CARE HOME ADULTS 18-65
Haddon House 145 West Heath Road West Heath Birmingham West Midlands B31 3HD Lead Inspector
Joe O`Connor Unannounced Inspection 8th December 2005 10:00 Haddon House DS0000016889.V270683.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 Haddon House DS0000016889.V270683.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. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Haddon House Address 145 West Heath Road West Heath Birmingham West Midlands B31 3HD 0121 475 1681 0121 475 1681 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) Haddon House Limited Mr Christopher Higgins, Ms Susan Newton Ms Joanne Tuke Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 27th June 2005 Brief Description of the Service: Haddon House is a large detached house situated in the West Heath area of Birmingham. It is situated along a service road adjoining the main West Heath Road. The home has six single bedrooms, two of which are on the ground floor and four on the first floor all of which have en-suite facilities. The lounge and dining room are to the rear of the premises. A toilet and shower room are situated on the ground floor. There is a bathroom on the first floor with a grab rail. There are two cars on the front driveway and access to the house is via sloped wooden decking area. There is a well maintained rear garden that also benefits from a wooden decking area that is covered over. This provides an attractive seating area for service users. A sloping ramp leads to a further small patio area and lawn. There is a range of garden furniture for the service users to use. The home has two cars enabling service users to access local facilities and Birmingham City Centre. Local amenities such as shops, banks and the GP practice are close by and the home has good transport connections via bus and rail services. The home is registered to provide personal care and accommodation to a maximum of six adults who have a mental disorder. The home provides three meals a day and is staffed on a twenty four hour basis. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a day. Two service users were present and were able to convey their views on life in the home. A tour of the premises was undertaken. Service users care plans and risk assessments were inspected. Staff recruitment and training records were also sampled. A number of health and safety records were examined. The Inspector spoke to one member of staff, a visiting social worker and the Registered Manager. An observation of care practice was also undertaken. What the service does well: What has improved since the last inspection?
The manger has addressed all but one of the requirements from the previous inspection. A sample of service users care records confirmed that service users’ weight was being documented on a monthly basis. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 6 Improvements have been made to the staff rota, which means there is clear information to show, who is on duty during the day and the hours worked by the staff. Since the last inspection the manager has introduced training at NVQ Level 1 in Basic Cleaning for a number of staff so they have a greater awareness about maintaining good hygiene in the home. An examination of the staff training records found that staff had completed updated training in food hygiene and infection control. The service users had managed to go on a holiday of their choice to Minehead but unfortunately they only partly enjoyed the holiday as two service users thought the accommodation was very basic and not to their liking. An examination of the fire safety records confirmed that staff had completed fire awareness training since the last inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Haddon House DS0000016889.V270683.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 Haddon House DS0000016889.V270683.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 Service users are only admitted to the service with assessments completed by qualified professionals identifying specific needs and requirements. The needs of the current group of service users are met through the maintenance of detailed records with positive, friendly staff support. EVIDENCE: The service has so far only been accommodating four service users. The manager stated there had been a lack of referrals from Birmingham Social Care & Health due to a lack funds. The manager had received one referral from an outside Local Authority and provided copies of information provided by the referring agency, which was an NHS psychiatric unit. The information seen was a nursing assessment and care plan completed by a Community Psychiatric Nurse. Because of the lack of referrals within the local mental health services the manager discussed the possibility of looking at applying for a variation to her registration category to accommodate service users with a dual diagnosis of mental health and learning disability. The manager has had a wide range of experience within learning disability services as well as mental health and two members of staff had undertaken training towards the Learning Disability Award Framework. One service user had been accommodated with the service since the last inspection and had previously lived there before being admitted to a psychiatric unit two years ago. An examination of the individual’s file found there were care plans and assessments completed by a social worker through
Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 9 the Care Programme Approach (1983 Mental Health Act). There was also evidence that the manager had completed an initial assessment covering most aspects of the service user’s daily living activities. Two service users were able to provide some comments about life in the home. One commented” We have our ups and downs but this is the best place for me much better than being in hospital”. Another commented, “Staff are alright to me but being the youngest means sometimes I get too much attention as if I am a child”. This service user had returned from college and reported to the manager that she and another student were being bullied by other students while waiting for the bus. The manager was observed to contact the college to find out what had happened and the service user was satisfied with what action had been taken. At the time of this inspection the service users appeared relaxed and dressed in clothing that was appropriate for the climate of the day. At the time of this inspection a visiting social worker was asked to contribute their views about the service. The social worker commented, “ I wish there were more places like Haddon House”. “The manager leads by good example and along with the staff understand the needs of the service users”. The social worker also stated that any concerns raised with the manager would be followed up. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Service users are encouraged to make decisions about their lives through service users meetings but these do not occur every month. How service users needs are met are detailed in care plans covering all aspects of their daily living activities. Service users have written individual risk assessments covering any issues around their vulnerability and limitations on their independence. EVIDENCE: Three service users’ care plans were sampled and these were detailed covering all aspects of their daily living activities. One service user’s care records confirmed she was part of the Care Programme Approach under the 1983 Mental Health Act and had an Enhanced Care Programme care plan. This is coordinated by mental health professionals including a Social Worker, CPN, and Consultant Psychiatrist. One care plan referred to one service user’s requirement that they must avoid sugary foods. Another care plan identified the service user’s likes and dislikes with their meals. A service user was asked if she had a care plan and stated there was one that was written in conjunction with her keyworker. The care plans had been reviewed since the last inspection.
Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 11 Discussion was held with a service user and a member of staff who said the service users were able to choose what they wanted to eat and when they get up and go to bed, apart from when they go out during the week. An examination of the daily records indicated service users were able to have a lie in during the weekend. One service user stated she was involved in interviewing for new staff since the last inspection. The member of staff who had been interviewed was on duty at the time of this inspection and confirmed which service user had been involved in his job interview. Service users are involved in making decisions about their life in the home. They are involved in meetings to discuss future activities, changes to menus and when arranging their holiday. Minutes seen from these meetings indicated that the meetings were not always held every month. Risk assessments were in place that covered topics such as prevention of falls along with other risk assessments covering other areas of vulnerability. For example a risk assessment had been developed for one service user who tends to spend long periods away from the service. There was step by step guidance in place to inform staff what they should do if the service user did not return to the service by a certain time. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 17 Service users are given opportunities for personal development through accessing appropriate community resources with support from staff. Service users access leisure activities that are appropriate for their age and lifestyle. Good relationships are maintained between service users and their families as part of their well being. A variety of wholesome and nutritious meals are available to service users meeting their daily dietary requirements. EVIDENCE: Two service users’ records sampled demonstrated each service user had a weekly programme of activities. One service user said she attends college during the week to do flower arranging and was pleased to show an example of a display she had recently completed. The service user was disappointed that a course for Indian head massage had been cancelled because of a lack of interest. Another service user also goes to college to do gardening, art and computers. She showed examples of Christmas cards made by herself. Both service users stated they were able to participate in shopping for food and were able to choose what they want off the shelves. The service users had gone on holiday during the summer to Minehead but did
Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 13 not enjoy this chiefly due to the poor standard of accommodation. An examination of the daily records indicated service users have participated in trips out to Dudley Zoo, Warwick Castle, the Cotswolds, pub lunches and the cinema. The records also confirmed service users were able to maintain contact with their relatives with two service users who spend time away from the service to be with their families. An examination of the menus confirmed service users had access to a varied and nutritious diet. The food cupboards, fridges and freezers were well stocked with foodstuffs brought through reputable suppliers. Service users are supported by staff to communicate their feelings and wishes. They have access to a qualified counsellor who involves them in alternative therapies including Tai Chi exercises and Reiki Therapy. These are designed to assist the service users in reducing any anxieties. Service users are able to receive one to one support where they can “ventilate” any concerns and anxieties. Service users are also encouraged to be independent and they are able to make drinks and manager their laundry. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 Service users are able to access community and specialist primary healthcare services through good recording systems. Medication management requires some improvement to maintain and promote service users’ good health. EVIDENCE: An examination of service users’ care records indicated their healthcare needs were generally being addressed. Each service user is registered with a GP and there was evidence where service user had contact with local primary healthcare professionals including a dentist and optician. At the time of this inspection one service user was receiving a visit from a District Nurse who was monitoring her blood levels due to the individual having diabetes. There was evidence on the service users’ records to confirm where they been seen by specialist health professionals including a Community Psychiatric Nurse and Consultant Psychiatrist. Service users weight was being recorded on a monthly basis. This was a requirement from the previous inspection. One service user’s care plan identified specific goals for a reduction to a target weight and the monthly weighing record confirmed the service user was making good progress. A service user stated she had recently been seen by her GP to have a test to check her levels of cholesterol. The management of medication was good but some improvements were required. There was no written protocol in place for one service user who
Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 15 required Chlorpromazine and Zopiclone PRN or as required and the manager must take action to address this. An examination of staff training records confirmed they had completed medication training with Boots and in the Safe Handling of Medicines Course provided by Solihull College. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 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 the following standard(s): 23 Service users personal allowances are managed appropriately protecting their interests. EVIDENCE: Standard 22 was not assessed in depth but neither the service nor the Commission have received any complaints since the last inspection. One service user stated she would be able to go to the manager if she had any complaints. A picture of the Inspector was on display in the hallway. An examination of service users personal allowances found each service user had their own personal allowance record that included information of monies coming in what had been spent and for what purpose. Receipts were maintained for individual expenditure. Two signatures were in place for each transaction. Each service user had individual bank accounts. A new member of staff provided satisfactory responses that they would be able to challenge poor practice and report any incidents to manager, and was aware of procedures for reporting abuse. The manager has a new copy of the Multi Agency Guidelines published by Birmingham City Council. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 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 the following standard(s): 24, 26, 27, 28, 29, 30 The premises is cleaned and maintained to an acceptable standard providing a homely, comfortable and accessible environment for service users. Service users have access to suitable bathing and toilet facilities that meet their current needs. Appropriate practices are in place for the control of infection maintaining service users health and well being. EVIDENCE: A tour of the premises was undertaken at the time of this inspection. The building was clean, tidy and smelt fresh. There is a comfortable lounge that is furnished to a high standard. Next to the kitchen is a separate dining room. There are adequate toilet and bathing facilities on the first floor with a toilet downstairs. Not all service users bedrooms were viewed but one seen was decorated and furnished to reflect their individual lifestyle that included photographs, DVD player, TV and stereo. The service user stated she had an en-suite facility, which had a shower and spoke of how much she liked her bedroom. No measurements were taken of the sizes of the bedrooms but they appeared to meet the spatial requirements. There is a separate laundry area with a washing machine and tumble dryer. Staff. There are appropriate facilities for the removal of clinical waste and
Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 18 there are procedures for the control of infection. Disposable towels and liquid soap is available in the toilet and bathroom. At the time of this inspection the service users were observed to be able to move freely around the premises. There is level access to the front entrance. Grab rails are in place in the bathroom upstairs. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Service users are supported by staff that are competent and qualified to meet their needs. Current staffing levels meet the needs of service users providing consistency of care. Staff recruitment records meet the requirements of the regulations ensuring the protection of service users. Staff are offered and provided training enabling them to undertake their duties in meeting the needs of the service users. EVIDENCE: Staff were observed to provide positive and friendly support towards the service users. One staff member who had recently commenced employment with the service was able to provide satisfactory answers to questions around service users’ daily routines. The levels of staffing at the time of this inspection were found to be adequate at the time of this inspection. The manager had addressed a requirement from the previous inspection for the staff rota to clearly state the hours worked by staff and the manager. One member of staff had been dismissed since the last inspection over issues relating to their performance. As the service does not have a full capacity of service users the post for team leader has not been recruited to. The manager has taken action to address a requirement from the previous action for staff to receive updated food hygiene training and infection control.
Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 20 Evidence was seen from a training matrix developed by the manager. Two staff had completed NVQ Level 1 in basic cleaning. Two members of staff and the manager were completing A1 training previously known as the NVQ Assessors Award. Two members of staff were undertaking training towards the Learning Disability Award Framework. Two staff were completing NVQ Level 2 while one was recently registered for this level of training. The manager stated that updated training in Health and Safety and challenging behaviour was being arranged along with awareness of mental health for new staff. One staff recruitment record examined for a new member of staff was found to have all the required documentation including a job application form, contract, job description, two references, CRB check and proof of identity including a photograph. There was also a record of induction and staff risk assessment. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 21 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, 38, 39, 40, 41, 42 Service users live in a home that is run by a competent and organised manager who is keen to improve and update her practice. There is a friendly and relaxed atmosphere benefiting service users and staff. The care records were generally up to date but some improvements are required to maintain good practice. The welfare of service users is promoted and maintained with minor improvements required. Service users and staff are able to provide comments about the management of the service to a visiting representative of the service. The service has a range of policies and procedures that reflect current practice and safeguard service users’ interests. EVIDENCE: The Registered Manager had addressed the majority of the requirements from the previous inspection. She was able to demonstrate an understanding of the needs of the current group of service users. Comments and suggestions made were received positively. The atmosphere was relaxed and friendly which the service users appreciate. One service user stated she would be able to approach staff and the manager if there were any concerns. The new member of staff stated he looked forward to coming into work every morning.
Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 22 A representative from the organisation visits the service every month and reports for these visits indicated that service users and staff were able to contribute their views about the management of the service. The service has a range of policies and procedures and these were viewed and signed by staff to confirm they understood their content and relevance in their work. The records were found to be generally up to date and locked in a secure facility. However when examining the care records for service users there were gaps in recording where some risk assessment documentation did not always have the service user’s name nor the date of when these had been completed. The manager must ensure these are checked on a regular basis to maintain good practice in record keeping. Records with regard to health and safety were satisfactory. An examination of the fire safety records confirmed the fire alarm was being tested every week and the emergency lighting tested every month. A fire drill had occurred prior to this inspection. Training in fire safety had occurred since the last inspection. A risk assessment was in place for the prevention of fire. A requirement for the hard wiring of the premises to be inspected and tested had not been addressed. The accident book was examined and it was noted three had occurred since the last inspection. However, two of these had not been reported to the Commission via Regulation 37 notification, although other incidents affecting the welfare of service users have been notified to the CSCI. Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 23 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 N/A 3 3 3 N/A Standard No 22 23 Score N/A 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 2 3 N/A Standard No 24 25 26 27 28 29 30
STAFFING Score 3 N/A 3 3 3 3 3 LIFESTYLES Standard No Score 11 N/A 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score N/A 3 3 3 3 N/A CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Haddon House Score N/A 3 2 N/A Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 2 2 N/A DS0000016889.V270683.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA8 YA20 Regulation 12(3) 13(2) Requirement Timescale for action 08/02/06 3. YA41 17(2) Sch 3 4. YA42 13(4) 23(2)(c) The Registered Person must ensure service users meetings occur on a monthly basis. The Registered Person must 08/01/06 ensure written protocols are in place for service users using PRN medication. The Registered Person must 08/01/06 ensure gaps in service users care records are completed and checked regularly to maintain good practice in record keeping. The Registered Person must 08/01/06 ensure that the hard wiring for the premises is inspected to confirm its worthiness. Outstanding Requirement. Timescale 27 July 2005 not met. 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 Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Haddon House DS0000016889.V270683.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!
