Inspection on 10/09/05 for Homer Road (22A-B)

This inspection was carried out on 10th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 17 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Homer Road (22A-B) 20/06/07

Homer Road (22A-B) 06/06/06

Homer Road (22A-B) 18/01/06

Homer Road (22A-B) 29/12/04

Homer Road (22A-B) 24/08/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Homer Road (22A/B) 22a/b Homer Road Hackney London E9 Lead Inspector Robert Sobotka Unannounced Inspection 10th September 2005 10:00 Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homer Road (22A/B) Address 22a/b Homer Road Hackney London E9 020 8525 3933 020 8502 3543 philipa.jones@heritagecare.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Heritage Care Ms Phillipa Jones Care Home 7 Category(ies) of Learning disability (7), Physical disability (7), registration, with number Sensory impairment (7) of places Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th December 2004 Brief Description of the Service: 22 Homer Road is a registered care home that provides 24-hour residential care for adults with learning disabilities and/or physical disabilities. Homer Road opened as a care home on 31st of March 2003. The premises are owned and managed by Peabody Trust and Heritage Care provide care. The home is situated in a residential area of Hackney within walking distance from local amenities and public transport links. All bedrooms in the home are single. The home has a garden at the rear of the building. The downstairs part of the house is wheelchair accessible. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The aim of this announced inspection was to check the home’s progress towards full compliance with the legislation. The inspection took place over 1 day and included speaking to some of the staff working in the home and spending time with the service users. The inspector also conducted a tour of the premises and viewed various records. What the service does well: What has improved since the last inspection? What they could do better: There is a number of requirements which remain outstanding from the previous inspection and must be met without any further delay. Care plans must be further developed and kept under review. Any action identified within care plan must be carried out and acted upon. The registered manager must also ensure that risk assessments are reviewed on regular basis. They must also be signed and dated by the author. All medication administered to service users must be signed for when administered. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 6 The responsible person must ensure that all records in relation to staff employed in the home are maintained and available for inspection. Monthly unannounced visits from the responsible person must be carried out and reports from these must be kept in the home. Copy should also be forwarded to the Commission. An application for the responsible individual for the home must be submitted to the Commission without delay. Records relating to food offered to the service users required improvement. Fridge/freezer temperatures must be recorded on a daily basis. Some areas of the building required redecorating, this included ensuring that all parts of the premises are appropriate ventilated and clean at all times. It is recommended that the service user meetings be reintroduced in the home. 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. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5. The needs of those living in the home were partly met, however review of care plans is required to ensure that they are fully met. Service users’ contacts required to be signed by the service users’ representatives/relatives. EVIDENCE: Although there was one vacancy in the home, there have been no new admissions to the home since the last inspection. The standard in relation to the admission process could not therefore be assessed. Although it appeared that the majority of needs of those who lived in the home were being met, it was noted that in case of one of the service user, care staff were not aware of their, needs as identified during placement review with one of the placing authority. This inspection visit also highlighted that some of the care plans have not been reviewed/updated. Although individual contracts are in place, they remain unsigned. It is required that the responsible person ensures that the individual service user contracts are signed by all relevant parties. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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, 8, 9, 10. Limited progress has been made on improving arrangements to ensure that the needs and goals of residents are identified and met. These shortfalls could have a potential to place those who use the service at risk. EVIDENCE: The inspector viewed four care plans, which were chosen at random. Individual plans of care were available, however there was no evidence that these have been updated/reviewed. It was also noted that some of the goals identified during the placement reviews were not being followed and staff did not appear to be fully aware of the identified needs. This required improvement. Those who lived in the home received regular input from the advocate as well as their relatives. The inspector was informed that there were plans to introduce a Person Centred Planning for each of the service users, which would replace the existing care plans. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 10 The resident’s meetings have not been taking place since October 2003. It is recommended that the service user meetings be reintroduced in the home. Some of the risk assessments viewed were not signed and/or dated. The inspector was therefore unable to establish whether they were being reviewed on regular basis. The registered manager must ensure that risk assessments are reviewed on regular basis. They must also be signed and dated by the author. Those who were living in the home were unable to comment on the quality of care provided and whether their needs were being met (due to their disability), however the inspector was satisfied that they appeared to be settled and happy in the home. Files were appropriately stored and kept confidential. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15, 16, 17. The service users are encouraged and supported to lead active lifestyles within the local community and develop and maintain friendships and family links. Their rights and choices were respected and they had opportunities for personal development. Storage of food, as well as recording of food offered to the home required improvement. EVIDENCE: The inspector was satisfied that service users were offered a wide range of activities both indoor and outdoor. Some of the service users attend day-care services. All service users living at Homer Road required staff support when being out in the community. The inspector was informed that Community Resource Services were currently not offering support with taking service users out in the community and that activities were being facilitated and organised by support staff working in the home. All service users have received their annual holiday at Butlins in Skegness. Those who live in the home are supported to maintain family contact and friendships. Service users receive visits from family members and friends and Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 12 befrienders. The home had a visitor’s book, which was well maintained. A visitor’s policy was in place. The inspector tasted the food served to the service users on the day of the inspection; it was attractively presented, well balanced and appetising. Food was mainly prepared by staff, but the service users also had an opportunity to assist in accordance with their wishes, assessed abilities and risk involved. There were appropriate food supplies in the home, however some products were not labelled when opened. In addition record of food offered to the service users required improvement. The recommendation for the home’s menus to be produced in pictorial form remains unmet. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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): 18, 19, 20. Personal care was adequately provided. The service users emotional health needs were being met. Improvement was required in monitoring the service users’ weight. Staff did not always record medication administered to service users. EVIDENCE: Service users have flexible times for getting up and going to bed, baths and other activities, which took into, account service users preferences. Privacy and dignity are core principles in the staff values. The home does not provide nursing care. Staff working in the home were seen to work in a sensitive and professional manner. The inspector viewed records relating to the healthcare needs of service users accommodated in the home. These were generally well maintained, however it was noted that in some cases weight of some of the service users was not recorded as indicated/agreed within care plan. The registered manager must ensure that service user’s weight is monitored and recorded as indicated within care plans. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 14 Medication systems were generally well maintained, however there were some gaps on the medication administration sheet. The registered manager must ensure that all medication administered to service users is signed for. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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, 23. The home’s policies and procedures on protection of vulnerable adults and complaints were implemented, however the recommendation for the formal system to be implemented for reviewing accidents/incidents remains unmet. EVIDENCE: There have been no complaints about the home since the last inspection. The Inspector viewed the complaints policy, which was available in a format accessible to the current service user group. The home had appropriate adult protection procedure in place. Staff working in the home at the time of the inspection demonstrated their awareness of the adult protection issues. Records relating to financial transactions made were well maintained and the service users finances were being checked during each staff handover. The Inspector viewed accident and incident records, which showed appropriate action taken by the home, however in some cases there was no evidence that accident were monitored/viewed by the management team. It is recommended that the formal system be implemented for reviewing accidents/incidents in the home. The inspector was satisfied that the responsible individual ensures that appropriate action is taken to ensure that service users are safeguarded from any form of abuse. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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): 24, 25, 26, 27, 29, 30. The premises were meeting the needs of the people using the service, however the condition of the building required improvement. EVIDENCE: The home provided adequate living space for service users. None of the service users living in the home were on respite/emergency/short-term placement. The home had one wheelchair user at the time of the Inspection, who occupied the room on a ground floor. There are two kitchens (one on each floor in the building). The kitchens were generally clean and well maintained with the exception of few tiles coming off the wall in the kitchen on the first floor. The registered manager must ensure that the wall tiles in the kitchen on the first floor are replaced. The home has a sufficient number of toilets, bathrooms and shower facilities. One of the bathrooms did not have sufficient ventilation. Door to another bathroom could not be fully closed. In one of the service user’s room (on the first floor) the carpet was stained and required cleaning. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 17 Kitchen drawer next to the cooker/stove in the upstairs kitchen must be replaced. The worktop in the same kitchen must be made stable. In addition the oven hood in the upstairs kitchen was dirty and required cleaning. Homer Road is a purpose built building; those service users who needed specialist equipment (i.e. hoist) have been assessed by occupational therapists. Satisfactory equipment was in place and available throughout the house. The home met the needs of the current service user group. The home had satisfactory arrangements for repairing and maintenance of specialist equipment. The home had appropriate clinical waste disposal arrangements in place. Laundry facilities were kept clean and in good working order, however the laundry room appeared to be very hot. The registered manager must ensure that the laundry room is appropriately ventilated. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, 36. The home is continuously staffed. Staff recruitment process and supervision offered to those working in the home required improvement. EVIDENCE: Duty rosters were displayed in the home. These showed that there were sufficient numbers of staff on each shift to meet the needs of those living in the home. There are 4 staff working in the home during daytime on each shift (2 members of staff on each floor). In addition there were either 1 or 2 care staff working flexible hours during the day. There is one person sleeping in and one waking night staff in place during night time. There was a mix of gender to provide personal care. There was an assessed person on each shift, who would be in charge of the medication. The inspector viewed a random selection of staff personnel files. Not all files viewed contained all information listed in Schedule 2 of the Care Homes Regulations. The requirement in relation to this standard has therefore been repeated and must be met without any further delay. The inspector was unable to access staff supervision files during this inspection visit. The recommendation that staff working in the home receive a minimum Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 19 of 6 supervisions per year has therefore been repeated and will be assessed during the next inspection visit. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 41, 42. Little progress has been made to ensure that the service user’s needs were being met. These shortfalls have a potential to place residents at risk. EVIDENCE: During the course of inspection, the inspector viewed reports from person in control. There was a gap of several months when visits from the responsible person were not carried out. Although it was noted that those visits have restarted, only two reports were available on file for the months of June and August 2005. It is required that visits from the registered provider take place at least once a month and are unannounced. Copy of the report should be supplied to the home and to the Commission no later than 14 days following the visit. The previous responsible person has moved to another region. The organisation appointed a new person, who has been overlooking the running of the home. It is required that an application is submitted to the Commission for the responsible individual to become registered. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 21 As described in previous parts of this report, some of the documentation required in the home required improvement. This included care plans, risk assessments, record of fire drills, records of food offered to service users and staff personnel files. The requirement for the fire drills to be carried out on a regular basis remains unmet and has therefore been repeated. It must be met without any further delay. Fridge/freezer temperatures were not being recorded on a daily basis. The registered manager must ensure that fridge/freezers must be recorded on a daily basis. All portable appliances have now been tested as required during the last inspection. The home had appropriate insurance cover in place. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 2 x 2 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 2 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 2 x 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x 3 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Homer Road (22A/B) Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x 2 2 x DS0000035305.V250382.R01.S.doc Version 5.0 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 YA24 Regulation 13(4) Requirement Timescale for action 01/12/05 2 YA24 13(4) 3 YA34 7, 9, 19 Schedule 2 4 YA17 16(2) Stains on ceilings in toilet/wet room and bathroom must be repainted. (Previous timescales of 01/03/04, 15/11/04 and 01/03/05 were not met.) Cracks in the wall around the 01/12/05 doorframe by staff sleepover room must be refilled and replastered. (Previous timescales of 01/04/04 and 15/11/04 and 01/03/05 were not met.) The responsible person must 15/11/05 ensure that all information and documents in respect of a person carrying on, managing or a working at the care home as listed in Schedule 2 of Care Homes Regulations are maintained and available for inspection. In addition, where documents are required to demonstrate entitlement to work, a record of these are held on individual’s personnel file. (Previous timescales of 15/03/04, 01/10/04 and 15/02/05 were not met.) The registered manager must 01/11/05 ensure that all opened food is correctly labelled to prevent food DS0000035305.V250382.R01.S.doc Version 5.0 Homer Road (22A/B) Page 24 5 YA42 23(4)(e) 6 YA6 15(2)(b) 7 YA19 12(1)(a) 8 YA39 26 9 YA5 17 10 YA9 13(4) 11 YA24 23(2)(d) 12 YA30 23(2)(d) 13 YA24 23(2)(b) poisoning. (Previous timescales o 15/10/04 and 01/02/05 were not met.) The registered manager must ensure that fire drills are carried out on regular basis. (Previous timescales of 15/10/04 and 15/02/05 were not met.) It is required that care plans are regularly updated/reviewed to reflect changing needs of the service users. (Previous timescale of 15/03/05 was not met.) The registered manager must ensure that service user’s weight is monitored and recorded as indicated within care plans. (Previous timescale of 15/03/05 was not met.) It is required that the person in control visits are undertaken on a monthly basis and are unannounced and that report from each visit is forwarded to the home without delay. (Previous timescale of 01/02/05 was not met.) It is required that the responsible person ensures that the individual service user contracts are signed by all relevant parties. The registered manager must ensure that risk assessments and reviewed on regular basis. They must also be signed and dated by the author. The registered manager must ensure that the wall tiles in the kitchen on the first floor are replaced. The registered manager must ensure that carpets in the service users’ bedrooms are cleaned/replaced. Kitchen drawer next to the cooker/stove in the upstairs DS0000035305.V250382.R01.S.doc 15/11/05 15/11/05 15/11/05 15/11/05 01/12/05 15/11/05 01/12/05 15/11/05 01/12/05 Page 25 Homer Road (22A/B) Version 5.0 kitchen must be replaced. 14 15 16 YA24 YA30YA27 YA39 23(2)(b) 23(2)(p) 7 The worktop in the upstairs kitchen must be made stable. The registered manager must ensure that all parts of the home are appropriately ventilated. It is required that an application is submitted to the Commission for the responsible individual to become registered. 15/11/05 15/11/05 01/11/05 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 2 3 4 Refer to Standard YA17 YA36 YA23 YA8 Good Practice Recommendations It would be a good practice for the home to provide menus in pictorial form for those with limited communication skills. It is recommended that staff working in the home receive a minimum of 6 supervisions per year. It is recommended that the formal system be implemented for reviewing accidents/incidents in the home. It is recommended that the service user meetings be reintroduced in the home. Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 Homer Road (22A/B) DS0000035305.V250382.R01.S.doc Version 5.0 Page 27 - 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!