Inspection on 01/11/05 for Colham Road, 3

This inspection was carried out on 1st November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Colham Road, 3 15/08/07

Colham Road, 3 12/10/06

Colham Road, 3 06/04/06

Colham Road, 3 16/05/05

Colham Road, 3 21/10/04

Colham Road, 3 10/06/04

Colham Road, 3 19/01/04

Colham Road, 3 10/12/02

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 3, Colham Road Hillingdon Middlesex UB8 3UR Lead Inspector Robert Bond Unannounced 1st and 2nd November 2005 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. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 3 Colham Road Address Hillingdon, Middlesex UB8 3UR 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) 01895 271 245 01895 236 588 ringlis3@hillingdon.gov.uk London Borough of Hillingdon Care Home 13 Category(ies) of Learning Disability (12), Dementia (1) registration, with number of places 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2005 Brief Description of the Service: 3 Colham Road is managed by the London Borough of Hillingdon and owned by the Health Authority. It provides residential care for ten permanent and three respite care residents. The residents have profound multiple learning, sensory and physical disabilities. All are non-verbal and two require PEG (pecutaneous endoscopic gastronomy) feeding. The home was purpose built in 1987 and is set on one floor, divided into four units: North, South, East and West Lodges. Each lodge is designed for four Service Users and leads out to an attractive central courtyard laid out with paved sitting areas and fringed with shrubs and trees. Each lodge is self – contained with a lounge, kitchen/diner, bathroom with toilet facilities and single bedrooms for each resident. All the bedrooms are attractively decorated with individual colour schemes and furnishings. The home is clean and bright and well maintained. Seven of the bedrooms do not meet the National Minimum Standard of 12 square meters for residents needing to use a wheelchair within their bedroom. All except one service user attends day centres for which London Borough of Hillingdon provide a special minibus. Residents attend medical appointments and use the home’s specially adapted transport for this. The home is set in it’s own large grounds near Hillingdon Hospital and is about three miles from central Uxbridge. The home has ample parking facilities and is easily accessed by public transport, having a bus stand just outside the gate. All 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector visited initially on 1st November 2005. This was a scheduled unannounced inspection that coincided with concerns about the provision of care and the high use of agency staff within the home that the Inspector had received the day before from a parent of a service user. As the manager of the home was away on a training day, the Inspector made arrangements to call back the following day to complete his inspection. The first inspection took place over a one hour period and included meeting with a senior residential worker, touring the home, talking to two staff, two service users, a second parent, observing the standard of care that was being provided and checking records of medication. The second inspection took place over three hours and involved talking to the manager and staff, and examining records. In particular the circumstances surrounding the concerns raised by the first parent with the inspector were discussed in detail. This parent is believed to be making a complaint using the London Borough of Hillingdon’s complaints procedure. A check of compliance with the requirements of the previous CSCI inspection report are usually undertaken during an inspection visit. In this case however, the Inspector undertook an ‘additional visit’ inspection on 17th August 2005 at which time the home’s action plan to deal with the Inspector’s previous requirements, was checked. It was found that most requirements had been met, and the others were being dealt with. No additional requirements or recommendations were made at that visit. At the time of this inspection, the senior residential worker reported that there were 8 permanent service users in the home and one of the three respite beds was in use. The Manager reported that the home had 10 whole time equivalent care staff vacancies, but that six appointments had recently been made pending clearance for the appointees to start. All vacancies are covered by the use of agency staff from one agency. The manager has only recently been appointed, has not yet been registered by the CSCI, and is on a one year contract, his substantive post being at another home operated by the London Borough of Hillingdon. The Inspector assessed the home against 12 of the key standards identified in the Department of Health’s National Minimum Standards (NMS). The Inspector made judgements on what extent outcomes for each standard had been met, and concluded that 2 outcomes had been fully met, 7 had been partly or almost met, and 3 had not been met. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 6 The Inspector made 15 requirements, 2 of which are carried over from the last inspection having not been achieved within the timescale set. The Inspector also made 6 recommendations, 3 of which are restated from last time. What the service does well: What has improved since the last inspection? Many of the Inspector’s requirements but none of his recommendations from his last inspection have been complied with. In particular, the home’s insurance policy and placement agreements have been revised, better assessments are undertaken prior to respite service users moving in, staff have been trained in PEG feeding and the recording thereof, a new manager has been recruited, and plans are being developed to refurbish the home so that the building will meet the NMS for physically disabled service users. The Manager identified improvements he had already introduced at the home. He reported that he was declining to have certain agency staff working at the home any more, requesting the agency that provides staff to properly supervise them and review their capabilities and learning needs, reporting his concerns about the agency and some of the staff they provide to his management team, and sharing information amongst the management team so that agency staff he turns down are not able to immediately obtain work at another London Borough of Hillingdon home. The Inspector commends his actions. Other improvements introduced by the manager include, revising the shift times of the senior staff rota so that a face to face handover is now possible, and redesigning the main staff rota so that it is easier to understand at a glance. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 7 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. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 8 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 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 9 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) 2 and 5 The outcome for Standard 2 is fully met. The outcome for Standard 5 is partly met EVIDENCE: NMS2: At the additional visit undertaken on 17th August 2005, the inspector was shown an assessment that had been undertaken on a new potential respite care service user. NMS5:There is an issue raised below at NMS 41 concerning what appropriate additional expenditure may be charged to service users. The current Adult Placement Agreement does not appear to cover this aspect. See Requirement 14. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 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 standard(s) 6 The outcome is not met for the reasons stated below. EVIDENCE: The Inspector examined a care file chosen at random. The file was well presented and contained a front index. Essential information on the service user, and his assessed needs were clearly identified. However the file contained a summary sheet designed to show at a glance when the next risk assessment was due, and the next service user care plan review was due, etc. The use of such a summary sheet is admirable but in this case, the information was four years out of date, and yet the two link workers had signed it this year as if it was current. Staff must be trained to only sign documents that are correct and current. The manager assured the Inspector that risk assessments and revised care plans had been undertaken more recently than the summary sheet indicated but they did not appear to have been done recently. See Requirements 1, 2 and 3, and Recommendations 4 and 5. The manager reported that two staff had been trained in Person centred planning techniques but that as action had not yet taken place to create such plans at Colham Road, he was going to discuss it at the next staff meeting. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 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) 12, 14 and 17 The outcomes for Standards 12, 14 and 17 is only partly met for the reasons stated below. EVIDENCE: NMS12 and NMS14: The manager reported that one of the service users who requires PEG feeding is now able to attend a day centre again, but the second one is not yet. See Requirement 15. NMS17:The manager reported that in his view the food that is served at the home is of a high standard and he has recently increased the food budget so that remains the case. The Inspector did not observe a meal being eaten but he did see good quality foodstuffs in a refrigerator. However, one aspect of the complaint that a parent had brought to the attention of the Inspector was that a service user was served his breakfast as late as 10.30 am and that the porridge served was cold. The manager reported that a cooked breakfast is not served on Sundays as a cooked lunch is served that day. The Inspector considers that to be as it should be. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 12 The manager reported that the service user had been assisted to get up late that Sunday because one of the agency care staff responsible for his care had arrived to work 45 minutes late, and it was appropriate to assist the other two service users in that Lodge before the service user in question. As reported elsewhere, the manager is dealing with agency staff difficulties. But there is no good reason why the porridge was served cold as it could have been remade hot, or heated up. See Requirement 4. Service users receive their dinner at 5.30 to 6 o’clock each evening, and have a milky drink before they go to bed around 8 pm. The gap between dinner and breakfast is potentially too long, if service users cannot be assisted to rise at the normal time. The manager has agreed therefore to make sure that as a matter of course service users are offered a snack before they go to bed, and a hot drink in bed in the morning if there is going to be a delay in assisting them to get up for breakfast. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 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) 20 The outcome for Standard 20 was fully met. EVIDENCE: The Inspector observed medication being handed to a relative to later be given to a service user who was being taken out for the day. The transaction was appropriately recorded. A check of the medication records in that ‘lodge’ did not disclose any errors in recording. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The outcomes for both Standards are partly met for the reasons stated below. EVIDENCE: NMS22: The manager has devised a complaints information sheet for the benefit of relatives, and he has designed a system for recording complaints within the home. Both are good ideas, in need of minor adjustments only in order to meet the requirement of the NMS. See Requirement 5. NMS23: The home now has a copy of The London Borough of Hillingdon’s ‘Safeguarding Adults’ procedure. The manager thought that all staff had been trained in its application but as examination of the training records of staff did not bear this out. See Requirements 6 and 7. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The outcome for Standard 24 is not met for the reasons stated below EVIDENCE: As reported in the last inspection report, all the current service users have physical disabilities and yet the home is not registered for this category. Some changes will have to be made as five existing bedrooms are too small for safe work with wheelchair users. See Requirement 8, which is restated from last time. The manager reported that The London Borough of Hillingdon are addressing the issue by drawing up plans to refurbish the home. The Inspector hopes that the plans will include refurbishing the kitchenettes which do not at present contain dishwashers. See Recommendation 1. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 16 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) 33 The outcome for Standard 33 is not met for the reasons stated below EVIDENCE: The last inspection, and the complainant who spoke to the Inspector, both indicated that the home was operating on substantial numbers of agency staff, some of whom were not providing a satisfactory level of service. The manager is well aware of the difficulties and has already taken steps to improve the calibre of agency staff who are accepted. Continued vigilance is necessary so that unsuitable agency staff are not able to continue working in care homes. See Requirement 10. Since the last inspection, a recruitment drive has taken place, and 6 of the 10 whole time equivalent care worker posts that are currently vacant have been offered to applicants. However the interviews were in July 2005 and it is now November. None of the applicants have been able to commence employment as their CRB disclosure checks have not come back. The government has introduced a system called POVA First to deal with such situations, but the manager was not aware of it. He has agreed to speak to the London Borough of Hillingdon’s Human Resources Department to discover why POVA First does not appear to be being used in this instance. See Requirement 9 and Recommendation 2. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 17 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) 42 The outcome for Standard 42 is not fully met for the reasons stated below. EVIDENCE: NMS41:The Inspector examined at random the records of expenditure by a service user from his personal allowance. The records were well kept and demonstrated that some of his money had been spent on a contribution towards the cost of the home’s bus, toiletries, a specialised item of bedding, and a sling for a hoist. The Inspector queried the practice of charging all these items to service users and was told this was normal policy at the home. In particular, regarding the specialised bedding and the sling, the Inspector was told the cost of equipment that was only going to be used by one service user was normally charged to that service user. The Inspector was told by the manager that the London Borough of Hillingdon did not have a written policy to guide staff in care homes on what was appropriate expenditure that could be legimately charged to service users’ personal allowances. Appendix 3 of the NMS lists policies that are required; the list includes ‘Management of service users’ money and financial affairs’. The charging of items to service users’ 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 18 personal allowance accounts in this way is an aspect that must also be adequately covered in the Placement Agreement/contract for each service user. See Requirements 13 and 14. NMS 42: The Inspector checked one of the kitchenettes and found that the refrigerator door was not closing soundly as a large amount of food had been crammed into it. The danger is that the required low temperature to keep food fresh and safe to eat will not be maintained if this happens. The Inspector examined the records of fridge and freezer temperatures throughout the home and found instances of incorrect recording where a minus sign was used instead of a plus sign, and other instances where temperatures in fridges were much too high but the record did not show what had been done about it, despite there being a section in the record for ‘comments’. See Requirement 11 and 12 and Recommendation 3. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 2 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x x Standard No 11 12 13 14 15 16 17 x 2 x 2 x x 2 Standard No 31 32 33 34 35 36 Score x x 1 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 3, Colham Road Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 6 6 Regulation 15 (2) (b) Requirement Timescale for action 01/12/05 01/12/05 3. 6 4. 17 5. 22 6. 23 7. 23 The registered person shall keep the service users plan under regular review 13 (4) (c ) The registered person shall ensure that unnecessary risks to the health and safety of service users are identified on a regular basis (review risk assessments) 18 (1c) The registered person shall ensure that persons working at the care home receive training appropriate to the work they undertake (how to maintain a care file appropriately). 16 (2) (i) The registered person shall provide in adequate quantities suitable wholesome and nutritious food which is varied and properly prepared and available at such times as may reasonably be required by service users. 22 The registered person shall establish a complaints procedure, and supply a copy to representatives of service users. 13 (6) The registered person shall make arrangements by the training of staff to prevent service users being harmed or suffering abuse. 17 The registered person shall G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc 01/01/06 01/12/05 01/12/05 01/01/06 01/01/06 Page 21 3, Colham Road Version 1.40 8. 24,25 and 42 9. 33 10. 33 11. 42 12. 42 13. 41 14. 15. 5 12 and 14 maintain records in the care home (including staff training records) 12, 13 ( 4 As service users have physical and 5) disabilities, the home will have and 23 (a, to be registered for that e and f) category. In order to gain this registration, the registered person will have to consider how the home can be refurbished in order to increase the size of certain bedrooms. THIS IS A RESTATEMENT OF A PREVIOUS REQUIREMENT. 18 (1) (a) The registered person must ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers appropriate for the health and welfare of service users. 18 (1) (b) The registered person must ensure that the employment of any persons on a temporary basis will not prevent service users from receiving continuity of care as is resonable to meet their needs 23 (2c) The registered person must ensure that equipment provided at a care home is maintained in good working order. 13 (4c) The registered person must ensure that unnecessary risks to the health and safety of service users are so far as possible eliminated. 13 (6) The registered person shall ensure that service users are not placed at risk of (financial) abuse by providing staff with the required guidance and policies 5 (1) (b The Placement Agreement must and c) include details of additional charges. 16 (2) (m The issue about whether one of and n) the service users who is PEG fed G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc 01/12/06 01/01/06 01/12/05 01/12/05 01/12/05 01/02/06 01/02/06 01/01/06 Page 22 3, Colham Road Version 1.40 may return to a day centre must be resolved quickly. THIS IS A PARTIAL RESTATEMENT OF THE REQUIREMENT MADE IN MAY 2005 WHICH HAS NOT YET BEEN ACHIEVED. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. Refer to Standard 24 33 42 6 6 41 Good Practice Recommendations Kitchenettes should be refurbished, to include dishwashers. POVA First procedures should be used so that new applicants may begin their employment pending receipt of an acceptable CRB disclosure. Whenever a fridge or freezer is found to be operating at an incorrect temperature, the reason (if known) and the action taken to put it right, should be recorded. The person-centred planning concept should be introduced. THIS IS RESTATED FROM THE LAST INSPECTION. Care plans should be re-typed after each review. THIS IS RESTATED FROM THE LAST INSPECTION. Address details of relatives and doctors should include their postcodes. THIS IS RESTATED FROM THE LAST INSPECTION. 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing, London W5 2ST 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 3, Colham Road G61-G10 s32552 Colham Road v214316 011105 Stage 4.doc Version 1.40 Page 24 - 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. 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