Inspection on 27/04/05 for Granville Road 75-77

This inspection was carried out on 27th April 2005.

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

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

Other inspections for this house

Granville Road 75-77 14/07/08

Granville Road 75-77 31/07/07

Granville Road 75-77 18/04/06

Granville Road 75-77 03/10/05

Granville Road 75-77 25/09/04

Granville Road 75-77 29/04/04

Granville Road 75-77 17/11/03

Granville Road 75-77 13/08/03

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

CARE HOME ADULTS 18-65 GRANVILLE ROAD 75 - 77 Granville Road Wood Green London N22 5LP Lead Inspector Susan Shamash Unannounced 27th April 2005 @ 11:45 am 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. GRANVILLE ROAD Version 1.10 Page 3 SERVICE INFORMATION Name of service 75-77 Granville Road Address Wood Green, London, N22 5LP 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) 020 8888 4189 020 8888 4189 HAIL (Haringey Association for Independent Living Limited) Majekodunmi Otubanjo (Not yet Registered) Care Home 6 Category(ies) of Learning disability registration, with number of places GRANVILLE ROAD Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th August 2004 Brief Description of the Service: 75 – 77 Granville Road is a registered care home providing personal care for six younger adults with learning disabilities. Circle 33 Housing Association owns the property and the care and support are provided by Haringey Association for Independent Living (HAIL), an independent sector provider offering a range of accommodation for people with a learning disability in the London Borough of Haringey. The home is a large converted domestic premises with three floors. The ground floor comprises the main communal areas and one service user bedroom. The second and third floors contain the remaining service user bedrooms with an additional activity/ therapy room recently created on the second floor. There are adequate bath and toilet facilities in close proximity to the service users bedrooms. The home was originally due to be relocated to different premises at the end of 2002 but this decision was reversed and substantial refurbishment to the premise has subsequently been undertaken. The home is situated in a quiet residential road within easy reach of Wood Green shopping centre and a range of multi cultural resources in the vicinity. The stated aim of the home is to provide twenty-four hour support and care for six people with a learning disability to live as independently as possible within the community of Wood Green. GRANVILLE ROAD Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately seven hours and was carried out as a routine unannounced visit to the home. The new manager was available within the home throughout the inspection, with two support workers during the early part of the inspection and the deputy manager and another support worker on the late shift. Two staff members were spoken to independently during the inspection. No residents were in the home at the start of the inspection, but five returned in the mid-afternoon (one was away with relatives). The inspector had the opportunity to speak to and spend time with all five residents (four of whom are non-verbal). A tour of the premises took place and care records were inspected. What the service does well: What has improved since the last inspection? Some concerns were raised at the previous inspection regarding the cleanliness of the home and a number of outstanding maintenance issues that had not as yet been addressed. The inspector was pleased to note that major improvements had been made to the building since the last inspection. Bathrooms had been refurbished and GRANVILLE ROAD Version 1.10 Page 6 looked bright and inviting with stencilling detail added by the new manager. The laundry room, a bedroom, and corridors in the home had been redecorated, and the carpets on the stairwells had been cleaned effectively. A therapy room had been set up in a spare room on the top floor of the building, including vivid murals painted by staff and a wide range of multisensory equipment. The room is warm and inviting, and is already in use despite the need for soft furnishings still to be purchased. The new manager also announced future plans to purchase a new cooker, new laundry equipment that can be stacked thus taking up less space, for the kitchen to be painted and new carpet for the lounge and leather sofas. The new manager has also reintroduced the use of communication books for each resident between the home and day services, which has improved communication regarding residents’ needs. A new quality assurance assessment report has also been completed by the manager, highlighting priority areas to be addressed. What they could do better: The inspector was concerned to note that hot water is not always available at a sufficient temperature to meet the needs and comfort of residents and staff and hygiene requirements for the kitchen. This problem must be addressed urgently. The home has also failed to obtain a satisfactory electrical wiring safety certificate, although a requirement was made regarding this at the last two inspections. As the previous certificate indicated that the electrical installation was unsatisfactory, this issue must also be addressed as a matter of priority. Staff records must be maintained at the home for all new staff and as-andwhen staff in order to evidence that a satisfactory recruitment procedure is in place, protecting residents appropriately. Care plans must be updated to include only current information and further risk assessments should be recorded in order to ensure that resident’s needs are met effectively and that their rights are respected. Finally a complaints book must be available within the home to ensure that service users’, relatives’ and visitors’ concerns are dealt with appropriately. GRANVILLE ROAD Version 1.10 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. GRANVILLE ROAD Version 1.10 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 GRANVILLE ROAD Version 1.10 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. New service users are only admitted following detailed assessments, and thus the home is able to meet the needs of all service users in the home effectively. EVIDENCE: As noted at the previous inspection, significant information is available to prospective service users in a video and pictorial format. There had been no changes to the service users living in the home since the previous inspection. Records maintained within service user files showed that their needs had been assessed comprehensively prior to admission. There was also evidence that their needs were being reassessed on a regular basis. Inspection of service user plans and observation of support provided to service users within the home indicated that their needs were being met effectively. GRANVILLE ROAD Version 1.10 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, 7, 8 and 9. Service users’ needs, choices and aspirations are generally assessed and monitored sufficiently to ensure that these can be met effectively. However there is room for improvement in the way the home addresses their changing needs within care plans and risk assessments to ensure that support provided is responsive. Mechanisms are in place to ensure that service users are involved in the running of the home and that they are encouraged to be as independent as possible, in accordance with their wishes. EVIDENCE: Service users had satisfactory individual plans, and a computerised recording system continues to be used by all staff members with regard to shift support plans. GRANVILLE ROAD Version 1.10 Page 11 At the previous inspection it remained required that personal support guidelines for all service users be reviewed at least six-monthly. The new manager advised that a new format was now being used to produce a life story book for each service user, alongside person centred planning books and reviews, however these were not yet in place for all service users. This requirement is therefore restated and amended. Whilst a number of written risk assessments were available for all service users, discussion with the manager and staff regarding service users’ individual needs indicated that these did not cover all specific risks for which preventative action was being taken (e.g. a service user whose clothes are not stored in her room, and a service user who can be physically aggressive under particular circumstances). A requirement is made accordingly. Minutes of service user meetings indicated that they were encouraged to participate in making decisions about the home, including holiday destinations and food to be available on the menu. Observation of staff/service user interactions also indicated that they were encouraged to be involved in household routines, thus practicing independent living skills, and that their choices were respected. GRANVILLE ROAD Version 1.10 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 standard(s) 12, 13, 14, 15, 16 and 17. The home is commended for the creative and innovative approach taken by the staff team in supporting service users with educational, vocational and leisure activities of their choice. Contact is encouraged and facilitated with family and friends according to service users’ wishes. Service users are involved in and satisfied with the provision of food at the home. EVIDENCE: GRANVILLE ROAD Version 1.10 Page 13 Service users’ activity charts, care plans and daily notes indicated that a wide range of activities were available to service users both within and outside of the home. Various games and jigsaw puzzles were available in the home, in addition to a recently refurbished therapy room equipped with a wide selection of multisensory equipment. All of the service users were attending day activities during the early part of the inspection, at various day centres within the local area. Activities at these centres included music, arts and crafts and swimming. One service user is attending an access to further education course for people with profound and complex learning difficulties at a local college. Each service user had a weekly rota of chosen activities within their service user plan. The manager advised that no service users have jobs or are involved in employment related programmes, however one staff member had arranged for and supported a service user, who expressed an interest in becoming a nurse, to have a day’s work experience in a residential care home for older people, which had been a huge success. As noted at previous inspections, there was evidence that the home had put in place a plan to ensure that the Turkish speaking service user’s needs were met, appointing him a Turkish speaking key worker, and ensuring that all members of the staff team learned rudimentary words in Turkish. Staff support one service user in attending a Hare Krishna temple and Hindu temple periodically, but no other service users choose to attend a place of worship on a regular basis. There was evidence within service user plans, and though observation of the evening routines in the home, that service users were encouraged to be involved in the day-to-day tasks of shared home living. Two service users visit their families on a regular basis. All service users visit restaurants and the pub regularly and utilise local shopping facilities with support from staff. The visitors’ book also indicated that friends/family members visited the home on a regular basis. At the time of the inspection one service user was staying with his family members in the run up to his brother’s wedding, which the home manager was also to attend. The manager advised that a number of destinations were being considered for service users to visit on holiday, and this was confirmed by the minutes of the most recent service user meeting. Menus seen were appropriate and indicated a range of balanced meals. Food was appropriately stored and in date, and the kitchen was clean and tidy. Service users spoken to indicated that they enjoyed the food served within the home. GRANVILLE ROAD Version 1.10 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 standard(s) 18, 19 and 20. Service users are supported with personal care needs according to their wishes and needs, with account taken of both physical and emotional health issues. Medication is administered safely in line with medical advice. EVIDENCE: Service user files inspected showed regular input from a variety of health professionals. These included psychiatry, psychology, speech and language therapists as well as appointments with G.P.’s and dentists. The inspector spoke to several staff members and observed the interactions of staff and service users prior to the early evening meal in the home. Staff were seen to act appropriately and sensitively with service users treating them with dignity and encouraging them to be independent where possible, whilst providing support as appropriate. In conversation staff spoke enthusiastically about their work, and were well informed and skilled in working with service users with profound learning difficulties. Staff were also seen to knock and wait for an answer prior to entering service users rooms, toilets and bathrooms as appropriate. GRANVILLE ROAD Version 1.10 Page 15 The home’s medication policy was seen previously and found to be satisfactory. There was evidence that the temperature in the medication cupboard is regularly monitored to ensure that it remains under 25°C as required. Service users current medication and MAR charts were inspected and appeared to be complete and dispensed satisfactorily. As noted at the previous inspection, all staff administering medication within the home had undertaken appropriate training in August 2004. As required at the previous inspection, the previous manager had written to family members requesting assistance in verifying service users ’ wishes in the event of death or dying. GRANVILLE ROAD Version 1.10 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 standard(s) 22 and 23. Whilst there is evidence that service user’s views are acted upon, the absence of a complaints record indicates that complaints may not be monitored. Service users are well protected from abuse and self-harm, as appropriate, with staff very aware of the need to monitor changes in the behaviour of service users who are non-verbal, and thus particularly vulnerable. EVIDENCE: The home has a satisfactory complaints policy and procedure. The new manager and the deputy manager advised that no complaints had been received at the home since the previous inspection. However the complaints record for the home could not be found. A requirement is made accordingly. Care plans and service user meeting minutes indicated that service users views are listened to. Discussion with staff members and observation of procedures within the home, indicated that staff were familiar with the adult protection policy for the home and that records were maintained as required. GRANVILLE ROAD Version 1.10 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 standard(s) 24, 26, 27, 28, 29 and 30. Vast improvements have been made to the home and service users benefit from a bright, comfortable and safe environment. It is of concern, however, that recently hot water has not always been available at an adequate temperature for service users comfort and hygiene. EVIDENCE: Service users live in an environment that appears to meet their needs with personalised rooms and sufficient toilets and bathrooms. A large number of requirements were made at the last inspection, regarding the décor and maintenance of the bathrooms and shower rooms in the home, the décor in a particular service user’s room, the laundry and corridors leading up to the top floor, and the cleanliness of the home, all of which were met. The inspector was impressed at the transformation of the bathrooms on the first and ground floor following refurbishment including stencilled designs on the walls. GRANVILLE ROAD Version 1.10 Page 18 Of particular note was the refurbishment of an empty room on the top floor of the home into a therapy room for service users. It included vivid murals on the walls, painted by staff, and a wide range of multi-sensory equipment. Although this room was not yet complete, lacking soft furnishings, it felt bright and welcoming, and the manager and staff confirmed that it was already in use by service users. The manager advised that he intended to purchase new washing and tumble dryer machines for the home, creating more space within the laundry, a new cooker for the kitchen (as the oven was unreliable) and was looking into the possibility of changing the carpet and sofas in the lounge. It remains required that the carpet in the sleeping-in room be replaced, and the manager advised that he had also ordered a new mattress for this room. However the inspector was concerned to note that the maximum temperature of hot water within the home was approximately 30 degrees Celsius. Records of water temperature indicated that there had been an intermittent problem for several months. The manager advised that an engineer had been called out the day before the inspection and registered another call for an engineer during the inspection. A requirement is made accordingly. GRANVILLE ROAD Version 1.10 Page 19 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, 34 and 35. Whilst it appears that service users are protected by a robust recruitment procedure, a lack of documentation retained in the home for new and as-andwhen staff has meant that the inspector cannot be certain that the procedure is followed in all cases. Service users are supported by staff who are experienced and have received appropriate training and thus are very able to meet their needs. EVIDENCE: The home has an effective recruitment policy and staff files inspected included all information specified under the care homes regulations. However staff files were not available for the most recently employed staff member and as-andwhen staff employed at the home. A requirement is made accordingly. Inspection of staff files and discussion with two staff members indicated that service users are supported by an effective and competent staff team, who have attended a wide range of training courses. Discussion with staff members, and examination of the rotas indicated that the manager was frequently included in the number of staff working with service users in the home, so that little time was put aside for other managerial duties. A requirement is made that this situation be reviewed. GRANVILLE ROAD Version 1.10 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42. The home is well organised, and the new manager has the support of the staff in continuing to improve services according to the wishes and in the best interests of service users. Whilst the health and safety of service users is generally promoted and protected effectively, the lack of a recent electrical wiring certificate places service users at risk. EVIDENCE: Observation and discussion with staff and service users in the home indicated that the new manager has the support of the staff and has already been effective in bringing about positive changes within the home with the support of the deputy manager and staff team (including refurbishment of the therapy room and restarting the use of communication books between day services and the home for each service user). GRANVILLE ROAD Version 1.10 Page 21 The manager advised that he had been in post since February, and that he would apply to be registered with the CSCI following successful completion of a three-month probation period. In the short time that the manager has been in post he has already conducted a quality assurance self assessment framework report for the home, and he advised that he intended to incorporate service users views as part of the report. Maintenance records and safety certificates were available for fire equipment testing and drills, gas safety, the water tank (and legionella testing). The portable appliance testing was due to be updated, and the manager advised that a date had been arranged for this to take place, however the engineer did not arrive. The inspector was concerned to note that despite a requirement made at the previous inspection, no current satisfactory electrical installation certificate was available for the home. It appeared that this was due to confusion over the previous certificate that was available, but indicated that the electrical installation was not satisfactory and testing should be repeated within three months. This requirement is restated. GRANVILLE ROAD Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 3 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x 3 3 3 4 3 Standard No 11 12 13 14 15 16 17 x 4 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 2 x GRANVILLE ROAD Version 1.10 Page 23 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. Standard 7 Regulation 15(2)(b) Requirement The registered person must ensure that all service user plans are reviewed and updated and that outdated guidelines are archived. (Timescale of 05/11/04 partially met.) This requirement is restated and amended. 2. 9 13(4)(b) 14(1)(a)& (2)(a) The registered person must ensure that further risk assessments are undertaken for service users so that all preventative action taken to avoid risks is recorded, and that these are reviewed at least sixmonthly. The registered person must ensure that a record of complaints is available within the home including details of any complaint made, action taken and timescales. The registered person must ensure that the carpet in the sleeping-in room is replaced. (Timescale of 22/10/04 partially met). This requirement is restated and GRANVILLE ROAD Version 1.10 Page 24 Timescale for action 5th August 2005 24th June 2005 3. 22 17(4) Sched 4(11) 22 23(2)(b) (d) 13th May 2005 4. 24 10th June 2005 amended. 5. 24 23(2)(j) The registered person must ensure that the temperature of hot water available in the home is sufficient to ensure comfort and hygiene, i.e. above 50 degrees Celsius in the kitchen and not more that 43 degrees celsius at other outlets. Records of hot water temperature must be maintained daily until the issue is resolved, with copies sent to the local CSCI area office. The registered person must ensure that staffing numbers within the home are reviewed with regard to providing sufficient staff so that the management have sufficient office time available. Records as specified in 17(2) Sched 4(6) of the Care Homes Regulations 2001 must be available for inspection for all new staff members and all asand-when workers employed at the home. The registered person must ensure that a copy of a current ‘satisfactory’ electrical installation certificate is sent to the local CSCI area office. (Timescale of 01/10/04 not met). This requirement is restated for the second time. 20th May 2005 6. 33, 34 17(2) Sched 4(6) 18(1)(a) 10th June 2005 7. 42 13(4)(a) 3rd June 2005 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 Good Practice Recommendations Version 1.10 Page 25 GRANVILLE ROAD Standard 1. GRANVILLE ROAD Version 1.10 Page 26 Commission for Social Care Inspection North London Area Office Solar House, 1st Floor 282 Chase Road London N14 6HA 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 GRANVILLE ROAD Version 1.10 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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