Inspection on 06/09/06 for Great Western Road, Flat 4, 22-24

This inspection was carried out on 6th September 2006.

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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Great Western Road, Flat 4, 22-24 29/05/07

Great Western Road, Flat 4, 22-24 17/01/06

Great Western Road, Flat 4, 22-24 12/07/05

Great Western Road, Flat 4, 22-24 23/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Great Western Road, Flat 4, 22-24 22-24 Great Western Road London W9 3NN Lead Inspector Ffion Simmons Unannounced Inspection 6th September 2006 10:15 Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Great Western Road, Flat 4, 22-24 Address 22-24 Great Western Road London W9 3NN 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) 020 7289 4752 020 8964 5507 The Westminster Society for People with Learning Disabilities Miss Michelle Hart Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2006 Brief Description of the Service: Flat 4 is a purpose built, wheelchair accessible, second floor flat that is registered to provide care for 6 people with learning disabilities. The property is owned by Paddington Churches Housing Association and the care is provided by the Westminster Society for People with a Learning Disability, a voluntary organisation. The home is located in a residential area of Westbourne Grove, close to shops and transport links. The home is part of a small residential block that includes a second registered care home and six flats for people with a learning disability who are living independently. Each person living in the home has their own bedroom. Communal areas, bathrooms and toilets are shared. The current scale of charge for the service as obtained from the pre-inspection information is £1,104.46 per week with no additional charges. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place over one day on the 6th September 2006. The inspector met service users, spent time observing care practices, talking to the staff and Manager. A range of documentation was checked as part of the inspection process including service users’ personal files, staff files and complaint and incident reports. What the service does well: What has improved since the last inspection? Five requirements were set following the last inspection. requirements have been met. Three of the five The home’s health records are now better maintained with some of the old information been removed and archived. Reports on behalf of the registered provider have improved since the last inspection and now include more information. These are being forwarded to the local office of the CSCI as per the requirements of the last inspection report. A new system for highlighting when staff training is due has been devised. This now needs to be implemented. What they could do better: Seven requirements and three recommendations were made following this inspection. Two of the seven requirements are repeated from the last inspection report. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 6 There is a need for the home to ensure that the service users’ care plans are updated to reflect their current needs. The new format for recording training undertaken by staff must be implemented. Staff must be up-to-date in their training in safe working practices and receive regular formal supervision. Staff developmental work is urgently required to ensure that staff respect service users, that their individual needs are understood, and that they are facilitated choice. Staff must develop the skills and experience necessary for communicating effectively with service users. The home’s Quality Assurance systems must include service users and quality of care must be regularly reviewed. 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. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of prospective service users are known prior to moving in to the home. Service users’ admission is carefully planned and service users are offered opportunities to visit the home prior to moving in. EVIDENCE: The file of the most recently admitted service user was seen during the inspection. The service user was admitted from another of the Westminster Society’s homes. There was evidence on file that careful preparation and introductory visits had been arranged to enable the service user to decide if they felt that the placement was suitable. Both staff teams worked together to co-ordinate the move, and the introductory visits, which included overnight stays. A good level of information was on file on the needs of the service user. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users’ individual care plans are detailed and person centred, and they clearly outline service users’ needs but two of the three care plans are in need of updating. Clear and up-to-date risk assessments are in place for identifying and minimising the risks to service users’ safety. Some evidence was seen during the inspection that service users’ choices and decisions are not always respected and that staff communication skills need improving. EVIDENCE: The care of three service users was tracked during the inspection and their personal records were checked. The new format for recording the needs of the service user “my support profile” has been introduced for one of the service users. This outlined the needs, preferences and wishes of the service user, which was written in the first person and was person centred. The support plan of the other two service users remains in the old format and are in need of updating, as the reviews are overdue. The inspector noted some poor interaction and communication skills during the inspection, where a service user was not facilitated choice and their wishes not Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 10 respected. Steps must urgently be taken to address this (see also section under staffing). Each of the service users had an updated risk taking policy on file. The risk taking policies highlight potential risks and strategies for minimising risks. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported to maintain personal and family relationships and are provided opportunities to be part of the local community. A healthy diet is promoted. EVIDENCE: When the inspector arrived at the home, two service users were up and one service user was enjoying a lie-in. Service users living at the home have a full programme of activities, which are outlined in their individual support plans. All service users have access to day services and take part in various classes and activities. This provides them with opportunities for personal development and social interaction with other service users and staff. Staffing rotas are carefully prepared to ensure that there is sufficient staff on duty to enable service users to be supported to follow their programme of activities. Service users’ individual abilities and housekeeping responsibilities are highlighted in individual plans. Service users’ daily notes were checked during the inspection. The inspector noted a number of references made to instances where service users were Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 12 supported to be part of the local community. Service users had recently been supported to go out to the pub, to go shopping, cinema and coffee shops. Service users are also encouraged to maintain relationships with relatives and friends and have opportunities to meet up socially with service users from another registered services, especially Flat 3 (which is conveniently situated downstairs). Service users are supported with tasks such as preparing meals and staff offer service users with a choice of what they would like to eat. One service user has a pictorial menu to enable them to choose their meals and have their own day for going food shopping Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 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 the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are well documented and service users’ preferences with regards to personal care are respected. The medication is well managed and service users have access to the multi-disciplinary health care team. EVIDENCE: Service users’ individual needs, preferences and wishes with regards to personal care are outlined in their care plans. Same gender care is offered wherever possible and personal care is provided in private. The health care records were seen during the inspection and have been improved and updated since the last inspection. There was evidence that service users have access to the multi-disciplinary team including Practice Nurses, Community Nurses, Challenging Behaviour Nurse, GP’s, Chiropodist and opticians. Since the last inspection, the Manager has introduced a review process “my month”. Each service user, with their key worker reflects on the achievements of the month and also what service users did not enjoy about the month. The review also analyses the number of outings and health care appointments attended. Service users’ medication is kept in a lockable cupboard. Medication is received mainly in blister packs. There are no service users currently selfGreat Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 14 medicating and no controlled drugs are currently in use. Further guidance has been put in place to minimise the risk of medication errors. The policy in place indicates that one person is delegated to administer medication for the shift. That person is not designated to any other duties i.e. answering the phone or supporting service users during that time. Daily balance checks on nonblistered medication take place. The medication records were checked for all service users and were found to be well completed with no gaps/errors noted. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 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): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints policy and procedure is accessible to service users and there is evidence that service users are supported to make a complaint when unhappy with aspects of the service. The overall format of recording complaints is under review and the new format should be introduced as soon as practicably possible. Policies and procedures are in place for protecting service users from abuse. EVIDENCE: The complaint policy has been updated since the last inspection to include details and pictures of the relevant personnel to contact at The Westminster Society. The complaint policy is accessible to service users. The complaint records were checked during the inspection and within these, there was evidence that service users are supported to voice their concerns if unhappy with any aspect of their care. Electronic complaints monitoring process is due to be introduced to the service, which will ensure a better system for logging the complaints, monitoring the response, feedback and actions taken to resolve the complaints. It is a recommendation that this system is introduced as soon as practicably possible. The home has a policy for the protection of vulnerable adults from abuse and a policy on physical intervention and restraint. There have been no reported adult protection incidents since the last inspection. In-house training sessions have taken place since the last inspection on the protection of vulnerable adults from abuse. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable and homely and suitable for its purpose. Steps must be taken to deep clean the carpets in the main lounge and the main corridor. EVIDENCE: The home is purpose-built, is wheelchair accessible and accommodates six people. The security in the home is good with entry to the main building via entry phone system. CCTV cameras have been fitted to monitor the main entrance. The home is located close to transport links and local shops, cafes and pubs. The communal areas were seen during the inspection. The home is comfortable and homely and service users have access to communal areas, which include a kitchen/dinner, main lounge and quiet lounge. There is a separate laundry room equipped with two washing machines and two dryers. On the whole, the home was clean and hygienic at the time of the inspection but the carpet in the communal lounge and main corridor needs to be deep cleaned. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 17 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, 34, 35,36 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Training opportunities are good and half of the staff team have an NVQ qualification at level 2 or above. Steps need to be taken to ensure that training records are kept up-to-date and that staff are up-to-date in their mandatory training. Some issues were identified around staff interaction with service user, which needs to be urgently addressed. Staff do not currently receive regular, formal supervision with their manager. Robust recruitment practices are in place involving service users. EVIDENCE: On the morning of the inspection there were two support workers in the home supporting three service users. The inspector observed some evidence of good interaction between staff and service users but also identified evidence of poor interaction, which included not respecting service users’ choice. The inspector noted an episode of infantilisation where the service user was asked to “be good” and blaming the service user for being challenging and not doing as told. The inspector felt that the staff on duty had little awareness of the service user’s non-verbal expressions. The poor interaction witnessed during the inspection was discussed with the Manager and will be addressed with staff at supervision. Developmental work is required to ensure service users are respected, that their individual needs are understood, and that they are facilitated choice. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 18 Training opportunities for staff are good with a range of available courses on offer. Pre-inspection information indicates that 50 of care staff have NVQ qualification at level 2 or above. Since the last inspection the home has developed a new format for recording training undertaken by staff, with the mandatory training being highlighted. This new recording format must be implemented fully to ensure that the system highlights when mandatory training updates are due and to fully reflect the actual training undertaken by staff. Current training records are not accurate with gaps in training evident. The Society’s human resources department is responsible for ensuring that all pre-employment checks have been completed prior to staff commencing work. The Manager receives confirmation in writing that the pre-employment checks, which include references and CRB and POVA checks have been completed and are satisfactory. Service users are supported to be involved in the recruitment selection and induction of new staff. The personal files of two staff were checked during the inspection. Each staff member has a signed supervision contract on their files. Staff are not receiving formal supervision as often as is required and steps must be taken to ensure that staff have formal, recorded supervision meetings at least six times a year with their senior/manager. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed by an experience and competent Manager. The home’s quality assurance systems need to be improved to ensure that they are effective in assessing the quality of the service offered and involve service users. The health and safety documentation is well completed, but staff must be up-to-date in the safe working practices training to fully promote the health and safety of service users. EVIDENCE: The home’s Manager is experienced and competent to run the home. She has the NVQ level 4 qualification and a degree in Social Sciences and Welfare studies. Recent training undertaken by the Manager includes person centred approaches to dementia, adult protection and swallowing & eating. The Manager is very caring and committed to meeting the needs of the service users. The requirements relating to the quality assurance systems in the home have not been met. The home’s last audit was in July 2004 and the current audit Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 20 tool has been suspended and remains under review. The service user quality assurance questionnaires have still not been introduced and are due to be introduced very shortly. The Society must ensure that the quality assurance systems are more robust and meet the National Minimum Standards and the regulations. Visits on behalf of the registered provider take place monthly, and since the last inspection, copies of the reports are forwarded to the CSCI. The report format for the visits has changed and now includes more information. Health and safety documentation was checked during the inspection and were found to be well maintained with evidence that weekly fire alarm checks take place and safety certificates in place. The home has an up-to-date fire risk assessment and a general risk assessment in place. Water temperatures in the home are regularly tested and were seen to be within safe limits. It remains a requirement that all staff are fully up-to-date with training in safe working practices. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 22 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 YA6 Regulation 15 2 Timescale for action The Manager must ensure that 01/11/06 service users’ individual plans are reviewed at least every six months with the input of the service user and representatives where appropriate. Staff developmental work is 01/11/06 urgently required to ensure that staff respect service users, that their individual needs are understood, and that they are facilitated choice. Staff must develop the skills and experience necessary for communicating effectively with service users. The carpet in the communal 01/11/06 lounge and main corridor must be deep cleaned regularly. This new format for recording 01/11/06 training undertaken by staff must be implemented fully to ensure that the system highlights when mandatory training updates are due and to fully reflect the actual training undertaken by staff. Requirement 2. YA7 & YA32 12 [2] [3] [4] 18 3. YA30 23 [2] (d) 4. YA35 13 [3][4] [5][6] 18 Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 23 5. YA35 13 [3] [4] [5] [6] Staff must be up-to-date with 01/12/06 their training in safe working practices including infection control, fire, health and safety, food hygiene and manual handling. Previous timescale of 01/10/05 not met. This requirement is repeated for the second time. Staff must receive regular, 01/12/06 recorded supervision meetings at least six times a year with their manager and cover the topics set out in standard 36.4. The home’s quality assurance 01/01/07 systems must be effective and must meet the National Minimum Standards and the regulations. This includes consulting with service users on the quality of the service and continuous selfmonitoring including at least an annual audit. Original timescales of 01/05/06 not met this is a repeat requirement. 6 YA36 18 [2] 7 YA39 24 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 Refer to Standard YA6 YA22 YA32 Good Practice Recommendations Consideration should be given to making the care plans more accessible to service users. The electronic complaints monitoring process should be implemented as soon as it’s practicably possible. The examples of poor interaction noted during the inspection and similar scenarios should be discussed at staff meetings and supervision. Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Great Western Road, Flat 4, 22-24 DS0000010878.V304135.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!