Inspection on 31/10/05 for Grindleford Avenue 2

This inspection was carried out on 31st October 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Grindleford Avenue 2 06/11/07

Grindleford Avenue 2 01/02/07

Grindleford Avenue 2 27/06/06

Grindleford Avenue 2 03/08/04

Grindleford Avenue 2 14/04/04

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 Grindleford Avenue 2 New Southgate London N11 1JN Lead Inspector Anthony Lewis Unannounced Inspection 09:50 31 October & 2 November 2005 st nd Grindleford Avenue 2 DS0000010447.V251495.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 Grindleford Avenue 2 DS0000010447.V251495.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. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grindleford Avenue 2 Address New Southgate London N11 1JN 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 8368 5177 020 8368 5177 PentaHact Miss Louise McInnes Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Limited to 4 adults of either gender who have a learning disability (LD) and who may also have a physical disability (PD). One specified service user who is over 65 years of age may remain accommodated in the home. The home must advise the registering authority at such times as the specified service user vacates the home. Two specified service users who have dementia may remain accommodated in the home. The home must advise the registering authority at such times as either of the specified service users vacates the home. 9th May 2005 Date of last inspection Brief Description of the Service: 2 Grindleford Avenue is a purpose built bungalow, situated at the end of a culde-sac on a relatively new housing estate in New Southgate. The home accommodates four adults who have learning and physical disabilities. The home is owned and maintained by Sanctuary Housing Association and managed by PentaHact through a written agreement. The current group of residents have lived in the home since it opened in 1997. The home is specially adapted and furnished to meet the needs of residents with physical disabilities, whilst still providing a comfortable homely environment. The home consists of four double bedrooms, one bathroom, a shower room, a toilet, a lounge, a kitchen/diner and an office. The home has a well maintained back garden and a small front garden, with off street parking for several vehicles. Twenty-four hour care and support is provided. The home has a minibus, which provides access to a range of day care and leisure facilities. Public transport, shops and amenities are a short walk from the home. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on Monday 31st October 2005 at 09:50am and was completed at 3:30pm. The manager, along with the permanent staff team, was on a training course for the day. Two agency staff, who have regularly worked in the home were available and helpful. The Operations Manager was kind enough to come to the home at 10:15am and stayed until 12:15pm and was very helpful in answering various questions. To gain access to staff files and to clarify various issues, a brief visit was conducted on Wednesday 2nd November at 3:15pm and was completed at 4:45pm. The manager was available and was very helpful. He has managed the home since July 2005 and is in the process of applying for registration. To gather further information for this report, four resident’s files and five staff files were viewed along with various safety certificates, files and documents. Three residents were spoken to informally and one member of staff was spoken to formally in the office. A tour of the home was conducted with the Operations Manager. What the service does well: What has improved since the last inspection? What they could do better: Eleven requirements have been made at this inspection, four of which are restated requirements. Care needs of each resident must be assessed and a record kept in the individual resident’s file. The staff team must ensure that all residents are supported, where necessary, to make decisions about their lives. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 6 Staff must ensure that the residents are consulted and are able to participate in all aspects of life in the home. To ensure the health and safety of all residents, their risk assessments must be reviewed and revised accordingly. A review of the meals prepared in the home must be undertaken to ensure that residents are receiving wholesome and varied meals. Staff must be more vigilant when recording resident’s medication administration to ensure that errors are not made or are identified immediately. To ensure that funeral arrangements are treated sensitively and with respect, the staff team must ensure that resident’s wishes are sought and recorded. The home must have an appropriate complaints file in place and all complaints must be recorded appropriately. To ensure that the identified resident and other residents, staff and visitors are not affected by offensive odours and safe from hazards, the carpet in the identified resident’s bedroom must be cleaned and the lino in the kitchen repaired or replaced. If residents, staff and visitors to the home are to be fully protected from any form of abuse, gaps in staff’s work employment history must be explained and recorded. To ensure the safety of everyone in the home, safety tests must be carried out and a certificate of the tests obtained. 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. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 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 Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 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, 3 and 5. Even though the staff team are ensuring that residents are supported with their personal care needs and that the home has the specialist equipment available, residents are not assured that their care needs will be assessed prior to their admission to the home or once admitted. EVIDENCE: Assessment records for the residents prior to moving in or when they moved into the home could not be found. A requirement is made that the registered persons must ensure that assessments are carried out regarding the care needs of each resident. The home was purpose built for residents with physical disabilities. There is an assisted bathroom, and shower room. There is also a hoist and commode. The home has a small mini bus, which has been adapted to accommodate wheelchair users. Each resident has a placement agreement between the resident and PentaHact, which explains the conditions of occupancy and the rights and responsibilities of all parties. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 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, 8 and 10. The staff team are disempowering residents by not including and consulting the residents in all aspects of life in the home. The staff team are also putting residents at risk by not ensuring that the resident’s risk assessments are reviewed regularly. EVIDENCE: All resident’s care plans were viewed and are now being reviewed more regularly, as was a requirement at the previous inspection. Three residents have had their annual review in the past month and the remaining resident’s review date is being set. There was a lack of evidence to show how residents make decisions about their lives. Resident’s meetings have not been occurring, which could give residents an opportunity to air their views and make decisions. A requirement is made that the registered persons must ensure that residents are supported to make decisions about their lives and that the information is recorded. There was also no evidence to show how residents are consulted and participate in all aspects of life in the home. Residents were observed in the lounge or the kitchen with staff but they were either standing around or sitting Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 10 watching television or wondering about the home, while staff prepared meals or cleaned the home. A requirement is made that the registered persons must ensure that residents are consulted and participate in all aspects of life in the home and that the information is recorded. Although a requirement at the previous inspection, resident’s risk assessments have not been reviewed and many dated back to 2001. This requirement is restated. Resident’s files are kept securely in the office in their own individual lockable filing cabinets. The home has a policy and procedure on confidentiality in place. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 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): 13, 14 and 17. Residents are confident that the staff will support them to be a part of their local and the wider community. However, the staff are not ensuring that residents receive a varied diet. EVIDENCE: At lunchtime, a resident had just returned to the home. He said that he had been out to work painting and seemed very pleased. The office wall contains information regarding resident’s activities, such as shopping, day centres and details about one resident who attends church regularly. Information on the office wall and in resident’s files indicates that residents are supported by the staff to participate in various leisure activities such as their local swimming bath, Barnet College, arts centre and places of worship. Although a menu is now compiled weekly to show what residents eat daily in the home, which was a requirement at the previous inspection the menu for the week was viewed and found to be quite bland. There was a lack of creativity and variety in meals prepared. Breakfast is the same each day and the lunch menu showed repetitiveness with soup being served three days in a Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 12 row. A requirement is made that the registered persons ensure that a review of meals provided in the home is undertaken ensuring that residents are consulted and a record kept of the outcome. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 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 and 20. Residents are confident that the staff team have the skills and experience to support them with their personal care and that they will be treated with dignity and respect at all times and any health issues will be taken seriously. However, residents are not confident that staff will record and respect all of their wishes. EVIDENCE: At the previous inspection, there was concerns regarding a resident who was having regular seizures and no action was being taken and it was not being recorded correctly in his file. Staff are now ensuring that a seizure chart is in place in his file and all seizures are recorded. The resident also saw a specialist on 15th July 2005, which resulted in his medication being increased. One member of staff was spoken to formally in the office about how she supports residents with resident’s personal care. She stated that she constantly speaks to the resident in a dignified manner to reassure them. She went on to say that she talks to the resident about the way in which the personal care is being carried out. She also said that she has a good understanding of each resident’s personality and encourages the resident to choose their own clothing as much as possible, giving support and guidance when necessary. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 14 The Medication Administration Record (MAR) sheet for all residents was viewed. On two consecutive days staff had failed to sign the (MAR) sheet and no explanation was given on the back of the sheet. On looking in the medication cabinet, the resident had received the medication. A requirement is made that the registered providers ensure that the administration of all medication is signed for on the (MAR) sheet and any non-administration coded as to the reason why the medication was not administered. A requirement has been made at the previous two inspections that residents, their family or representatives wishes be sought in the event of the resident becoming terminally ill and dying. This has not been completed. This requirement is restated. Grindleford Avenue 2 DS0000010447.V251495.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): 22 and 23. Although staff have received training in the protection of vulnerable adults, they are not ensuring that complaints made, especially by residents, are taken seriously enough and that the correct policies and procedures are followed. EVIDENCE: Although it was made a requirement at the previous inspection, the home still has no formal complaints book/file in place. One complaint has been made since the previous inspection but has not been recorded in a complaints book/file. This requirement is restated and revised in that the registered persons must ensure that a complaints book/file is created, which records the actual complaint, the investigation and the outcome. The home has in place, the London Borough of Barnet’s Multi Disciplinary Agency Adult Protection Policy and Procedure file. The home’s training overview document indicates that all staff have received adult protection training. Grindleford Avenue 2 DS0000010447.V251495.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 and 30. Although the majority of the home is clean and tidy, staff are not ensuring that all areas of the home are free from offensive odours. EVIDENCE: The staff team have ensured that the home is kept generally safe, comfortable and homely. One resident spoken to said that she was ok and that she was comfortable living in the home. However, one resident’s bedroom had a strong smell of urine. The kitchen lino was damaged and stuck down with tape, which was worn and damaged. A requirement is made that the registered persons ensure that the identified resident’s bedroom is free from offensive odours and the kitchen lino is repaired or replaced. The home has a dedicated cleaner who ensures that all areas are generally clean and tidy. The home has its own laundry room. The washing machine has its own sluicing programme. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 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): 33, 34, 35 and 36. Residents are confident that the staff working in the home are fully trained and competent to meet their needs and that the staff are receiving supervision to monitor their personal development but residents are not confident that the registered providers are following the correct recruitment procedures, which is designed to ensure the safety of everyone in the home. EVIDENCE: The staff rota shows that there are at least two staff on the early and late shifts. Four staff files were viewed and each contained various training certificates. Most of the staff have worked in the home for many years. Staff on duty were indirectly observed interacting in a professional manner towards the residents. According to the manager, the identified member of staff who had unexplained gaps in her employment history at the previous inspection has now left. On looking through other staff files, the manager noticed that two other staff also had unexplained gaps in their employment history. A requirement is made that the registered providers ensure that a full written and signed explanation is obtained from the identified staff members and a copy retained in their file for inspection. The four staff files viewed, showed a variety of training certificates. The staff training overview sheet indicates that staff have received the necessary Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 18 training required for the work that they do and to ensure that they can meet all of the needs of the residents. The manager is ensuring that all staff working in the home receive regular recorded supervision. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 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): 37, 40, 41 and 42. Residents are confident that the manager has the skills and experience to manage the home and meet its aims and objectives. However, residents, staff and visitors are being put at risk because staff are not ensuring that all necessary safety tests are carried out and a certificate obtained. EVIDENCE: Although relatively new in the post, the manager has been managing various services since 2002. Certificates in his file show that he has successfully completed his National Vocational Qualification level 4 (NVQ), is a qualified counsellor and has an (NVQ) assessor award. The home has various policies and procedures, which are kept in the office where residents and staff have access to them when required. The manager stated that all residents and staff would be involved in developing policies and procedures. Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 20 All records, especially confidential information regarding residents and staff are kept securely in the office. The home has in place a fire safety and fire risk assessment manual. All fire tests are carried out regularly and a record kept of the outcome. Fire alarms are tested weekly from a different call point and the last fire drill took place on 15th October 2005. The last London Fire and Emergency Planning Authority (LFEPA) inspection took place on 3rd January 2002, no contraventions were identified. A legionella test was carried out on 7th September 2005. The manager could not locate the Portable Appliances Test (PAT) certificate nor could he locate the Gas inspection certificate. A requirement is made that the registered providers must ensure that a (PAT) test and gas inspection is carried out and a copy of both certificates are forwarded to the Commission. Grindleford Avenue 2 DS0000010447.V251495.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 2 3 X 3 Standard No 22 23 Score 1 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 2 1 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Grindleford Avenue 2 Score 3 x 1 1 Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 2 3 DS0000010447.V251495.R01.S.doc Version 5.0 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 YA2 Regulation 14(1), (2). Requirement The registered persons must ensure that assessments are carried out regarding the care needs of each resident. The registered persons must ensure that residents are supported to make decisions about their lives and that the information is recorded. The registered persons must ensure that residents are consulted and participate in all aspects of life in the home and that the information is recorded. The registered persons must ensure that resident’s risk assessments are reviewed and updated regularly. (Timescale of 27/05/05 not met). This requirement is restated. The registered persons must ensure that a review of meals provided in the home is undertaken in consultation with residents and a record kept of the outcome. The registered persons must ensure that the administration of all medication is signed for on the MAR sheet and any nonDS0000010447.V251495.R01.S.doc Timescale for action 02/03/06 2 YA7 12(2, 3). 02/03/06 3 YA8 12(2,3). 02/03/06 4 YA9 13(4)(b). (14) 02/03/06 5 YA17 16 (2) (i) 02/12/05 6 YA20 13 (2) 28/11/05 Grindleford Avenue 2 Version 5.0 Page 23 7 YA21 8 YA22 9 YA24 10 YA34 11 YA42 administration coded as to the reason why the medication was not administered. (Timescale of 27/05/05 not met). This requirement is revised and restated. 12 (2) The registered persons must ensure that in the event of a resident becoming terminally ill and dying, that their wishes are recorded. (Timescale of 03/06/05 not met). This requirement is revised and restated. 22 The registered persons must (1,2,3,5,8) ensure that a complaints book/file is in place in the home, which includes details of the complaint, the investigation and the outcome. (Timescale of 27/05/05 not met). This requirement is revised and restated. 16(2)(k). The registered persons must 23(2)(b). ensure that the identified resident’s bedroom is free from offensive odours and that the kitchen lino is repaired or replaced. 18 (1) (a) The registered persons must ensure that a full written and signed explanation is obtained from the identified staff members regarding unexplained gaps in their employment history and a copy retained in their file for inspection. (Timescale of 27/05/05 not met). This requirement is revised and restated. 23 (2) (c) The registered persons must ensure that a Portable Appliances Test (PAT)and gas inspection are carried out and certificates obtained. 02/03/06 02/12/05 02/12/05 02/12/05 02/12/05 Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 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. Refer to Standard Good Practice Recommendations Grindleford Avenue 2 DS0000010447.V251495.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate 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. 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