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Inspection on 14/07/05 for Cobham Road (60)

Also see our care home review for Cobham Road (60) for more information

This inspection was carried out on 14th July 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 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

The home has a good care planning process and care plans are simple and easy to follow. There is a communication board using pictures to enable service users to make choices about activities. The complaint procedure has been translated using a widget format to make it easy for some service users to understand. The home has a group of staff some of whom have worked at the home a long time. The inspector noted staff had positive relationships with service users who were happy, smiling and relaxed.

What has improved since the last inspection?

What the care home could do better:

Documentation and records at the home must be improved. Policies and procedures must be signed and dated by the manager to ensure they are monitored. Staff files must contain the appropriate recruitment documents including a statement of terms and conditions. The Statement of Purpose must be updated to ensure service users have accurate information on which to make decisions. The environment must be improved to safeguard the well being of staff and service users. The floor covering in the toilet, bathroom andkitchen must be replaced and all substances hazardous to health must be stored appropriately in a locked cupboard. The home must obtain an up to date copy of the Surrey Multi-Agency Procedures for the Protection of Vulnerable Adults to ensure staff have adequate and current information to protect service users from abuse.

CARE HOME ADULTS 18-65 60 Cobham Road Cobham Road Fetcham Surrey KT22 9SS Lead Inspector Mr Deavanand Ramdas Announced 14 July 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 60 Cobham Road Address 60 Cobham Road Fetcham Surrey KT22 9SS 01543 442500 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Milbury Care Services Ltd Mrs Rosalind Herty Mensah Dodd Care Home 6 Category(ies) of LD - Learning Disability (6) registration, with number of places 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 3. The age/age range of the persons to be accomodated will be : 30-60 YEARS OF AGE Date of last inspection 17.11.04 Brief Description of the Service: Cobham Road (60) is a care home for six service users with learning disabilities. The home has a vacancy for one service user. The property is located in a residential area in Fetcham, Surrey and is within walking distance of the town centre. Epsom, Guildford and Leatherhead shopping centres are nearby and can be accessed using public transport. The property has a private drive and parking is available. There is a well maintained garden to the back of the property that is private and secure. Accommodation is on two floors which can be accessed by stairs. There are six single bedrooms. The facilties on offer include an office, a large communal area, a dining room, a kitchen, bathing and washing facilties and a laundry. The registered provider is Milbury Care Services Limited and the Registered Manager is Rosalind Dodd. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection by one inspector carried out over 6 hours. Staff, visitors and service users were spoken to and documents and records were checked. The inspector would like to thank the manager, staff and service users for their contributions during the inspection. Comment cards, feedback forms and business cards were left at the home. Service users at the home had communication difficulties and it was difficult to obtain to feedback from them. What the service does well: What has improved since the last inspection? What they could do better: Documentation and records at the home must be improved. Policies and procedures must be signed and dated by the manager to ensure they are monitored. Staff files must contain the appropriate recruitment documents including a statement of terms and conditions. The Statement of Purpose must be updated to ensure service users have accurate information on which to make decisions. The environment must be improved to safeguard the well being of staff and service users. The floor covering in the toilet, bathroom and 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 6 kitchen must be replaced and all substances hazardous to health must be stored appropriately in a locked cupboard. The home must obtain an up to date copy of the Surrey Multi-Agency Procedures for the Protection of Vulnerable Adults to ensure staff have adequate and current information to protect service users from abuse. 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. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 The homes Statement of Purpose and Service User Guide are good providing service users and prospective service users with details of the services the home provides enabling an informed decision about admission to the home. The assessment process is adequate ensuring service users’ needs are assessed and identified. The home offers service agreements ensuring service users tenancy rights are protected. EVIDENCE: The home had a Statement of Purpose and Service User Guide. It contained information about the home and stated the aims and objectives, philosophy of care and services and facilities on offer. The information was clear and well presented. It was updated in 2005. The Service User Guide was written in plain English and some of the information for example the complaint procedure was in widget format (symbols and pictures) to make it easier for service users to understand. The home had an assessment tool to assess service users needs. It is called an Everyday Living Skills Assessment and covered areas such as communication, personal hygiene and social skills. The home had a policy on assessment and meeting of needs that was dated May 2004. Service users had contracts that were called service agreements. Samples of the service agreements were available in the home. The inspector noted the Statement of Purpose needed updating to reflect changes to the profile of the manager and also the telephone number of the commission must be added to the complaint section. This was discussed with the manager. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9,10 There is a clear care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users’ needs. The systems in place at the home ensure service users are supported to make decisions about their lives. The arrangements for risk assessments are adequate ensuring service users are supported in taking risks as part of an independent lifestyle. Information at the home is handled appropriately. However, improvements must be made to ensure sensitive and confidential information about service users is appropriately stored and secured. EVIDENCE: The home had Service User Plans. These were sampled and it contained a Profile, Religious Needs, Communication and Behaviour, Medication, Leisure, Personal Care, Social Contact, Mobility, Eating and Drinking, Birthdays and Outings. The care plans were written by key workers, signed and dated. Pictures were used in care plans to put activities in context for service users. One plan was signed and dated 22.4.05 and the review date was recorded as August 2005. There is a Home Skills Training programme to support service users to engage in domestic living. Service users are encouraged to make decisions about their lives. One service user who is autistic likes his bedroom to be organised in a certain way that is supported by staff. There is a 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 10 communication board in the dining room with the day of the week, a photo of service users and pictures of different activities that is used to encourage service users to make decisions. The home had risk assessments which were sampled. Risk assessments were dated and signed by the key worker and covered areas such the use of public transport, swimming and kitchen safety. The inspector noted four service users travelled by bus on the day of the inspection to the local town centre. Service users files containing sensitive and confidential information such as medical details were not securely stored. This was discussed with the manager. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 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 standard(s) 11,13,14,16. Links with the community are good and support and enrich service users’ personal development, social and leisure opportunities. Personal support in this home is offered in such a way as to respect service users’ rights. EVIDENCE: The home had a Home Skills Training programme and a communication board to enable service users to have opportunities to develop their social and communication skills. On the 16.6.05 it was recorded service users went to a local farm to pick strawberries and on the 26.6.05 they went to Richmond Park to watch the wildlife. The inspector noted the home had it’s own transport and service users had bus passes ensuring access to the community. One service user had an aromatherapy session at the home of the aromatherapist who lived in the vicinity of the care home. It was recorded service users went shopping for toiletries and one service user had a gym session at the local leisure centre. An afro-carribean service user went to Brixton in London to buy reggae music and plantains (fruit). During the inspection service users were engaged in activities in the home by Us in a Bus staff. They stated they visited the home weekly to provide leisure activities. The manager stated a music teacher visited the home to do music activity. It was recorded the service 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 12 users went on regular trips out for drives in the house car and for walks around Leatherhead Tennis Club. Staff respected the rights of service users. The inspector observed staff addressing service users by their preferred names. The manager knocked on service users bedroom doors before entering. Service users had unrestricted access to the home. The inspector noted one service user leaving the garden and returning to his bedroom that was cooler after mid-afternoon drinks. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 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 standard(s) 18,19. Personal support was offered in such a way as to maximise service users dignity and independence. The health needs of service users are well met with evidence of other health care professionals being involved on a regular basis. EVIDENCE: Staff supported service users appropriately. Service users had designated key workers that understood the needs of service users that were reflected in the care plans. During a meeting staff stated they discussed and reviewed care plans regularly. This was recorded in the minutes of the staff meetings held on the 4th June 2005. On the day of the inspection service users were appropriately dressed in shorts and sleeveless tee shirts because of the hot weather. Four service users went out to lunch in the local town using public transport and supported by staff. When they returned the inspector noted they were relaxed and smiling. The manager stated the recruitment of local staff was difficult and as a result the staff team did not reflect the ethnic background of service users. This area is under continuing review. Service users were registered with a local GP whose practice was within walking distance from the home. Other health care support was provided from Leatherhead Hospital. The inspector noted one service user saw the dentist on the 30.3.05, the dietician on the 13.4.05 and the chiropodist on the 9.6.05. The home had Health Action Plans that was completed and up to date and covered areas such as physical, mental and sexual health. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 14 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The complaint process in this home is satisfactory with complaints information available to service users. However the home must ensure it has up to date policies for the protection of service users. EVIDENCE: The home had a complaint policy that was kept in the Policies Folder in the office. For service users, the policy was in a widget format to make it easier to understand and was kept in the service user guides. The home kept a record of complaints. The inspector noted the last complaint was recorded on 13.6.03 and action was taken. The home had a whistle blowing policy that was issued in 2004. Information on whistle blowing was displayed on the staff notice board. The manager stated the company had a behaviour therapist that provided support to staff. She remarked no physical intervention had been used and that all staff were trained in Non Crisis Intervention. The inspector checked the operational folder and noted a policy on the use of physical restraint issued on 1.5.04. During a meeting staff stated they were aware of the complaint and whistle blowing policies that were discussed during their induction. The home did not have an up to date policy on the local authority (Surrey County Council) multi-agency procedures for the protection of vulnerable adults. The company procedures did not have a category for professional abuse. This was discussed with the manager. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The standard of environment within this home is good providing service users with an attractive and homely place to live. However, the floor coverings in some areas must be improved to make it nicer for service users and hazardous substances must be appropriately stored to maintain a safe environment for service users. EVIDENCE: On the day of the inspection it was noted that extensive work was being undertaken to the front of the property due to a water leak. The inspector noted appropriate action was taken by staff to maintain the safety of service users. The home was clean, ventilated and free from mal odour. The standard of décor was good throughout and furnishings, fittings and lighting were of good quality. The heating was not checked because it was a hot day. The manager stated the boiler was is in good working order. Bedrooms were well presented and personalised with family photographs, television, CD player, books, video, ornaments, pictures and paintings. Toilets and bathrooms were adequate, clean and hygienic. The dining room was nicely decorated and had a display cabinet, the communal lounge was spacious and comfortable with a television, CD player, a large mirror, paintings and adequate seating. The garden to the back of the property was private, secure and had a large patio 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 17 area with tables and chairs. The kitchen was spacious and well equipped with adequate storage space. The laundry had an industrial washer and dryer. The inspector noted the floor coverings in the toilet downstairs, the bathroom upstairs, and kitchen needed replacement. Hazardous substances were stored in a cupboard under the sink in the kitchen that was not locked. This was discussed with the manager. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,36 Staff have a good understanding of service users support needs. The arrangements at the home for staffing are satisfactory ensuring there is sufficient numbers of staff to adequately support service users. The standard of vetting and recruitment practices are satisfactory with appropriate checks being carried out to protect service users. However, full documents were not available in one file. The arrangement for supervision is adequate ensuring staff are well supported to carry out their job. EVIDENCE: The home has a training programme for staff to achieve the NVQ. Out of the three staff on duty on the day of the inspection, one had NVQ Level 3, one had NVQ Level 2 and the other had enrolled at Lambeth College to start NVQ training in September 05. The manager stated the company had NVQ training links with Thames Valley University and four staff were enrolled on the programme. On the day of the inspection the manager was on duty and three support workers. The rota was sampled for June 2005 and July 2005 and reflected adequate numbers of staff on duty, three in the morning, three in the afternoon, one waking night and one ‘sleep in’ for five service users. The home did not use agency staff and sickness levels were low. The inspector checked staff recruitment files and noted they had the appropriate documents such as application forms, references, photo identity, work permits, health declaration, police checks and job descriptions. The inspector noted one file did not have 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 19 terms and conditions of employment. This was discussed with the manager. Staff stated they had regular supervision. The manager supervised all permanent employees and the deputy supervised bank staff. The inspector sampled supervision records and noted they were up to date. One staff had supervision on the 23.5.05 and the record were signed and dated by the supervisee and the manager. The home had a policy on staff supervision. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40 The manager is supported well by staff in providing clear leadership throughout the home enabling service users to benefit from a well run home. The policies and procedures at the home are adequate ensuring service users’ rights and interests are protected. EVIDENCE: The manager has been in post for three years. She has NVQ level 4 and the Registered Manager Award. The manager is also an NVQ assessor. She stated she recently graduated with a management degree from Middlesex University. The manager is aware of her overall responsibilities and stated she had responsibilities for the budget. The inspector checked the budget and noted a budget statement with details of the annual budget and monthly breakdown of figures. The petty cash form for the period 10th July, 05 to 14 July 05 was audited and was correct. The manager stated she had monthly supervision with her line manager and felt well supported. The manager described her management style as being democratic and gets everyone involved in making decisions. During a meeting staff stated the manager was approachable and 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 21 supportive. Two activity co-ordinators from US in a BUS stated the manager was open, kept them informed of what was happening in the home and communication was good. The home had a range of policies and procedures that were regularly reviewed, amended and updated. The inspector noted policies and procedures were not signed and dated by the manager. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x 3 3 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 60 Cobham Road Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 3 x 2 x x x H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 23 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 13(3) Requirement The registered person must ensure the Statement of Purpose is updated to reflect changes to the profile of the manager and the telephone number of the Commission must be added to the complaint section. The registered person must ensure service user files that has sensitive and confidential information are stored securely and confidentially in the home. The registered person must ensure all COSHH substances in the home are suitably stored in a locked cupboard to ensure the health and safety of service users. The registered person must ensure all policies and procedures are signed and dated,monitored,reviewed and amended. The registered person must ensure that staff recruitment files contain a copy of the terms and conditions of the employment. The registered person must ensure the floor covering in the toilet, bathroom and kitchen is Timescale for action 01.08.05 2. YA41 17(1)(b) (a) 01.08.05 3. YA42 4(a)(c) 01.08.05 4. YA41 24(1)(a) (b) 01.09.05 5. YA34 19(4)(b) 01.09.05 6. YA42 4(a)(c) 01.11.05 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 24 replaced to prevent the spread of infection and ensure safe working practice. 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 YA40 Good Practice Recommendations The registered person shall obtain an up to date copy of the local authority (Surrey County Council) Multi-Agency Procedure for the Protection of Vulnerable Adults and that the Companys policy is updated to include the category of professional abuse. 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 60 Cobham Road H58_s13894_Cobham Road_v227621_140705_stage4.doc Version 1.30 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!