excellent standard of cleanliness was again found in all parts of the home. In addition to residents helping with some household tasks, there is also a part-time cleaner. An independent infection control and hygiene assessment carried out last year awarded a 100 score. In recognition of this, and the consistently high standard found at successive visits, the household standard is again rated at the ‘commendable’ level. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 36. This home has a stable, experiences and well-qualified staff team. EVIDENCE: The normal pattern of cover is two people on both the early and late shifts, excluding the manager. Night cover is one person on sleep-in duty. Staff on duty at this visit corresponded with the planned rota. The manager says this level of cover is adequate to meet the needs of residents. The staff team is very stable, with most support workers having over five years experience in this setting. There have been no changes in the team for two years, the current deputy being the last person to join in February 2004. All the team have NVQ at Level 3. Outlook Care cover gaps by using staff from their other homes doing monitored extra hours through agency bookings. The inspector checked a sample of staff files at a previous visit. These had copies of all the required documents, including separate file of CRB certificates. There is a regular programme of individual supervision, with a forward planning programme on display. When the inspector arrived, the manager was doing an annual appraisal with a support worker. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40 and 41. The inspector continues to find this to be a very well managed service. Outlook Care have a systematic approach to operating their services by having up-todate policies, procedures and accountability checks. This home’s manager works well within this structure, notably as most local services are for adults who have a learning disability rather than a former mental health needs. She again was found to be competent and methodical in responding to the updates asked for at this inspection. EVIDENCE: The manager has achieved the ‘registered managers award’, having already gained NVQ in Care at Level 4. All documentation requested at this inspection was presented in an efficient manner. The organisation’s standardised policy and procedures files are available, listing when each was last revised. The inspector was shown an initial sample of policies that have recently been done in an ‘Easy Read’ style as a further step in achieving service user involvement. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 20 The company operate a quality assurance scheme – called the ’Continuous Improvement Programme’ (CIP). The manager is familiar with the guidance booklet that steers this imitative. All staff have been given a copy; have attended briefings; and “signed up” to the scheme. This has been tied in with the company’s intranet computer system, including ensuring staff are familiar with all current policies, guidelines, and practice forms. Other quality assurance schemes that can be evidenced include ‘ISO9002’; ‘Investors in People’; ‘Positive About Disabled People’; and reports to confirm regular monthly service audits in compliance with Regulation 26 of the “Care Standards Act 2000”. The evidence is sufficient to confirm the company’s commitment to quality assurance and control systems required under this heading. At the last visit the inspector asked to see a range of documentation and certificates covering health and safety. This included fire safety arrangements; electrical, gas and water safety checks; EHO inspections; and insurance cover. The ordered and efficient manner in which the manager presented evidence under this heading justified the award of the highest ‘commendable’ rating. Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 21 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 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 4 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTH3CARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 X 3 3 X X Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Refer to Standard Good Practice Recommendations Hainault Road (49) DS0000027854.V277131.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. 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