CARE HOME ADULTS 18-65
Colegrave Road, 77- 79 77-79 Colegrave Road Stratford London E15 1DZ Lead Inspector
Seka Graovac Key Unannounced Inspection 23th June 2006 11:15 Colegrave Road, 77- 79 DS0000058207.V298779.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 Colegrave Road, 77- 79 DS0000058207.V298779.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. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Colegrave Road, 77- 79 Address 77-79 Colegrave Road Stratford London E15 1DZ 0208 534 1101 0208 534 1153 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) Consensa Care Limited Post Vacant Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th December 2005 Brief Description of the Service: Colegrave Road (77-79) provides medium-term accommodation, support and care for 7 people with enduring mental health needs who have been discharged either from hospitals or secure units. The building is situated in a residential area in Stratford and has its own garden at the back. It is close to public transport and other local amenities. The home is owned and managed by Consensa Care Limited that also owns and manages some other mental health residential care services in Newham. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted approximately five hours. The inspector saw all six service users. Some of them were resting in their bedrooms, while the others went out for a meal and shopping at the time of the inspection. Therefore, the inspector did not have the opportunity to have in depth conversations with any of them. However, the inspector did have short chats with all of them. The inspector also spoke to two Directors of the company, one of whom is also the Registered Person and two staff members who were on duty at the time of the inspection. One of the Registered Managers from the other Company’s home was also present for the feedback about the inspector’s findings. The inspector viewed various records kept in the home, such as: service users’ individual files, daily records, minutes of the meetings, duty roster, etc. What the service does well:
The inspector viewed individual files for three service users. All of them contained evidence that comprehensive care and support needs assessments were carried out by the home’s senior staff before the placement was offered. The signed individual contracts were also available on the files. The activities were organised for service users on individual basis as that seemed to work the best for the service users, the inspector was told. They were encouraged to attend the local colleges and engage in the activities in the local community. Communal living, eating together and watching movies together was encouraged by the home. The service users were also supported to maintain and develop relationships with their families. On the day of the inspection, the staff member took service users out for a Chinese meal and then they went shopping to get food for the home. When they returned, the service users told the inspector that they enjoyed the experience. The kitchen was well organised and clean. Two service users had halal meat in accordance with their cultural background and wishes. The appropriate foodsafety related records were kept as well as menu records. There was a cookery group organised for service users. The service users also had their own fridge. They also helped staff with keeping the home clean and tidy and the specially
Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 6 designed rota for this purpose that included staff and service users was shown to the inspector. The atmosphere in the home was relaxed. The routines were flexible and allowed for personal preferences. However, the home was also trying to motivate service users to lead more active and independent lives. The service users looked well and were satisfied with the support provided. The inspector saw the Company’s policies and procedures for dealing with concerns, complaints and protection issues that were compliant with legislation and good practice. The related logs were kept and showed that no issues have been raised with the home since the previous inspection. The service users told the inspector that they did not have any concerns about the service and were generally satisfied. The Registered Person stated that out of eleven, seven staff (64 ) had National Vocational Qualification in Health and Care. What has improved since the last inspection?
The inspector identified a significant improvement in the home’s compliance with legislation. The staff team consisted of eleven rehabilitation associates. The Registered Person stated that this title was chosen by the staff themselves as they felt that it was describing what they do and the aim of it (full rehabilitation) in the best way. The inspector was shown a copy of the job-description. The Company has also developed a Staff Handbook. The duty roster was displayed in the office and was correct at the time of the inspection. Recruitment has become thorough and all required records that the inspector asked to see were available. Evidence of identity checks, references from the previous employment and Criminal Records Bureau disclosures were available (faxed through from the Head Office) for the inspection. The inspector was also shown a copy of the Company’s Human Resources Workforce Strategy that included a training and development plan for the home showing significant budget being allocated for this purpose in the current financial year. The inspector was told that all the staff had training in protection of Vulnerable Adults, Dealing with Challenging Behaviour, Health Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 7 and Safety and Medication. The Registered Person delivered specialist in-house training on Mental Health. Many issues related to environment have been resolved as the home underwent a significant building work. Since the previous inspection, two homes next-door to each other that previously had separate registration have merged into one. Apart from creating an extra bedroom, a bigger lounge and a separate smoking lounge were made available to service users. New flooring was put in all the communal areas and some bedrooms. Another toilet with a shower and separate laundry facilities were also made available downstairs for service users and staff. The home was clean and tidy when the inspector visited. The service users were comfortable in it. The inspector was shown the Company’s Business Plan that indicated expansion of the service provision in the coming years. What they could do better:
Three requirements were restated. The Registered Persons must ensure that the individual care plans are written in consultation with the service users and that this process could be demonstrated. The care plans must be comprehensive, include all the details regarding medication, be dated and signed. Staff must enable service users to take responsible risks within the context of the individual plans and of the home’s risk assessment and risk management strategies. All staff must understand the risk assessment process used by the home and have full working knowledge of the documentation produced. The home must have a permanent Manager who is registered with the Commission for Social Care Inspection. The Commission was informed that a manager for the home was appointed and would take the post from 01st of July. Further four requirements were made, totalling seven requirements. The inspector was told that no individual supervision meetings have been held in this calendar year. This was due to the home’s Manager being on sick leave before resigning from her post. The staff must receive regular one-to-one supervision. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 8 Three requirements were made regarding fire-safety awareness and required checks. Since the merger of the homes, a new fire-safety alarm system has been installed. The inspector was concerned that the staff on duty did not know how the system worked and how it could be tested. The plan that identified different zones was not available. The tests were not done on a regular basis and no fire-drills have been done since the installation of the system. The inspector discussed her concerns with the Directors of Consensa Care who promised a swift action to ensure fire safety in the home. The Registered Person(s) must ensure that all the staff receive fire-safety training that is appropriate for the home. They must know how the system operates and where the zones are. The fire-alarm tests must be conducted on a weekly basis. The fire-drills must be conducted at least twice a year. 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. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 9 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 Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 10 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): 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Prospective service users’ individual care and support needs were assessed prior to their placements and contracts being agreed. EVIDENCE: The inspector viewed individual files for three service users. All of them contained evidence that comprehensive care and support needs assessments were carried out by the home’s senior staff before the placement was offered. The signed individual contracts were also available on the files. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 11 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 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Each service user had an individual care plan and risk assessments. However, further improvements were needed in this area. EVIDENCE: All examined files contained copies of individual care plans. Some of them were of high quality, but the inspector also identified that more details were needed in respect of one person’s medication related care plan. Majority of care plans were not signed by anybody, thus questioning the extent of service users’ involvement or if the service users were in agreement with it. Some of the care plans were not dated, either. This issue was raised at the inspection in December 2006. The related requirement was restated. The Registered Persons must ensure that care plans are written in consultation with the service users and that this process could be demonstrated. The care plans must be comprehensive, include all the details regarding medication, be dated and signed.
Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 12 Comprehensive risk assessments were available for each service user. However, the staff on duty could not explain the elements that were used to assess the risks and the abbreviations used on the form. All staff must understand the risk assessment process used by the home and must have the full working knowledge of the documentation produced. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 13 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, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users were supported to live fulfilling lifestyles and enjoy their food. EVIDENCE: The activities were organised for service users on individual basis as that seemed to work the best for the service users, the inspector was told. They were encouraged to attend the local colleges, and engage in the activities in the local community. Communal living, eating together and watching movies together was encouraged by the home. The service users were also supported to maintain and develop relationships with their families. The Registered Person was sensitive to potential financial protection issues in case of one service user’s relationship with her mother and a close male friend. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 14 On the day of the inspection, the staff member took service users out for a Chinese meal and then they went shopping to get food for the home. When they returned the service users told the inspector that they enjoyed the experience. The kitchen was well organised and clean. Two service users had halal meat in accordance with their cultural background and wishes. The appropriate foodsafety related records were kept as well as menu records. There was a cookery group organised for service users. The service users also had their own fridge. They also helped staff with keeping the home clean and tidy and the specially designed rota for this purpose that included staff and service users was shown to the inspector. The atmosphere in the home was relaxed. The routines were flexible and allowed for personal preferences. Three service users were still in bed when the inspector arrived midmorning. However, the home was also trying to motivate service users to lead more active and independent lives. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 15 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, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users received personal and healthcare support in accordance with their needs and choice. EVIDENCE: The individual care plans specified the assistance and encouragement that the service users needed in relation to their personal care, emotional and physical health. Further correspondence with the health and social care professionals were available in the service users’ files indicating a good working relationship between the home and the other services. The service users looked well and were satisfied with the support provided. The inspector checked the medication held in the home and the related records and found no discrepancies. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home had the appropriate procedures for dealing with concerns, complaints and protection. EVIDENCE: The inspector saw the company’s policies and procedures for dealing with concerns, complaints and protection issues that were compliant with legislation and good practice. The related logs were kept and showed that no issues have been raised since the previous inspection. The service users told the inspector that they did not have any concerns about the service and were generally satisfied. Colegrave Road, 77- 79 DS0000058207.V298779.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The environment was clean and fit for its purpose. EVIDENCE: Since the previous inspection, two homes next-door to each other that previously had separate registration have merged into one. This involved significant building work. Apart from creating an extra bedroom, a bigger lounge and a separate smoking lounge were made available to service users. New flooring was put in all the communal areas and some bedrooms. Another toilet with a shower and separate laundry facilities were also made available downstairs for service users and staff. The home was clean and tidy when the inspector visited. The service users were comfortable in it. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staff had clear roles and responsibilities, were well recruited, competent and trained. However, there were not adequately supervised. EVIDENCE: The staff team consisted of eleven rehabilitation associates. The Registered Person stated that this title was chosen by the staff themselves as they felt that it was describing what they do and the aim of it (full rehabilitation) in the best way. The inspector was shown a copy of the job-description. The company has also developed a Staff Handbook. The duty roster was displayed in the office and was correct at the time of the inspection. The Registered Person stated that seven staff (64 ) had National Vocational Qualification in Health and Care. The inspector was also shown a copy of the company’s Human Resources Workforce Strategy that included a training and development plan for the home showing significant budget being allocated for this purpose in the current financial year. The inspector was told that all the staff had training in protection of Vulnerable Adults, Dealing with Challenging
Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 19 Behaviour, Health and Safety and Medication. The registered Person delivered specialist in-house training on Mental Health. The staff records that the inspector requested to see indicated that the home’s recruitment process was thorough and the staff were appropriately vetted before being offered the jobs. Evidence of identity checks, references from the previous employment and Criminal Records Bureau disclosures were available (faxed through from the Head Office) for the inspection. The inspector was told that no individual supervision meetings have been held in this calendar year. This was due to the home’s manager being on sick leave before resigning from her post. The Registered Person(s) must ensure that staff have regular, recorded oneto-one meetings at least six times a year. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 and 43. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The home must have a Manager who is registered with the Commission and implement the appropriate fire safety procedures. EVIDENCE: The Commission has been informed that the Manager who the inspector met at the previous inspection resigned from her post before becoming registered. The previous two Managers did the same. The home hasn’t had a Registered Manager for quite sometime. At the time of the inspection, the Registered Manager for another home from the same Company was overseeing the service. No management staff was employed for this particular home at the time of the inspection. The Commission has been told that a Consensa Care employee has been appointed as the manager for 77-79 Colegrave Road and would be taking her post from 01st of July 2006. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 21 The Registered Person must ensure that the home has a permanent manager who is registered with the Commission for Social Care Inspection. The previous target expired on 28/02/06. The other previous on 30/06/05. The last service users’ satisfaction survey was carried out in August 2005 and the report was available. The Registered Person has been closely involved in running of the home and the reports of the monthly monitoring visits were available for inspection. Service users’ and staff meetings were regularly held. Since the merger of the homes, a new fire-safety alarm system has been installed. The inspector was concerned that the staff on duty did not know how the system worked and how it could be tested. The plan that identified different zones was not available. The tests were not done on a regular basis and no fire-drills have been done since the installation of the system. The inspector discussed her concerns with the Directors of Consensa Care who promised a swift action to ensure fire safety in the home. The Registered Person(s) must ensure that all the staff receive fire-safety training that is appropriate for the home. They must know how the system operates and where the zones are. The fire-alarm tests must be conducted on a weekly basis. The fire-drills must be conducted at least twice a year. The inspector was shown the Company’s Business Plan that indicated expansion of the service provision in the coming years. Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 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 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 1 3 Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes (three) 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 Persons must ensure that care plans are written in consultation with the service users and that this process could be demonstrated. The care plans must be comprehensive, include all the details regarding medication, be dated and signed. The previous target expired on 31/01/06. The Registered Persons must ensure that staff enables service users to take responsible risks within the context of the individual plans and of the home’s risk assessment and risk management strategies. All staff must understand the risk assessment process used by the home and have working knowledge of the documentation produced. The previous target expired on 31/01/06. The Registered Person(s) must ensure that staff have regular, recorded one-to-one meetings at least six times a year. The target date is set for at least one
DS0000058207.V298779.R01.S.doc Timescale for action 30/09/06 2. YA9 12 30/09/06 3. YA36 18 31/08/06 Colegrave Road, 77- 79 Version 5.2 Page 24 4. YA37 9 5. YA42 23 6. 7. YA42 YA42 23 23 supervision session this year for the each staff member. The Registered Person must ensure that the home has a permanent manager who is registered with the Commission for Social Care Inspection. The previous target expired on 28/02/06. The other previous on 30/06/05. The Registered Person(s) must ensure that all the staff receive fire-safety training that is appropriate for the home. They must know how the system operates and where the zones are. The Registered Person(s) must ensure that fire-alarm tests are conducted on a weekly basis. The Registered Person(s) must ensure that fire-drills are conducted at least twice a year. 30/09/06 30/06/06 26/06/06 31/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Colegrave Road, 77- 79 DS0000058207.V298779.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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