Inspection on 26/06/06 for Hall Road

This inspection was carried out on 26th June 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hall Road 12/06/08

Hall Road 12/06/07

Hall Road 30/11/05

Hall Road 10/05/05

Hall Road 10/02/05

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 Hall Road 7 Hall Road Wallington Surrey SM6 0RT Lead Inspector Deborah Yapicioz Key Unannounced Inspection 26th June 2006 09:30 Hall Road DS0000060793.V296655.R02.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 Hall Road DS0000060793.V296655.R02.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. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hall Road Address 7 Hall Road Wallington Surrey SM6 0RT 020 8254 9895 020 8669 1288 hall@independencehomes.co.uk 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) Independence Homes Limited Susan Jane Parish Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Bedroom 7 is for the use of a service user in a wheel chair only. Date of last inspection 30th November 2005 Brief Description of the Service: 7 Hall Road is a large, detached house situated in a residential road in Wallington, fairly close to local shops and local transport links. Hall Road is registered with the Commission for Social Care Inspection to offer care and support to service users between the ages of 18-65 with epilepsy and severe learning disabilities. The home opened in July 2004. The registered provider is Independence Homes limited. Care and accommodation is provided on the ground and first floors with the second floor providing office space and staff facilities. The home also has a garden to the rear of the property. The home has their own transport in the form of one wheel chair accessible vehicle and another standard vehicle. The registered providers have installed a lift and other environmental adaptations to ensure the home meets the needs of the service users. The scale of charges at the time of the inspection ranged from £2,800 to £3,200. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. The inspection was unannounced and began at 9.30 on 26th June 2006. Hall Road has a new manager since the last inspection. Mr John Ogbe facilitated the inspection. The service users at the home have limited communication skills, which restricted the way that service users could be involved in the inspection process, the staff team have built up a good relationship with the residents and use that knowledge to advocate on their behalf. Other methods of inspection included a tour of the premises, observation of contact between staff and service users and discussions with staff members, the home manager and the admin manager. Records examined included service user plans, care manager assessments, risk assessments, medication records, complaints, staffing records, health and safety and fire records. The home manager had completed a Pre Inspection Questionnaire. The inspector would like to thank the service users, the staff team and Mr Ogbe for their help in facilitating the inspection. What the service does well: The home has an effective admissions procedure and service users are only admitted to the home once a full assessment of their needs is completed. Information is taken from a range of sources. The home manager explained that any prospective service user would have a gradual introduction to the home with a series of short visits and overnight stays. The time frame would be flexible depending on the service user. The home offers one to one staffing and there are a wide variety of activities both in the home and in the community. The home uses therapists who work alongside the staff team at the home to devise individual programmes for the service users. The home also employs a nutritional therapist who works along side the cook to provide a balanced diet that takes into account the various needs and intolerances of each individual service users at the home. For example many foods including tomato sauce are made “from scratch” to avoid any items that the service users are allergic to. The staff team were observed to treat service users with dignity and respect during the inspection. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 6 What has improved 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. Hall Road DS0000060793.V296655.R02.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 Hall Road DS0000060793.V296655.R02.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): 1,2,4,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides introduction opportunities for prospective service users and their families to make an informed choice about moving to the home, however a statement of purpose and a service users guide is not yet generally available. EVIDENCE: The home is part of the “Independence Homes” group and the inspector was informed that the company has nearly completed the process of devising a corporate service users guide for all the homes in the area. This will also include information relevant to individual homes. The home is also compiling a statement of purpose, as there have been changes in the management structure of the home. Service users are only admitted to the home once a full assessment of their needs is completed. The home manager explained that any prospective service user would have a gradual introduction to the home with a series of short visits and overnight stays. The time frame would be flexible depending on the service user. Although the home has had no new service users since the last inspection, the service users files looked at during the inspection all contained in depth assessments completed by care managers before the service users moved into the home. The home manager confirmed that cultural and religious issues were also discussed at the time of referral to the home and ways of meeting these needs Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 9 would be included in the service users care plans The organisation also has a pre-assessment format. There has been some progress in implementing contracts between the home and service users a draft format has been sent to the Commission for Social Care Inspection, Croydon office for consultation. The home collectively has a range of experience and skills amongst its staff group in order to deliver the service. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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): 6,7,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have comprehensive individual care plans with good information on their needs and personal goals. Individual care plans are regularly updated to reflect current needs. EVIDENCE: Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 11 The service users individual needs are regularly assessed. Each of the service users has an individual tailored care plan, known as Fundamental Care Plans. The care plans are on the service users file and is a record of their aims and goals as well as their achievements. These plans cover all aspects of care, such as the client’s physical skills, their communication ability, self-care skills, health, behavioural issues and community living skills. Information is also available in respect of service users’ preferred likes and dislikes and any dietary needs. The home also has a daily file for each of the service users with a copy of the care plan, seizure protocols, dietary needs and the service users individual timetable in it as well as other relevant day-to-day information. Staffing is provided on a rotating one to one basis. The staff member worker with the service users for that session make a record of the activities undertaken and any other relevant information, which is used as a monitoring tool. The home also keeps a checklist of bed alarms etc on the service users records. The service users have all had recent reviews and a record of reviews are kept on the service users files. The home has a confidentiality policy Information is kept in the office, and is locked away when the office is not in use. In discussions with a member of staff, she had a clear understanding of the elements of confidently and how to put it into practice. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users at the home are offered the opportunity to engage in age appropriate activities with an emphasis on using community based facilities. The service users have a varied programme of social activities organised by the staff team to reflect service users individual interests. The daily routines and house rules promote residents’ rights and encourage independence. The home has an open visitors policy to ensure friendships and family links are maintained. EVIDENCE: The staff team at the home encourage service users to remain in contact with family and friends who can visit regularly. Family and friends are made aware of the home’s visiting policy and there are few restrictions about when people can visit. Some service users also have regular weekend visits with their parents. The home has a key worker system and it is part of their role to keep parents and carers informed of their progress. Activities are provided on a one to one level. The staff team work with the service user group on a rotation basis. There is a strong emphasis on service users using the community and the home has two vehicles. The service users Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 13 also have a bus pass. The activity programmes are initially based on the original assessments completed during the induction process. Once a service user moves into the home activities are developed depending on needs and goals. The service users timetables demonstrated that they access a range of activities including trampolining, bike riding, bowling and swimming. The home employs several therapists who work alongside the staff team at the home to devise individual programmes for the service users. These include an occupational therapist, music therapist, reflexologist, complimentary therapist, physiotherapist, nutritional therapist and a psychologist. Each service user has a copy of their timetable in their rooms as well as on their files. The home manager informed the inspector that some of the service users at the home have particular dietary needs such as “gluten free” or “dairy free” meals. To this end the home employs a nutritional therapist who works along side the cook to provide a balanced diet that takes into account the various needs of each individual service users at the home. For example many foods including tomato sauce are made “from scratch” to avoid any items that the service users are allergic to. The home manager told the inspector that there has been a drop in the number of seizures and challenging behaviour in some service users since they moved into the home. Each of the service users has an individual menu. The nutritional therapist employed by the home “agrees” the menus with the cook. They are very detailed information with any food intolerances taken into account. The staff team at the home have had training to improve their knowledge of why some service users have a particular diet Some of the service users also take food supplements, which are prescribed after detailed background information and relevant information has been gathered. The home manager explained that the staff team are in the process of organising holidays with the service users. Some of the destination suggested is Tenerife, Blackpool, Disneyland (Paris) and Centre Parcs. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consist care in this area. Residents’ medication is well managed to ensure good health. EVIDENCE: The home has a policy on the receipt, recording, storage, handling, administration and disposal of medication. It is the homes policy that all medicines administered are recorded on Medicine Administration Record Sheets. The home uses a “nomad” system for medications. As part of their induction staff at the home attend a “familiarisation” course, which includes medication training. All of the staff team are trained in the administration of rectal Diazepam. The home has a pictorial reference file for each medication as a memory aid for the staff team. The service users all need assistance with their personal care. The service users have all had manual handling assessments and risk assessments. There are hoists, overhead tracking, specialist baths and handrails in place to assist with manual handling. The staff team at Hall Road have all had instructions on manual handling, which forms part of the induction and is, followed up by mandatory training. The level of support a service user needs would be detailed at review meetings and their preferred routines are set out in their individual Plan. Personal care is provided in private, and timings of this are Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 15 flexible. Issues around respect and privacy are discussed with staff members as part of the induction process. When a new member of staff starts working at Hall Road they have to “Shadow” a more experienced member of staff. All of the service users are registered with a General Practitioner. Seizure activity is monitored and reported to the homes director of care. The home manager stated that he meets with the director of care on a monthly basis as well as sending a report. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The home has a clear complaints policy, which includes the timescales and the process of the investigation. The home has had one complaint in the last twelve months, which was appropriately investigated and recorded. The home has a copy of Sutton’s Vulnerable Adults Policy and Procedures. The Staff team spoken to during the inspection were aware of the complaints procedure and the adult protection policy and were aware of the need to report any incidents. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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): 24,25,27,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general décor of the home is good providing a comfortable, clean and safe environment for service users to live in. Service user’s bedrooms provide privacy and reflect individual interests and preferences. EVIDENCE: 7 Hall Road is a large, detached house situated in a residential road in Wallington, fairly close to local shops and local transport links. The house is indistinguishable from any other in the road, and is suitable for purpose. On the day of the inspection, the home was comfortable, bright, well ventilated and free from offensive odours. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 18 Care and accommodation is provided on the ground and first floors with the second floor providing office space and staff facilities. The home has a sensory room and therapy rooms as well as a communal lounge and dining room. There is a cellar, which is used for storage. The home also has a garden to the rear of the property. All seven bedrooms meet the minimum standards with regards to size six bedrooms have ensuites, which consists of toilets and wash hand basins. One bedroom does not have an ensuite. It is a condition of registration that this bedroom is only used by wheelchair user (where a normal sized ensuite would not be suitable). A disabled toilet and bathroom are close to the bedroom just along the corridor. There is also a Parker bath on the first floor and a bath with a bath lift on the ground floor. Each of the service users bedrooms has been individualised according to their interests. The registered providers have installed a lift and other environmental adaptations such as ramp to the front and back doors as well as hoists, to ensure the home meets the needs of the service users. Environmental risk assessments have been completed for areas such as the ramp. The home was clean and tidy at the time of the inspection. The home has appropriate laundry facilities separate from the kitchen and the preparation of food. The washing machine is capable of washing clothes at high temperatures, which helps with the control of infections. The laundry has suitable flooring. There is a locked cupboard for the Control of Substances Hazardous to Health products in the laundry room. The home has policies and procedures on the disposal of clinical waste. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home The staff team have all had Criminal Records Check, as a safeguard to offer protection to the homes service users. EVIDENCE: As mentioned before the staffing at the home is provided on a one to one basis. This is done on a rota basis and the home manager explained that this is so that each staff member can be aware of the care needs (and character) of each individual service user. Staff records looked at during the inspection confirmed that staff files contained job descriptions, proof of identity, written references, terms and conditions of employment and all information required under the standards. The job descriptions for staff at the home staff clearly states what is expected of its employees in terms of their roles and responsibilities and the values that should underpin their conduct Criminal Records Checks are completed before a new member of staff can begin work in the home. The home has a rolling programme of staff training in place including LADAF, fire safety, adult protection and Non Violent Crisis Intervention. The details of any training coursed attended are kept on the staff files. A supervision structure is in place with three of the seniors as well as the manager undertaking supervision sessions. However on the day of the Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 20 inspection the number of staff supervisions undertaken were less than what is required under the national minimum standards. The manager explained that this was probably due to the change in management this will be monitored at the next inspection. Handovers occur at the start of each shift and the home has regular staff meetings, which are recorded. The staff members spoken to felt they worked well as a team and would have no difficulties approaching the manager and senior members of the staff tram if they needed to. The staff team were observed to treat service users with dignity and respect during the inspection. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style appears to be transparent with clear lines of accountability. In the main health and safety arrangements are in place to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised. EVIDENCE: Hall Road has a new manager since the last inspection. Mr John Ogbe has been managing the home since 6th March 2006 and has registered with the Commission for Social Care Inspection. Records required for the safety and well being of service users are in place including accidents, water temperatures, complaints, incidents, food records, staff and service users case files, medication records and so forth. Administration and record keeping at this home is generally of a good standard. All staff must attend mandatory health and safety training including moving and handling. The home has a health and safety policy in place. Environmental risk assessments are in place. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 22 A first aid box and a fire blanket are situated in the kitchen. There are fire extinguishers throughout the house. Coloured chopping boards and knives were seen in the kitchen. Health and safety law posters issued by the health and safety executive were on display. A representative of the registered provider visits the home regularly and copies of the visit report are sent to the Commission for Social Care Inspection Corydon office. Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 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 Standard No Score 1 2 2 3 3 X 4 3 5 2 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 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA1 YA36 Regulation Sch 2 18 (2) Timescale for action Th home manager must ensure a 30/11/06 statement of purpose and service users guide is in place. The home manager must ensure 30/11/06 that all staff receives regular recorded supervisions. Requirement 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 Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Hall Road DS0000060793.V296655.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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