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Inspection on 04/01/06 for Harelands House

Also see our care home review for Harelands House for more information

This inspection was carried out on 4th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Each service user who comes to stay at Harelands House has very different needs and the care and support they are given by the manager and staff team is of a high standard. The 3 service users spoken to said they liked the staff that worked there and that they looked forward to their visits to Harelands House. The care plans are good because they set out everything about each person in detail saying what they need help with and what they can do for themselves. They also said what the person liked and didn`t like. The service users are supported by the staff, to keep in touch with their families, carers or friends if they choose to do so during their stay. The home is very good at checking out with other people, e.g. parents and the service users themselves, what they think about the service.

What has improved since the last inspection?

A fly screen had been fitted in the kitchen to stop insects coming into the house when the windows were open. All but the newest staff had done training in how to make sure service users were treated properly (Protection of Vulnerable Adult training). The new staff will be doing this training as soon as it can be arranged.

What the care home could do better:

Before coming to stay at Harelands House, service users admitted quickly were not always assessed, which could mean the home may not be able to care for them properly.The staff files did not all have letters on them, from places where they had worked before coming to Harelands House, saying they were able to do their jobs properly (references).

CARE HOME ADULTS 18-65 Harelands House Samson Street Belfield Rochdale OL16 2XW Lead Inspector Jenny Andrew Unannounced Inspection 4th January 2006 13.30 Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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 Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Harelands House Address Samson Street Belfield Rochdale OL16 2XW 01706 651712 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) Rochdale MBC Debra Jayne Wild Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 5 service users to include: up to 5 service users in the category of LD (Learning Disabilities under 65 years of age). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home can accommodate the brother of a service user already booked in for respite care, in the ground floor adapted bedroom, providing that the number of service users does not exceed five (5) in total. 3rd August 2005 Date of last inspection Brief Description of the Service: Harelands House, which is owned by Rochdale MBC, offers short-term support accommodation for up to 5 service users over the age of 19 years, with a learning disability. The service aim is to provide respite to parents/carers of people who are cared for in their own home, to enable them to maintain their role as carers. The home is adapted to meet the needs of profoundly disabled individuals. Four beds are for short-term respite care and 1 bed is for emergency placements. Lengths of stay vary dependent upon need, but the service is available 52 weeks a year. An outreach service is also provided. The bedrooms are single and have en-suite facilities. The home is situated close to local shops, pub and public transport. A safe enclosed garden area is provided which is accessible by people reliant upon wheelchairs. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 3 hours. At the time of the visit, three service users were on planned short stay breaks and two people had come in due to emergency situations. The Inspector looked around parts of the building and checked care plans and some records. In order to get information about the home, the manager, 2 support workers and 3 service users were spoken to. As one service user was not able to speak, the Inspector watched how they made their needs known to the staff. What the service does well: What has improved since the last inspection? What they could do better: Before coming to stay at Harelands House, service users admitted quickly were not always assessed, which could mean the home may not be able to care for them properly. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 6 The staff files did not all have letters on them, from places where they had worked before coming to Harelands House, saying they were able to do their jobs properly (references). 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. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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 Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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 Service users placed at Harelands House in an emergency do not always have assessments undertaken and without such assessments there are no assurances that their care needs will be able to be met. EVIDENCE: All new referrals are made via Rochdale MBC care management team and it is usual for the potential service user’s care manager to complete an assessment of need, identifying the individual’s service requirements prior to their first visit. The family carers’ interests and needs are taken into account during this process and parental signatures were seen on risk assessment documentation. On this inspection, it was identified that for one service user, admitted in an emergency, there was no assessment undertaken. In such situations, it is expected that as soon as possible after admission i.e. no longer than 48 hours, a full assessment is done to ensure the placement is suitable and able to meet their identified needs. In this instance there was however, a lot of information passed over, from their previous placement, which the manager had utilised when developing a support plan. Upon speaking to this service user, it was identified that his needs were being well met and he was clear that the placement was only on a temporary basis until more appropriate arrangements could be made. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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 There was a clear, consistent care planning and risk assessment process in place to ensure staff were provided with the information they needed to meet the needs of the service users. Staff supported and enabled service users to take control of their own lives, as far as possible, within the constraints of risk assessments. EVIDENCE: As the individuals using the service have very diverse needs and abilities, it is essential that as much information as possible is obtained in order to ensure their normal preferred routines are adhered to throughout their stays. The care plan document was entitled “Listen to Me” and was a simplified version of a person centred plan. It was user friendly, explicit and identified each service users likes/dislikes, personal care/medical needs, routines and interests. When compiling the plan, service users and/or carers had been fully involved and consent forms had also been signed with regard to treatment and outside activities. In addition to the care plan there was a pen picture together with all other relevant information about next of kin, Doctors and other health care professionals. As many of the service users had been coming to stay at Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 10 Harelands for many years, the information held had been developed and expanded upon as necessary over this time. Due to the transient nature of the service, the plans were kept updated through liaising with carers and day care centres prior to visits. The good practice of recording any restrictions on choice/freedom was noted with regard to the use of listening devices. Parental consent had been obtained where such appliances were in use. Whilst 2 new staff had been recruited since the last inspection, the team continued to have a very good understanding of the service users support needs and this was evident from the positive relationships, which have been formed between the staff and service users. From speaking to three of the service users, it was clear they liked all the staff and one person particularly praised the manager for the help and support he was receiving. One service user, who could not verbally communicate, was able to be understood by the staff on duty at the time of the inspection. The service users’ rights to make decisions about their lives and every day routines is respected by the staff and several examples were given by the service users spoken to i.e. rising/retiring times, what to wear, to use their rooms when they chose, whether or not to have a key to their bedrooms, what activities to go on. It was however, clear that staff balanced the service users rights to choose with what was detrimental to their well being i.e. missing meals, staying in bed all day etc. and also the parents/carers wishes were also taken into account for those on respite placements. One service user was being supported to attend a self-help group during his emergency stay. Where possible service users manage their own finances and this was the case for one of the service users on emergency placement. It is however, usual for parents/carers to deposit money for safe keeping with the staff as part of the admission procedure. Any money spent on behalf of the service user is accounted for by the staff and receipts returned together with any balance of monies, when the service user goes home. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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): 15 & 16 The service value the role which parents/carers continue to play in the lives of the service users and this participation is encouraged. The individual service users preferred daily routines were respected with staff ensuring that service users independence and choices were promoted. EVIDENCE: Although the main aim of the service is to provide respite for parents and carers, the staff are excellent at liaising with them and liaising when any decisions need to be made. The service delivery agreement includes a section on the involvement of carers but makes it clear that they cannot accommodate visitors. As service users lead an active social life during their stay, carers are asked to arrange appointments to visit in order to make sure that the person they are visiting is in. Courtesy calls are made to the carer, prior to the visit to check whether there is anything new they need to be aware of about the individual and another call at the end of the stay is made to check out if everything is satisfactory. Good relationships have been formed with many of the carers, as a result of the outreach scheme, which Harelands offers to many of the service users utilising the respite service. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 12 Friendships between the service users have been made and the scheme endeavours to accommodate requests from service users to arrange dates to coincide with their friends. Daily routines promote independence and staff endeavour to follow similar routines as the person enjoys in their home environment i.e. preferred rising/retiring, breakfasts, attendance at day centres etc. All bedrooms are equipped with safety locks and service users able to hold their own keys do so. Two service users were keeping their bedroom doors locked at the time of the inspection. Service users are able to choose to be alone or in company and an example of this was given by one of the service users. He said he chose to go to his room during the evening to watch his own television and then retire to bed when he chose. Although the majority of service users enjoy going out socially, their wishes are respected and if they do not wish to join in, staffing arrangements are made so it is possible for them to remain at the house. Whilst many of the service users are unable to assist with household tasks, they are encouraged to do as much as possible for themselves in accordance with their care plan. One service user spoken to said he “loved vacuuming” and “enjoyed helping with tea”. Another person was given encouragement to make his own drinks and snacks. Rules on smoking and alcohol are made clear as part of the admission procedure and are included in the service delivery agreement. One person who smoked was clear he could only do so outside, as the house was non-smoking. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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): 20 The medication system in place is well managed and service users assessed as able to retain and administer their own medication were enabled to do so safely. EVIDENCE: Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 14 A member of staff is responsible for the collection and return of all service users medication. Any queries were addressed on the initial courtesy call to the parent/carer. Carers were requested, wherever possible, to send in the exact amounts necessary for the duration of the stay. Where this was not possible, staff took on the responsibility for ensuring excess medication was accounted for, recorded and returned at the end of the stay. There was a section in the service delivery agreement with regard to medication issues, which also included self-medication. Parental/carer or service user “consent to treatment” forms were signed and in place in each of the 3 files inspected. One service user was self medicating and a risk assessment in relation to this was in place dated 3 January 2006. In accordance with the medication policy, service users who self-medicate must keep their medication in a lockable tin and keep their room locked at all times and this was being adhered to. In accordance with the Authority’s corporate policy, for service users on long term emergency placements, medication is obtained from Boots in blister packs. This had been done for one service user currently placed. Satisfactory storage arrangements were in place for all medication, including controlled drugs. Good monitoring arrangements were also in place with staff having to account for all medication at each staff handover. It was however, noted that on one occasion, the number of controlled drugs recorded in the book, did not match those on the medication administration record. The manager stated this discrepancy of one tablet had been an error made by the staff and had not been picked up at the time. All staff must be vigilant and ensure they accurately record all drugs taken. Staff are clear about what they are able to assist service users with and what to do in emergency situations. This is clearly recorded on individuals’ care plans. Where allergies are identified, this is made very clear on the care plan. Whilst some staff had undertaken Boots medication training, others had not. The reason for this was that because service users were coming in from home with medication in bottles, the Boots training was not appropriate. Instead, the manager undertakes such training, on an individual basis with each new member of staff. They cannot dispense medication until assessed as competent to do so and at this stage, the manager signs off their training record. One of the newer staff members had recently been assessed as competent but another staff member was still being trained and was unable to dispense medication. He was therefore always working alongside an experienced trained member of the team. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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 An effective complaints system was in place, which ensured service users views were listened to and acted upon. EVIDENCE: As well as the corporate complaints procedure, a user friendly version had been formulated and this was included in the service user guide, which had been issued to all service users/carers. A copy of the guide was also held in each of the bedrooms so that service users had access to it during their stay. One service user interviewed said, “the staff are friendly and I would complain if there was anything to complain about, which there isn’t”. The majority of service users attend day care centres and have the opportunity to talk to their respective key-workers if they have any concerns to address. Feedback questionnaires were also completed at the end of each respite stay and service users were supported through this process by their day centre key-worker or parent/carer. There had been no complaints sent directly to the Commission for Social Care Inspection in the last 12 months and the manager stated she had not had any complaints to investigate in-house. She did however, state that the courtesy calls made at the beginning and end of each service users stay, enabled carers to express their views before grumbles became complaints. It was identified however, that when in the past, complaints had been investigated, copies were held centrally and not at the house. Any future complaints must be held inhouse in order they are available at inspection visits. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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): EVIDENCE: Core standards 24 and 30 were not inspected on this occasion as they were assessed at the last inspection. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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): 34 Good recruitment and selection procedures were in place providing the necessary protection for service users. EVIDENCE: There was a thorough recruitment and selection system in place and one of the more recently employed staff, who had commenced working at the home in November 2005 was spoken with. She confirmed that she had not commenced work until a satisfactory Criminal Records Bureau had been obtained together with 2 written references. She had undertaken the TOPSS induction training course and was due to start the foundation training in March 2006. As part of her induction she had already undertaken training in cultural awareness, infection control and administration of medication. The staff personnel files are kept at the Social Service Department head office at Municipal Offices, Rochdale. Certain documentation is also held in-house and evidence of Criminal Record Bureau checks having been undertaken was seen in all 3 files inspected. The file for one newly appointed support worker was incomplete as he had been transferred from another service, but his file is available for inspection at Municipal Offices. References are kept separate from other documentation, due to confidentiality reasons. Two references had been obtained for another worker and whilst the third file did not contain copy references, the manager stated these were with the person’s supervision Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 18 notes, which were currently being updated and not accessible. Copies of the references were however said to be available at Municipal offices. The induction training pack issued to each new employee, contains useful policies/procedures and other documentation, which includes a copy of the General Social Care Council Code of Conduct. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 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 & 39 The manager is experienced and provides strong leadership, guidance and support to staff, thus ensuring service users receive a consistent high standard of care and support. Effective quality assurance and monitoring systems were in place in order to assess the service was achieving its aims. EVIDENCE: The manager has worked in the learning disability field for many years and during this time has provided a reliable and consistent service for the people using the Harelands House respite scheme. She is extremely committed and motivated to providing a respite care service, which meets the needs of a diverse client group and co-operates fully with the Commission for Social Care Inspection in respect of implementation of requirements, which are within her remit. Supervision is regularly undertaken and the training needs of the staff are identified and appropriate training sought. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 20 In order to ensure she remains abreast of contemporary care practice, she continues to seek out training opportunities and in March 2005, undertook health and safety and risk assessment training for managers. She is a qualified assessor for LDAF (Learning Disability Award Framework) and NVQ training, which has greatly benefited the service in that staff may be assessed in-house. She is also trained in moving/handling and as a result of attending a 4 day course in November 2003, is able to pass on her knowledge and experience, in this field to the staff team. The authority has a corporate strategic plan reflecting aims and outcomes for service users and an effective quality assurance system is in place. A continuous self-monitoring evaluation system, which involves service user surveys being circulated after each stay, is in place. In order to ensure an independent person is involved in assisting the service user in completion of the form, it is sent to the service users’ key worker at the day care centre they attend. If they do not attend a centre, then the parent/carer is requested to assist in completing it. On the 3 files inspected, many questionnaires were filed with some very complimentary feedback being given. Where suggestions for improvement are made, these are discussed fully at the staff team meetings and staff endeavour to implement ideas wherever possible. The courtesy calls made before and after respite stays are also a way of obtaining parent/carer feedback and very often, this system prevents grumbles becoming complaints. Policies/procedures are reviewed and updated in the light of changing legislation and a new policy had recently been written and implemented in relation to bullying and harassment. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 4 X 4 X X X X Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 22 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. Standard YA2 Regulation 14 Requirement All service users must be assessed prior to first admission or in the case of emergency admissions within 48 hours of admission. The manager must ensure that the number of tablets as recorded in the controlled drug book, match those on the medication administration record. Copies of complaints must be retained in house and be available for inspection. Timescale for action 31/01/06 2. YA20 13 31/01/06 3. YA22 22 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA34 Good Practice Recommendations Copy references should be retained in house and be available for inspection. Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Harelands House DS0000049196.V274637.R01.S.doc Version 5.1 Page 24 - 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. 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