Inspection on 12/12/05 for Elizabeth House

This inspection was carried out on 12th December 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elizabeth House 13/12/07

Elizabeth House 10/05/06

Elizabeth House 04/05/05

Elizabeth House 17/01/05

Elizabeth House 17/06/04

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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 Elizabeth House 59/61 St Ronans Road Southsea Hampshire PO4 0PP Lead Inspector Richard Slimm Unannounced Inspection 12th December 2005 10:00 Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 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 Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 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. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address 59/61 St Ronans Road Southsea Hampshire PO4 0PP 02392 733 044 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) Mr M Khoyratty Mrs M Khoyratty Mr M Khoyratty Care Home 20 Category(ies) of Learning disability (20), Mental disorder, registration, with number excluding learning disability or dementia (20) of places Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Current service users over 65 years of age may remain at the home. One named service user whose date of birth is 06/04/1936. Service users in the MD/LD categories must be at least 35 years of age. Date of last inspection 4th May 2005 Brief Description of the Service: Elizabeth House is a large residential care home that has been operating for many years. Consequently provision of services to the service user groups, for which the home is registered, have moved onto new models of care. The home has varied conditions of registration to remove the older person category. However, the home appears to be having difficulties in transition to provide an enabling adult persons service. Accommodation is arranged over three floors, with a cellar where residents do not have access. The home has a small-enclosed rear garden, which is paved with flowerbeds and features. The kitchen is sited to the rear of the ground floor with an access to the dining area, which is communal. There is a smoking room off the dinning area and a small communal WC. There are two bedrooms and two lounge/TV areas on the ground floor also. Access to the second floor is aided by a stair lift, with this floor containing bedrooms, communal toilets and bathrooms. The next floor contains bedrooms but there is no communal WC or en suite facilities. The home has two shared bedrooms and 16 single rooms. Elizabeth House can only provide limited daily independent living skills opportunities to service users. Services, including meals, laundry and domestic services, are generally provided by the staff group with little or no planned involvement of service users on a daily basis. The home is very large given current trends to house people with learning disabilities and mental health problems in smaller, more domestic accommodation, with an emphasis on independent living, and ordinary housing with support. However, a number of people living at Elizabeth House have resided there for a significant number of years, and some have come from hospital/institutionalised backgrounds, and have become adapted to life at the home. However, it is unlikely that the service would meet the needs of younger people, as there is a lack of emphasis on providing rehabilitation or the promotion of independence. Consequently it is important that the registered Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 5 persons give careful consideration to the future configuration of services provided at the home, in line with current social policy, commissioning trends and potential new service users needs and wishes. The home is registered with the Commission for Social Care Inspection (CSCI) and provides accommodation and support for up to 20, younger adults who have a learning disability or a mental disorder, with additional conditions as identified above. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 12/12/05 at 10 am. The inspector met and spoke to 10 residents, all of whom confirmed that they were contented living at Elizabeth House. One resident advised that arrangements were being made for her to move to more independent living. The inspector also spoke to staff. The manager/owner assisted throughout the inspection, and the inspector toured the premises, inspected records and documentation. Some action had been taken by the registered person to comply with requirements and recommendations made in the last inspection report, however, there are still a number of important issues that still need to be addressed at the home. This report will make two requirements and a number of recommendations. What the service does well: What has improved since the last inspection? What they could do better: Staff must not be employed in an unsupervised capacity until Criminal Record checks have been returned to the home as clear. Adult protection risk assessments in one case needed updating, as did the individual plan of care that needs to monitor issues. The owners’ work in excess of 100 hours per week, consequently staffing levels still need to be increased. Night staff arrangements may need to be reviewed in line with the assessed needs of residents. The staff team need to be trained within the Learning Disability Award Framework (LDAF) when undertaking NVQ training courses. Care planning needs to be more person centred. Staff members need improved professional supervision. Key worker systems need to be introduced to support and promote improvements in outcomes for residents living at the home. The owners should consider using the flat in the basement to provide residents with opportunities to sample independent living, as part of a care planned Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 7 assessment of daily living skills. The home needs to develop a clear redecoration plan for 2006/07 with allocated budgets. 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. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 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 the following standard(s): 2-3 Prospective residents are assessed. The current service model limits the degree to which the home is able to meet the needs and aspirations of residents in the development and improvement of independent living skills. EVIDENCE: The home admits residents who have been assessed by social services care managers. Records of key information were available, but some of this information was dated. One resident recently admitted to the home needed access visits outside of the home to be monitored and risk assessed. Mr Khoyratty advised this happened informally. The inspector advised adult protection issues need to be monitored formally and fully recorded and risk assessed. Consequently in at least one case record sampled, current and up to up to date risk assessment information was not readily available or being used by care staff working with residents on a daily basis. Assessment and care planning files may benefit from having some dated, historical information archived, and more emphasis placed on the need to keep current information up to date. There was no evidence of a structured system of key working, which linked to supervision systems and specific outcomes for residents. Some residents were not fully aware of their care records, but did confirm that they had recently contributed to a survey at their home. No residents spoken to were directly involved in food shopping or preparation at their home even though they potentially possessed the abilities to develop these skills. Two residents confirmed that they did carry out tasks such a laying the tables. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-7-8-9 Care pans were not of a sufficient detail, quality or adequately person centred. Service users are not fully motivated to increase their independence, and the home fails to offer structured, realistic, meaningful opportunities to practice daily living skills. The home must improve consultation and information gained via the recent anonymous survey should be used to ensure the service develops in line with the needs and wishes of residents. Risk assessments need to be updated and more carefully monitored by key staff and managers. EVIDENCE: One care plan needed more detailed information in an area where risks had been identified. Risk assessment was lacking in this instance. A resident stated that she did not wish to remain at the home, but understood why she was currently living at Elizabeth House. Another resident shared her intention to move on to more independent living, with the support of her social worker. The home had carried out an anonymous survey of residents and visitors to the home. Residents spoken to said they were contented with the services provided. However, there was a lack of evidence of any structured key working that led to improved outcomes for service users. While more able residents appear to enjoy a reasonably full and active life, more dependent residents and residents with serious motivation difficulties appeared to spend most of their Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 11 time sitting in the TV or smoking lounges. Staff did play dominos with three residents, and another resident was observed colouring in pictures during the visit. Apart from these ad hoc activities, there did not appear to be any structured meaningful activity in place or planned to promote resident independence in the area of daily living skills. A number of residents attend day centres/colleges, where independent living skills are taught, but there was little opportunity at the home for residents to continue this or practice/reinforce newly learnt skills at the home. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 12 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): 11-12-13-14-15-16 There is a lack of opportunity for personal development. Activities are ad hoc, rather than structured, meaningful and planned. Activities are not based on the assessed needs and wishes of residents and fail to promote independence. The model of the service limits the degree to which the home respects and promotes the rights of residents to take control over their daily lives, and gain greater independence or daily living skills. Staff members are not encouraged or trained to be imaginative or to take responsibility for improving and developing the service. EVIDENCE: Written plans did not appear to fully address residents’ potential. During the visit and previous visits residents with significant difficulties in such areas as motivation and general mental health problems, appear to be left for significant periods to their own devises. In some activities age appropriateness could be further promoted and protected. Access to the local community is possible for more able residents, who journey out independently. One able resident had just returned from an annual holiday with a relative. Another resident could not recall the last time he enjoyed a holiday away from the home. The owner explained that the home does not provide residents with Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 13 annual holidays, but does provide occasional trips out during the summer months. Less able residents are dependent on day services for many aspects community access, and for stimulating activities. The home supports residents to keep relationships outside of the home. Residents confirmed that they received visitors and were also able to visit friends and loved ones outside of the home when they wished. Staff members at the home are not routinely provided with training within the specialist areas of learning disability of mental health. The home fails to run an adequate system of key working to promote positive outcomes for residents, and accountability. It appeared that formal supervision did not link to any aspect of goal planning or individual success for residents or staff, leading to a lack of accountability and the home being constantly overseen by the manager. This leads to a problem of a lack of delegation by the manager and the manager having to work excessive hours. A further knock on effect of this issue is that staff members are not stretched or encouraged to be imaginative or flexible in their support of residents. Residents are not actively encouraged or supported to shop for their food, and are rarely involved in budgeting food preparation or cooking. Staff members tend to provide/do most aspects of daily practical support, cleaning, laundering, cooking, shopping etc. with little planning to more fully involve the resident. This leads to a rather old fashioned institutional style of service similar to the old hostel model. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 14 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): 19 The home assesses residents’ health care needs and makes arrangements for these needs to be met by local community health care teams/professionals. EVIDENCE: Residents access health care in similar ways to any other member of the local community. One resident confirmed that she could see her GP on request. Some residents attend appointments at GP surgeries and local dentist etc. Some residents are under the care of specialist health care teams due to ongoing mental health issues. The manager of the home appeared to have a good understanding of the health care needs of the resident group. Residents spoken to said they were happy with the arrangements in place to meet their health care needs. The home was storing excessive quantities of incontinence aids, the manager advised that an incontinence nurse will be visiting to sort out this matter soon. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion – see last report - no complaints received or logged EVIDENCE: Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24-26 The home needs decorative attention in consultation with residents about new colour schemes. One double bedroom fails to provide separate facilities to the two residents sharing the room. The home has no planned programme for upkeep of decoration. Residents are expected to share bedrooms without adequate consultation. EVIDENCE: Some areas of the home are beginning to look warn and tired. The owner has no plan for the upkeep of décor throughout the home, but is aware of the need to replace some external woodwork. Some carpets look worn and old. Some furnishings are old and worn. While the basement area has benefited from significant improvement, residents do not have access to this area and many communal areas of the home begin to show signs of a lack of investment. The basement area could be developed to provide an independent living area where residents could partake in assessments while living more independently. The home has two shared rooms. Some residents sharing these rooms appeared to be exercising informed choice, one of the double rooms only had one sink, meaning the residents who are neither partners or related have to share the same sink facility. One resident stated that he would prefer a single room, with more space for his belongings. One resident said she was Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 17 sometimes cold, but did not mention this to staff. At the time of the visit the home was warm, and residents were happy with the temperature. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 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): 32-33-34-35-36 The home does not routinely or regularly provide adequate specialist training in mental health and learning disabilities to staff. The home fails to run an adequate key worker system to promote effective and efficient outcomes for residents. The home fails to ensure that staff member checks are carried out prior to employment in unsupervised roles. The home fails to provide appropriate forms of professional supervision and support to care staff members that promotes resident independence and staff accountability. Nighttime arrangements may benefit from review. EVIDENCE: The home employs six care staff, plus the two owners who work at the home. For the week of the visit the two owners were rostered to work 108 hours. Current night staffing is a waking staff and sleep-in cover provided by the owners, who live in the next house that has a linked fire and personal alarm system. The manager advised the inspector that night arrangements work well and are safe, and that he is rarely disturbed. There arrangements will need to be kept under review, as some care staff may feel reluctant about disturbing the owners at night. Residents spoken to said that staff members treat them with dignity and respect. Residents were very positive about Mrs Khoyratty. Five of the eight staff team have NVQ 2 training, but this training did not include LDAF input, or mental health electives. The inspector was advised that four staff are planning to progress onto the NVQ 3 training. The owner will need to seek clarification that these candidates will be offered electives Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 19 relevant to the homes categories and conditions of registration. There is no accredited specialist training in the learning disability of mental health areas for staff development. Since the last inspection the home now provides 24hour cover with first aid trained staff on duty. One staff member recently employed was rostered to work unsupervised during a night shift, prior to the home receiving a cleared criminal records bureau check. A POVA first check had been carried out. The home does not adopt a modern, effective system of key working and supervision to promote greater efficiency, safe delegation, accountability and improved outcomes for residents. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 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): 42 Arrangements for the maintenance of health and safety were in place, and are monitored regularly by the manager of the home. The home needs to risk assess and monitor hot surface temperatures around the home. EVIDENCE: The manager advised the inspector that staff members receive appropriate health and safety training. The home is now able to provide 24-hour cover with first aid trained staff. Regular in-house fire training is in place, and fire alarms are tested frequently. Residents confirmed fire alarm tests and fire drills take place. Any staff member handling food is adequately trained. Service contracts are in place to ensure safe operation of the home. The manager maintains a maintenance book for the home. Residents said that they felt safe living at the home. Health and safety information is available to staff members employed at the home. Some surface temperatures were high, and this needs to be risk assessed and monitored in line with the needs of residents who may be more physically frail. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 2 x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 2 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 x x x x LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score x 2 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elizabeth House Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x DS0000012234.V259417.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 14-15 Requirement Timescale for action 01/01/06 2 YA34 19 3 YA33 18 The registered persons must ensure that where adult protection issues are identified for residents in their care this is reflected in risk assessments and care plans and clearly monitored in recorded form. The registered persons must 12/12/05 ensure that staff members are not employed in an unsupervised role until all checks including CRB checks are returned to the home cleared. This matter was raised as an immediate requirement at the time of the inspection. The registered person must 30/01/06 review the high number of working hours they cover at the home. Night staff arrangements need to be kept under regular review. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 23 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 YA3YA6 Good Practice Recommendations 2 3 4 5 6 The registered person should develop care-planning systems that are person centred to ensure that residents take increased control and responsibilities for their care plans. Key working is needed to promote greater independence with residents, and to provide increased meaningful opportunities for residents’ to take part in the running of their home and to practice their independent living skills in their home. YA35YA18YA7 The national minimum standards identify the need for key working a number of times, in line with current best practice. It is strongly recommended that the registered persons develop clear systems of key working within the staff team, and allocate specific residents to have key workers. Staff members will need updated training in mental health and learning disabilities. That should be provided by an accredited source, such as the (LDAF) module to NVQ training. The registered manager will need to monitor the effectiveness of key working via professional support/supervision of the staff team. YA11 The registered persons should consider developing the service model and the facilities in the home that enhance and improve opportunities for residents to practice independent living skills. Key working should improve the degree of opportunity for residents to take increased control over their lives, and to fully contribute to the daily running of their home. YA24 The registered persons should forward a clear decoration plan for the home for the budget period 2006/2007, with clear plans of how they intend to consult residents about the upkeep of their home. YA25 The registered persons should regularly review arrangements where residents are sharing bedrooms to establish that the people concerned are only sharing having exercised informed choice. When residents choose not to share a bedroom they will be offered a single bedroom. The registered persons should make arrangements to put adequate facilities in shared rooms, for example 2 sinks, or an en suite facility. YA42 The registered persons should risk assess hot surface DS0000012234.V259417.R01.S.doc Version 5.0 Page 24 Elizabeth House temperatures throughout the home and where necessary provide radiator/pipe covers. Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Elizabeth House DS0000012234.V259417.R01.S.doc Version 5.0 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. 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