Inspection on 23/05/07 for Harwood Road

This inspection was carried out on 23rd May 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harwood Road 16/06/08

Harwood Road 22/05/06

Harwood Road 08/03/06

Harwood Road 04/10/05

Harwood Road 21/03/05

Harwood Road 04/10/04

Harwood Road 09/02/04

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

CARE HOME ADULTS 18-65 Harwood Road Harwood Road 95-99 Harwood Road Fulham London SW6 4QL Lead Inspector Sheila Lycholit Key Unannounced Inspection 23rd May 2007 10:10 Harwood Road DS0000019149.V336592.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 Harwood Road DS0000019149.V336592.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. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harwood Road Address Harwood Road 95-99 Harwood Road Fulham London SW6 4QL 020 7731 7142/45 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) Hestia Housing Stuart Johnston Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22 May 2006 Brief Description of the Service: Harwood Road is a registered care home providing accommodation and support for fifteen people with long-term mental health needs. The service is provided by Hestia Housing in a building owned and maintained by Shepherd’s Bush Housing Association. The building consists of three Victorian terraced houses that have been converted into an inter-connecting building. Thirteen service users have a selfcontained flat with kitchen facilities and an en suite shower or bath and lavatory. Two people have a single room and share a bathroom and kitchen. The flats are situated on the ground, first and second floor of the building. There are two sitting rooms, one smoking and the other non-smoking, on the lower ground floor. There is also a patio/garden area to the rear of the home. The service is not suitable for anyone with a mobility problem, as there is no lift and all areas are accessed by a number of steps, including the front entrance. Staff provide support throughout the day and evening, with two members of staff sleeping-in at night. The home is well located, close to Fulham Broadway, providing good access to transport links and local amenities. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Wednesday 23rd May from 10.10AM until 5PM. All of the 15 places were occupied, though one person was in hospital and would not be returning. The Manager, Acting Deputy and 2 Project Support Workers were on duty. One Project Support Worker had phoned in sick. The Domestic Assistant was present from 11AM until 2PM. The Inspector spoke with 3 residents in private and was introduced to a number of other residents during the day. The Manager had completed a pre-inspection questionnaire and made himself available throughout the visit. Four relatives returned surveys, with very positive comments about the service. What the service does well: What has improved since the last inspection? What they could do better: While the service overall is assessed as an improving service, a number of issues continue to need attention. As at the previous inspection, there is still Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 6 no permanent senior staff team. The Manager has recently returned from managing another service but he is without a permanent Deputy Manager. Staff supervision has been restarted by the current Manager after a long gap. Staff training in health and safety is given insufficient priority. Staff must ensure that any incidents between residents involving physical harm or harassment are referred to the Safeguarding Adults Co-ordinator. 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. Harwood Road DS0000019149.V336592.R01.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 Harwood Road DS0000019149.V336592.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The revised Statement of Purpose and Service User’s Guide provide clear information about the service. An established admission procedure is in place, which includes a multidisciplinary assessment. Each resident has a detailed licence agreement. EVIDENCE: The Statement of Purpose was reissued in February this year and the Service User’s Guide in March. Comprehensive information is provided about the service, including Hestia’s philosophy of care, the admissions procedure and the complaints procedure. Residents are provided with a ring binder, with copies of the Statement of Purpose and Guide to keep in their rooms. Each of the 3 residents’ files seen contained a needs assessment and other information from the Mental Health Team, including the hospital discharge notes. All prospective residents visit the project as part of the pre-admission process to see the vacant room and to meet staff and other residents. The opportunity to stay overnight is available. An induction list for new residents is completed. A licence agreement signed by the resident was seen on each file. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and up to date. Hestia has a philosophy of resident participation and residents are encouraged to make their views known and to participate in the life of the home. EVIDENCE: The care plans and risk assessments for 3 residents were seen. The care plans were detailed and showed evidence that residents had been involved in the development of their plan. Care plans tend to emphasise support with daily living activities, rather than psychological or emotional support. This may reflect the skills of the staff group, who with the exception of the Manager, do not have training in therapy or counselling. In discussion residents spoke positively about the support they receive from staff. Reviews take place regularly in addition to the annual care management review. A white board in the office is used to monitor the frequency of reviews. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 10 Key workers hold a one to one session with residents at least monthly. These are recorded and signed by the resident. One resident had signed to note her disagreement with the notes. Risk assessments were seen on each of the 3 residents’ files. While these were generally of a good standard, staff must ensure that all areas of risk identified in the hospital discharge notes are covered in the home’s own risk assessment. For example steps to minimise the risk to female staff when working with a resident who has behaved inappropriately to female staff in previous settings should be clearly stated. The statement of purpose sets out Hestia’s policy of resident involvement. There is a regular tenants’ forum for all users of Hestia’s services, which is advertised in the home. Residents’ meetings at Harwood Road take place fortnightly and are recorded. Menus are agreed at this meeting. A number of residents undertake work at Harwood Road for which they are paid. A policy on confidentiality is available. Residents’ files are kept in a locked cupboard. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 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. Residents are supported to take part in a range of activities, using specialist and community services. The Manager has recently taken steps to improve the diet of residents by increasing the frequency of the communal meal. EVIDENCE: Records show residents take part in a range of activities, including attending day services, hospital rehabilitation services and adult education classes. None of the current residents is employed and staff recognise the need for residents to have a structure to the day and to take part in meaningful activities. An in-house group to help residents discuss aspects of coping with mental illness has recently been started. Contact with relatives, families and friends is supported. One resident visits family members who live nearby daily. Four relatives completed surveys, giving positive feedback about the service. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 12 The activities file shows photos of regular outings, including a boat trip, a visit to the Natural History Museum and trips to the cinema and pub. As at the previous inspection, the computer in the residents’ sitting room is not connected to a functioning printer and has no internet connection. The Manager explained that he has no budget to support IT for residents, even though the Statement of Purpose refers to in-house training in using a computer. Residents are encouraged to be self-catering but in recognition of the difficulty some experience in shopping and preparing meals, the Manager has increased the frequency of the communal meal from once to three times a week. In addition sandwiches are now made available each day. Residents are encouraged to help with the communal meals and preparation of sandwiches. Each tenant receives £23 per week for food shopping, in addition to the meals provided. Bread for toast and cereals are available in the main kitchen for residents to help themselves at breakfast time. The Manager raised his concern about the diet related health problems, including diabetes and over-weight, experienced by a number of residents. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staffing levels and the key working system allow residents to receive individualised support from staff. Attention is paid to residents’ general health in addition to their mental health needs. While generally medication is carefully recorded staff must ensure that the medication policy is followed regarding medication prescribed ‘as required’. EVIDENCE: Only one resident requires some assistance with bathing, from time to time others need prompting regarding personal care, as noted in their care plans. A checklist for health care appointments was available on each of the residents’ files looked at. Residents are currently registered with six local GP practices and are also supported to attend audiology and chiropody clinics, Dentists and Opticians. The home uses the Boots monitored dosage system for medication. A number of residents handle their own medication, which is put into a Dosset box by staff. Risk assessments, signed off by the Consultant or GP, were seen for each of the residents who currently handle their own medication. Although there was reference on one resident’s file to Diazepam being given to calm him down Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 14 following an outburst, this was not recorded on the MAR sheet. Staff must ensure that medication prescribed PRN is recorded when given, with the reason noted on the reverse of the sheet. The MAR sheet for a resident who is receiving her medication from the High Support Team was left blank with no reference to the changed arrangements. One older resident, who has lived at Harwood Road for many years is provided with some additional assistance with bathing but is generally fit and active and able to manage the stairs between all floors. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 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. 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 service has an established complaints procedure that notes residents’ concerns and inter-resident disputes, as well as formal complaints. Steps need to be taken to ensure that staff are clear when to make a referral to the Local Authority under the safeguarding adults procedure. EVIDENCE: The complaints procedure is clearly set out in the service users’ guide. The complaints logs and notes of residents’ meetings show that residents concerns and complaints are taken seriously and acted upon. Three complaints were noted since the last inspection. Training records show that staff have received training in adult protection and a policy is available in the office. No POVA referrals were made in the previous 12 months. Records show that one resident received bruises and scratches to his hand from another resident and is regularly asked for cigarettes and money by the same resident. This issue was not referred to or discussed with the local Safeguarding Adults Co-ordinator, as the local policy requires. The Manager was planning to issue one resident with a written warning regarding her verbal abuse to staff. Harwood Road DS0000019149.V336592.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, 26, 27, 28 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The building, which is well located for local services, generally suits the needs of residents who value the opportunity to have self-contained accommodation. Communal areas are comfortable and in a good state of decoration. Some of the residents’ accommodation would benefit from upgrading. EVIDENCE: Harwood Road is indistinguishable from its neighbours in the terrace and is close to local services on Fulham Broadway. The two sitting rooms, one of which is designated for smokers, are furnished with good quality sofas and chairs and have TVs and music centres. A good supply of books is available in a bookcase. The non-smoking sitting room leads out to the back garden, which is largely terraced. One of the residents is growing vegetables and plants and keeps the garden tidy. The Manager said that plans are in hand to create a closed-in bin area, which will hide the black bin liners and other refuse. New curtains and nets have recently been fitted, which improve the appearance of the communal areas, including the stairways. CCTV monitors the front door. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 17 Two residents’ rooms were seen. The rooms exceed the minimum size and have kitchen facilities and a bath/shower room. The kitchen facilities, while adequate, would benefit from upgrading. One resident pointed out mould in his shower room, which may have been caused by poor ventilation. A bare bulb was hanging from the ceiling in the other room looked at, with a stained lampshade on the other light in the room. As these rooms are the long-term home for a number of residents, steps need to be taken to create a more attractive setting. The communal areas were clean and tidy. The main kitchen was being cleaned by the Domestic Assistant during the inspection. There is a laundry for the use of residents, which is fitted with commercial size machines. Some residents’ clothing, including underwear, was left around the laundry. Residents’ washing should be kept separate in individual baskets or bags to prevent the risk of cross infection. Harwood Road DS0000019149.V336592.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): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Current staffing levels allow staff to spend some time providing individual support to residents. Staff have access to NVQ training and the majority of staff have achieved NVQ2 or 3. A system of regular supervision has not been fully established. EVIDENCE: The service has a full staff team, although the Assistant Project Workers are on temporary contracts because of the time-limited finding of their posts. The number of staff holding an NVQ level 2 or 3 has improved since the last inspection, with 75 of staff achieving the award. Three staff records held at the home showed that while staff had attended a number of training workshops, two staff had not attended fire safety training. Priority must be given to staff completing health and safety training with their probationary period. Other than the Manager, no staff have training in counselling or therapy. Consideration should be given to increasing staff skills so that residents can be provided with more psychological support. Rotas normally allow 3 staff on duty during the day, which meets the support needs of the current residents. Two staff sleep-in each night. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 19 The Manager is having to deal with a number of issues within the staff team, which indicate a lack of cohesion. Staff are recruited by Hestia’s HR team, with the Manager’s involvement. Confirmation of CRB checks was seen for all staff. The three staff files looked at showed that staff supervision has recently been re-introduced by the Manager, after a period when supervision was very infrequent. Recording of supervision is detailed and in addition to staff development issues, each of the member of staff’s key working residents is discussed. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Manager is experienced and well qualified but the home is still without a permanent Deputy Manager. Hestia has an established system of regular service reviews, which include the views of residents and other stakeholders. Comprehensive policies and procedures are available, including health and safety policies. EVIDENCE: The Manager has returned to the service after a fifteen month period at another home. He is experienced in managing mental health services and has completed a range of training including NVQ4 and the RMA. Records show that he has addressed a number of issues since his return and has taken steps to improve the day to day service to residents, for example by increasing the number of meals provided. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 21 As the Deputy Manager, who had been acting up, has moved to another of Hestia’s services the senior staff team is still incomplete. The size of the service and the complex needs of some residents indicate that experienced senior staff need to be in post to provide direction and support to staff. A regular review of the service takes place, which includes the views of residents and other stakeholders. The Manager was expecting staff from head office, including the Chief Executive, to visit and to look at all aspects of the service. The next review is planned for June 2007. Copies of Hestia’s policies and procedures are available in the main office. Record keeping is of a good standard and files seen were up to date and wellordered. The home received an ‘excellent’ rating from the EHO who visited earlier this year. A packet of corned beef was in the fridge, with no note of when it was opened. The Manager said that he would remind staff and residents to note the opening date of similar food. Fire checks are regularly carried out and risk assessments undertaken for residents who smoke. Fire drills take place every 3 months and are recorded in detail. The emergency lighting system is functioning but has been identified as needing renewal. A fire risk assessment and general risk assessments, which are regularly reviewed, are available. Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 3 4 3 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 2 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 2 3 3 3 3 3 Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 13 Requirement Residents’ risk assessments must cover all of the areas indicated in their discharge notes and in any mental health assessment. Staff must follow the home’s procedure for recording all medication, including medication prescribed ‘as required’. Incidents of assault or harassment of a vulnerable resident must be referred to the local Safeguarding Adults Coordinator. A programme of regularly improving residents’ rooms should be put in place to ensure that attractive and pleasant accommodation is offered. All staff must receive training in fire safety during their induction period. A system of regular staff supervision must be established, with staff receiving supervision at least 6 times a year. Steps must be taken to establish a permanent senior staff team. DS0000019149.V336592.R01.S.doc Timescale for action 30/06/07 2. YA20 13 30/06/07 4 YA23 13 30/06/07 5 YA26 23 30/09/07 6 YA35 18 31/07/07 7 YA36 18 31/07/07 8 YA38 18 30/09/07 Harwood Road Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA12 Good Practice Recommendations Consideration should be given to providing a PC with internet connection for the use of residents in line with the Statement of Purpose. Steps should be taken to ensure that residents’ laundry is kept separate to avoid the risk of cross infection. Opportunities to develop skills in counselling or therapy should be considered for suitable staff. Staff should be reminded to note the opening date on packets of food, such as cold meat. 2 3 4 YA30 YA33 YA42 Harwood Road DS0000019149.V336592.R01.S.doc Version 5.2 Page 25 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 Harwood Road DS0000019149.V336592.R01.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. 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