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Inspection on 11/06/07 for Harrow Road, Flats A, B and C

Also see our care home review for Harrow Road, Flats A, B and C for more information

This inspection was carried out on 11th June 2007.

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 4 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

The home is spacious, bright and well equipped and is fully accessible to people who use wheelchairs. The home is well staffed during the day and the Inspector saw some excellent interaction between staff and people living in the home. People`s bedrooms are comfortable and very individual. Standards of record keeping in the home are good.

What has improved since the last inspection?

Flat C was last inspected in November 2006. 12 Requirements were made and these have all been met. More permanent staff have been employed, staff are completing essential training, the management of medication has improved and building issues have been dealt with.

What the care home could do better:

The recording of non-prescribed medication must be improved. There is also a need to improve the management and recording of people`s money. Managers must make sure that all staff follow the local authority`s safeguarding adults procedures. The Society should look to build closer links with the local authority`s safeguarding adults team and access training that is available. The Fire Officer must be asked to check fire doors in the home to make sure that they are safe.

CARE HOME ADULTS 18-65 Harrow Road, Flats A, B and C Flats A, B and C 291 Harrow Road London W9 3NF Lead Inspector Tony Lawrence Key Unannounced Inspection 11th June 2007 09:30 Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harrow Road, Flats A, B and C Address Flats A, B and C 291 Harrow Road London W9 3NF 020 7266 3072 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) najiboye@wspld.org The Westminster Society for People with Learning Disabilities Miss Nikky Ajiboye Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2006 Brief Description of the Service: 291 Harrow Road is located close to the transport links, shops and amenities of Paddington and Westbourne Park. The home is registered to provide accommodation and care for 13 men and women with learning and physical disabilities. Flats A and B were registered by the Commission in March 2007 to provide care for 8 people. Flat C provides care for 5 people and has been registered for a number of years. At the time of this visit, 5 men and 7 women were living in the home and there was one vacancy. Each person living in the home has his / her own bedroom and access to shared amenities. The home is wheelchair accessible and is fully equipped to enable people to pursue a full and active life. The care is provided by the Westminster Society for People with Learning Disabilities, a local voluntary organisation. The property is owned by Kensington and Chelsea Primary Care Trust. Current fees as outlined in the pre-inspection information is £1,714.88 per week. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Monday 11th June 2007 from 09:30 – 16:30. Tony Lawrence, Regulation Inspector carried out the inspection. During the day he spoke with people living in the home, staff on duty and managers. The care of three people was tracked by talking with them, observing the care they received during the day and reviewing care records kept in the home. The home is well staffed to provide care for people with significant care needs and all people living in the home received very good standards of care during the day. Two relatives and three health / social care professionals returned confidential questionnaires and their comments are included in this report. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 6 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 Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Significant time and effort is spent making admission to the home personal and well managed. EVIDENCE: The Manager and staff confirmed that people in Flat C have lived together for more than 10 years. Flats A and B opened in March of this year and people have been moving in since. Most of the people in Flats A and B have moved from placements out of the Borough to make contact with families easier. The home has an excellent Statement of Purpose and Service User Guide that accurately detail the services provided in the home for prospective residents and their representatives. Both documents are available in accessible formats, making excellent use of photos, pictures and Plain English. Managers from the Westminster Society visited each person referred to Flats A and B and completed a full assessment of their care needs. The assessments were then used to develop detailed, individual transition plans that included visits to the home, overnight stays and involvement in choosing furniture, bedding etc for the person’s room. Each person living in the home has a contract with the Society that details their terms and conditions of residence. One relative said they ‘usually’ get enough information about the home to help them make decisions. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are involved in planning their care. Each care plan includes a comprehensive risk assessment that is reviewed regularly. EVIDENCE: During this visit the Inspector checked the care plan files of three people living in the home. The Westminster Society has a very good system of Individual Support Profiles and is improving this further by introducing a more personcentred care planning approach. This involves care staff working with individual residents to complete a series of detailed ‘All About Me’ forms that are then used to write the person centred care plan. The three files reviewed by the Inspector included a great deal of evidence that staff are working creatively to involve people in planning their care and developing their own plans. This is a major piece of work that will take time to complete, but staff are to be congratulated on the quality of work produced so far. During the day the Inspector saw care staff in all three flats offering people choices about their care. This ranged from choices of food and drink to opportunities to go out or stay at home. When residents asked for support, staff in all three flats responded promptly and professionally. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 9 The three care plans files each included a number of individual risk assessments and risk management plans. These covered personal care, access to and use of community facilities, use of public transport and manual handling. The assessments were well completed and included guidance for staff on how risks could be minimised. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are involved in meaningful activities in the home and the local community. The service is committed to the principle of inclusion. EVIDENCE: ‘The home is good at supporting service users to access the community and make use of community resources’. Comment from a health/social care professional. During this visit the Inspector checked the care plan files and daily log books of three people living in the home. All three care plans and log books included evidence that people are asked about their interests and arrangements are made to access relevant day services or other opportunities. Each person had a weekly programme of activities that included a mixture of sessions at formal day services, activities in the home and the local community. The All About Me forms that staff are completing with each person included important people, dates and activities for each resident. One person’s file included care reviews that had been completed one month and three months after the person moved into the home. The Inspector felt that these were an excellent summary of the Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 11 person’s daily life in the home and staff had made very good use of digital photos to make the information more accessible to the resident. The summaries and entries in the log books showed that this person is supported regularly by staff to take part in activities outside the home, including trips on public transport to London Zoo and Hyde Park and regular outings to the local park. Individual’s log books are arranged so that staff on duty each morning, afternoon and night record specific information about each person’s care. The Inspector felt that the logs were well completed by staff and showed that each person takes part in an activity of their choice most days. On the day of this visit, some people were at day services, one person went to hospital and all 12 people were supported by staff to spend some time outside the home. One person’s care plan file included evidence that they had a number of paid jobs, including representation in a number of advocacy organisations and interviewing staff for the Westminster Society. The care plan files and All About Me forms included details of people’s relatives, friends and other significant people. During this visit, the Inspector saw staff supporting people to contact their relatives on the phone and talking to individual residents about their relatives and friends. One relative who returned a confidential questionnaire said that their relative was unable to contact family members but they were able to visit and phone the home at any time. A second relative did not answer this question. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident’s personal and healthcare needs are well recorded as part of their care plan. People are referred appropriately to specialist services. EVIDENCE: ‘I have no concerns about (my relative’s) care, all his needs are met as far as they can be’. Comment from a relative. ‘The staff are always very supportive, for which we are very grateful’. Comment from a relative. The three care plan files checked by the Inspector each included good information about the person’s personal and healthcare needs. All three files included information and copies of assessments by relevant health care clinicians. Staff who spoke with the Inspector were able to describe each person’s care needs and how these are met in the home and elsewhere. Health Action Plans (HAP) were in place for two of the three people whose care was tracked by the Inspector. Staff confirmed that these would be reviewed annually. The third person’s HAP was being developed by staff in the home and the outcome of tests was needed before the plan could be finalised. This person has complex health care needs and their care plan file included a great deal of information about these needs and how they are met. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 13 Two of the three care plan files included detailed guidance for care staff on how people should be supported with their personal care. During the day, the Inspector saw all staff following these guidelines consistently. There was secure storage for prescribed medication in each of the three flats. The Inspector checked Medication Administration Record (MAR) sheets in each flat. The MAR sheets are well completed by staff for all prescribed medication, but staff must make sure that they record on the MAR sheet the dosage of any non-prescribed painkillers given to residents. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that is accessible to some residents. There is a need to make sure that all staff know and follow the local safeguarding adults policy and procedures. EVIDENCE: ‘No serious concerns raised to my knowledge. The home have always been helpful and responded to any general concerns or queries’. Comment from a health / social care professional. The home has a clear complaints procedure that is produced using pictures and drawings to make the information more accessible to some residents. A copy of the complaints procedure was included in each of the three care plan files checked by the Inspector. Contact details for the Commission are included in the procedure. During this visit, the Inspector checked the finance records for three people living in the home and discussed procedures with managers. There is a need to make sure that staff clearly record the expenditure of each person’s money, including details of what the money is used to pay for. Receipts must be obtained each time residents’ money is spent. During this visit the Inspector discussed the recording of bruising, scratches and other marks with managers. Some people living in the home have behaviours that are challenging and incidents where people may hurt themselves or other people happen regularly. While staff are recording incidents and injuries when they occur, these are not being dealt with in accordance with the local multi-agency safeguarding adults procedures. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 15 Managers must make sure that unexplained bruises or scratches are reported to the local authority Social Services Department. Social Services are the lead agency for safeguarding adults and officers from the Department are responsible for arranging meetings to agree a plan to make sure that residents are cared for safely. The Inspector accepts that Flats A and B have only opened recently and the focus for managers has been to recruit staff and make sure that people’s moves into the home are a positive experience. Managers explained that one member of staff in each flat has completed their Learning Disability Awards Framework induction training that includes a full day on safeguarding adults, whistle-blowing and grievances. The Inspector felt that the Society should look to build closer links with the local authority’s safeguarding adults team and access training that is available. This would make sure that staff are familiar with and follow the agreed multi-agency procedures. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides comfortable, well maintained accommodation and aids and equipment to meet residents’ needs. EVIDENCE: ‘Flat C is well kept, clean and tranquil, staff are friendly and welcoming. People are happy, you can see it is their home rather than just a place where they live’. Comment from a relative. ‘Very good food and cleanliness – very important’. Comment from a relative. The home is located on the Harrow Road, close to shops and transport links in Paddington and Westbourne Park. Flats A and B share one building. Flat C is separate. All three flats have level access and are fully accessible for people using a wheelchair. Fixed hoists are provided in communal areas and bathrooms in all three flats. Flats A and B opened in March 2007, following a complete refurbishment. Flat C has been open longer and was last refurbished in 2002. The home provides Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 17 good standards of accommodation. Bedrooms are individual, well furnished and decorated. Communal areas are spacious and comfortable. There is sufficient communal space to enable people to spend time on their own, in small or larger groups. There is an enclosed garden that residents can use safely. There are two sensory rooms with specialist equipment and a music room is being developed. A separate room is available for use by visiting physiotherapists, aromatherapists and massage therapists. Each flat has an accessible bathroom and shower room. Assisted baths / showers are provided in each flat. During this visit the Inspector saw four people’s bedrooms and all communal areas. All parts of the home were clean and hygienic. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough staff in each flat to meet people’s care needs. The Society’s recruitment procedures protect people living in the home. EVIDENCE: On the day of this unannounced inspection, the Inspector felt that there were enough staff on duty in each of the three flats to support individual residents. Throughout the day the Inspector spent some time in each flat, observing staff supporting people. People were treated consistently with respect, affection and patience. Staff made sure that each individual was offered choices about their care whenever possible. Interactions between staff and people living in the home were consistently professional. The Society has clear recruitment procedures that include pre-employment checks. The manager confirmed that staff do not start work in the home until an Enhanced Disclosure has been obtained from the Criminal Records Bureau (CRB). A record of CRB checks is kept in the home. Staff told the Inspector that the Society provides good training opportunities and access to training is good. During this visit the Inspector saw a manager discussing training needs and access to appropriate training with a new member of staff. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the required experience and qualifications to run the home. The Manager has a clear understanding of best practice with an emphasis on involving people who live in the home. EVIDENCE: Following the registration of Flats A and B earlier this year, the Society has decided to register one Manager for the three Flats that comprise 291 Harrow Road. The proposed Manager is experienced and qualified and has a clear vision for the future development of the service. The Society has completed some very good quality assurance work as part of an annual review of all residential services. This work involved an external auditor visiting each service to produce a quality assurance report. An overall report was also prepared for all residential services. There is evidence in the quality assurance reports that the views of people living in the service, their relatives and representatives are sought and included as part of the review. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 20 During this visit the Inspector checked a selection of care records kept in the home. Standards of record keeping in the home are good and records are generally well maintained. One health and safety issue was discussed with managers during this visit. A Fire Safety Officer from the London Fire and Emergency Planning Authority visited the home as part of the refurbishment and approved the planned works. There is a need for the Society to ask the Fire Safety Officer to visit again to check the completed works. In particular, the gaps at the tops and bottoms of some fire doors to be checked to make sure that the home provides safe accommodation. In addition to the quality assurance work mentioned above, regular monitoring visits are made to the home each month. Written reports are sent to the home and the Commission following each visit. Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 4 2 3 3 X 4 4 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 2 3 Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 Requirement Staff must make sure that they record on the MAR sheet the dosage of any non-prescribed painkillers given to residents. Staff must clearly record the expenditure of each person’s money, including details of what the money is used to pay for. Receipts must be obtained each time residents’ money is spent. The Society should look to build closer links with the local authority’s safeguarding adults team and access training that is available. This would make sure that staff are familiar with and follow the agreed multi-agency procedures. The Fire Safety Officer must be asked to visit and check fire doors in the home. Timescale for action 01/09/07 2. YA23 13 01/09/07 3. YA23 13 01/09/07 4. YA42 23 01/09/07 Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 23 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 Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Harrow Road, Flats A, B and C DS0000010875.V340261.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!